Best Practice No 157 Guidelines for the laboratory handling of laryngectomy specimens

These guidelines are intended to facilitate the dissection and reporting of those tumours of the larynx, hypopharynx, and piriform fossa that may be treated by laryngectomy. The guidelines incorporate the core data for histopathology reports on head and neck carcinomas previously published by the Royal College of Pathologists which indicate the information required, in addition to clinical data, for the consistent management of these diseases and to give patients as accurate a prognosis as possible. The optimal reporting of specimens from the head and neck area requires a partnership between the pathologist and surgeon/ oncologist. The surgeon can help the pathologist by the appropriate handling and labelling of the specimen in the operating theatre. The discussion of cases at clinicopathological meetings, and correlation with preoperative imaging studies, are important in maintaining and developing this partnership. The larynx is a diYcult specimen to dissect owing to its complicated anatomy and to the mixture of soft and calcified tissues that are present. A careful, methodical approach is required to provide an accurate record of the extent of spread of laryngeal neoplasms. The pathologist needs to understand the normal anatomy of the larynx, the types of operation performed by surgeons for laryngeal cancer, and the nature of the information required by surgeons for patient management and audit.