Orient the specimen: apex (distal, urethral margin), base (proximal), anterior, posterior (rectal), seminal vesicles, and vasa deferentia.
Weigh the entire specimen, and measure the prostate (three dimensions): apex to base, transverse, anterior to posterior.
Measure the seminal vesicles (three dimensions) and the vasa deferentia (length and diameter).
Determine whether the left and/or right neurovascular bundle (which appears as excess soft tissue) is present along the posterolateral aspect of the prostate near the base.
Blot dry the specimen and apply ink: left anterior = red, right anterior = blue, posterior = black. Dip in Bouin’s solution for 5 seconds or spray with alcohol and blot dry. Do not contaminate the interior of the specimen with ink.
Place the specimen in formalin for 18-24 hours or more, according to the lab’s protocol.
Shave off the apical (distal urethral) margin (doughnut) and cut in a radial fashion (similar to a shallow cervical cone).
Shave off the proximal urethral margin (bladder neck area). This margin may be processed in many different ways (radially, en face, perpendicular to margin), so check with the attending pathologist if you are unsure.
Shave off the margins of the vasa deferentia.
Using a very sharp knife or a long blade, serially section the prostate in the transverse plane, perpendicular to the posterior (rectal) surface at 3 mm intervals from the apex to the base. The slices should have complete and continuous margins.
Lay out the sections on the cutting table consecutively from apex to base and assign a number to each slice, beginning with number 2 at the apex (the apical margin is number 1). It is important to maintain orientation and include this information in the section code.
Inspect the slices for areas of yellow discoloration or obvious tumor (especially in the posterior peripheral zone), areas of nodularity (in the transition zone), calculi, and defects due to a previous transurethral resection.
Apical (distal, urethral) margin: entirely submit, in a radial fashion, in 2 cassettes (right and left) if small or in 4 cassettes (quadrants) if large.
Bladder neck (proximal) margin: entirely submit, according to the lab’s protocol (e.g. radially, en face, perpendicular to margin).
The remainder of prostate may be submitted in quadrants or as a whole-mount of the complete cross-sections, according to the lab’s protocol. Whole-mounts are entirely submitted, whereas quadrants may be submitted representatively or entirely (check with lab protocol). Wrap any unsubmitted tissue in paper towels labeled as to slice number so that additional tissue can be submitted later if necessary.
Right and left at the junction of the base of the prostate in separate cassettes.
One additional representative cross-section from each side in separate cassettes.
Vas deferens margins: right and left, en face, in separate cassettes.
Received without fixative/in formalin, labeled _____ and “_____”, is a prostate gland with attached bilateral seminal vesicles and vas deferens stumps weighing __ grams in toto. The prostate measures __ cm apex to base, __ cm left to right, and __ cm anterior to posterior. The right seminal vesicle measures __ x __ x __ cm, the left seminal vesicle measures __ x __ x __ cm, the left vas deferens measures __ cm in length x __ cm in diameter, and the right vas deferens measures __ cm in length s __ cm in diameter. The prostatic capsule is _____ (color, smooth vs. rough, focally disrupted on the left/right anterior/posterior aspect). The left/right/bilateral neurovascular bundles are present/absent. The right side is inked black, and the left side is inked blue. The prostate has a _____ (describe) parenchyma with _____ (describe, measure, and give location of any lesions). The bilateral seminal vesicles/vasa deferentia are _____ (describe) and without tumor/have firm, tan-yellow areas contiguous with the prostate suspicious for tumor. About ___ % of the specimen is submitted as follows:
#__ = right urethral margin, radially sectioned; __ pieces.
#__ = left urethral margin, radially sectioned; __ pieces.
#__ - #__ = bladder margin, radially sectioned (#__ left anterior, #__ left posterior, #__ right posterior, #__ right anterior)
#__ = right prostate-seminal vesicle junction; __ pieces.
#__ = left prostate-seminal vesicle junction; __ pieces.
#__ = right seminal vesicle and vas deferens margin, en face; __ pieces.
#__ = left seminal vesicle and vas deferens margin, en face; __ pieces.
Entire remaining prostate (unless specified, sections from each slice submitted in order: left anterior, left posterior, right posterior, right anterior):
#__ - #__ = slice 2; 1 piece in each.
#__ - #__ = slice 3; 1 piece in each.
#__ - #__ = slice 4 (#__ left anterior, #__ left posterolateral, #__ midline posterior, #__ right posterolateral, #__ right anterior)