89
esophagus longitudinally avoiding transection of the tumor
and pin the specimen to a board for fixation (Fig. 3 ). Generally,
it is best to open the stomach along the greater curvature.
Photograph the mucosa after opening the specimen.
Fresh tissue is submitted for tumor banking at some insti-
tutions. The decision to provide tissue to a tissue bank or other
research should be made when the pathologist is sure that the
diagnostic process is not going to be compromised.
- All measurements should be in SI units unless otherwise stated.
- In some cases, a lesion may not be obvious because of tumor
response to neoadjuvant therapy, or in some centers, the pro-
cedure is sometimes performed for severe dysplasia, which
may have only subtle macroscopic features. In the case of
neoadjuvant therapy, there will usually be some indication of
the tumor bed, such as a palpable firmness corresponding to
fibrosis of the submucosa and muscularis propria close to the
gastro-esophageal junction [ 10 ]. In the case of neoadjuvant
therapy where there is no definite residual tumor identified
macroscopically, the entire tumor bed should be submitted.
Figure 4 shows an esophagogastrectomy specimen after neo-
adjuvant chemotherapy and radiotherapy. The remaining
tumor bed is identifiable by thickening of the esophageal wall
and fibrosis.
Fig. 3 A polypoid tumor noted upon opening the esophagus longitudinally avoiding
transection of the tumor (arrow)
Cut Up of Resected Specimen of Esophageal Adenocarcinoma
