Weigh and measure (three dimensions) the specimen.
Examine the pleural surface for nodularity, adhesions, fibrosis, and other lesions.
Dissect hilar lymph nodes (individually or as a group) and slice off the bronchial resection margin.
Dissect the specimen in the unfixed state unless the attending pathologist requests formalin inflation (which involves filling the specimen with formalin through the bronchial tree and clamping it off) and overnight fixation prior to sectioning.
Open all bronchi and their branches longitudinally with scissors, examining for lesions. Serially section the lung.
Examine the lung parenchyma for abscesses, nodules, scarring, infarcts, emphesematous changes/bullae/honeycomb appearance, consolidation, and other lesions. Measure these (individually or give a range) and note their location.
If infection is suspected, use a sterile blade to take a piece from a suspicious area (there will be bacterial contamination). Submit the tissue to microbiology for culture. Discuss with the pathology attending whether to request special stains before reviewing the H&E sections.
If rib is included, examine the external surface for abnormalities. Make a cross-section through any suspicious areas or through the center, if unremarkable.
If mesothelioma is suspected, a part of the specimen should be saved in glutaraldehyde for EM.
Received without fixative/in formalin, labeled _____ and “_____”, is a __ g, __ x __ x __ cm left/right lung with bronchial stump measuring __ cm in length x __ cm in diameter. The pleural surface is _____ (color, texture, adhesion-covered, fibrotic, multinodular). The cut surface is focally/diffusely _____ (color, homogeneous vs. heterogeneous, mottled, consolidated, honeycombed, fibrotic). There are multiple _____ (color) abscesses/nodules/bullae/peripheral infarcts ranging from __ to __ cm throughout the lung but most extensively in the _____ region. Tissue from abscess is submitted for culture to microbiology. Representatively submitted as follows: