Pathology handling of pancreatoduodenectomy specimens: Approaches and controversies

Figure 1 Pancreatoduodenectomy specimen images. A: Pancreatoduodenectomy specimen after fixation (posterior view); B: The circumferential soft tissue margins were inked (PTM: Violet, PMM: Orange, PPM: Green). PTM: Pancreatic transection margin; PMM: Pancreatic medial margin; PPM: Pancreatic posterior margin.

Figure 2 Consecutive parallel sections of 0. 5 cm thickness following an axial plane perpendicular to the duodenal axis. Tumor seems to be in contact with

Figure 3 Microscopic picture. A-C: Microscopic picture of tumor glands in direct contact with an inked margin (R1 resection) (HE × 200, × 400 and × 200, respectively); D: Neoplastic cells within 1 mm of the resection margin colored in black (HE × 200); E, F: Examples of free medial or posterior margin (HE × 200); G: Ganglionar metastases (HE × 200); H: Vascular invasion (HE × 200); I: Perineural invasion (HE × 400).

Figure 4 Elaborated checklist for the pathological reporting of pancreatic ductal adenocarcinoma.