Description
This detailed academic note on Specimen Grossing provides essential procedural knowledge for tertiary students in Histopathology, Histotechnology, and Laboratory Medicine. Derived from the authoritative text "Bancroft's Theory & Practice of Histological Techniques" by Dr. S.K. Suvarna et al., the document meticulously outlines the critical steps involved in the gross examination and dissection of surgical pathology specimens. It defines grossing as the art of inspecting, describing, measuring, inking, and sectioning tissue for accurate diagnosis, beginning with proper specimen reception and accessioning. The guide explains the objectives of gross examination, the necessary tools and workspace setup, and emphasizes the importance of pre-dissection planning. It provides specific dissection plans for various specimen types, including small biopsies, core biopsies, skin ellipses, large bowel resections, gynecological samples, and breast resections, highlighting techniques for orientation, margin assessment, and lymph node retrieval using fat clearance. This material is vital for diploma and degree students to understand how meticulous grossing contributes directly to diagnostic accuracy, ensuring proper tissue processing and informative slide preparation for the pathologist. Download this comprehensive guide to master the foundational techniques required in a professional histopathology laboratory.
What's inside
Specimen Grossing Lecture Objectives • State steps involved in grossing. • Discuss how grossing contributes to accurate diagnosis. • Describe grossing/dissection plans for common resections. Introduction • Grossing=inspecting the specimens, describing and measuring the tissue, inking if needed, and sectioning the tissue to be processed for diagnosis. • Biopsy specimens are grossed as an initial step in the preparation of a slide. • The objective in preparing slides is to provide the pathologist with a clear and informative microscopic picture of the specimen. Grossing is an art • Proper grossing techniques are essential for accurate diagnosis. • A knowledge of what needs to be taken for microscopic study is vital for final diagnosis. Specimen Reception • Verify that the sample is: • Properly labeled • The nature of tissue to be examined • Requisition form is also duly filled • Adequate volume of fixative Specimen Reception • Give the specimen a pathology number called the accession number. e.g. case 139-2007 is the one hundred and thirty ninth sample of the year 2007. • Note this number carefully on the requisition form as well as the container. • Make the entries in biopsy register. • Once validated and identified→ grossing/dissection room Grossing/Surgical Cut-up/Specimen Dissection •Gross examination is done to: • Describe the specimen’s size, shape, weight, color, and any apparent abnormalities. • Describe margins and orientation markers •The specimen is cut into representative sections and put in small plastic cassettes to hold the tissue. • Modern dissection areas often have: • Ventilation Filtration Hood • Integrated dissection desks • Shelves for specimen container • Ready access to sink with water • Ready access to formalin • Box of instruments, Box with cassettes, labels Cut-up/grossing tools • A range of small and large bladed tools are advocated along with forceps, ruler and a fluid-resistant dissecting surface. • An appropriate measure and access to photography are needed. • Varying sizes of cassette (centrally) in a range of colors and sizes →handling of varying amounts of sample and also to indicate handling issues that follow tissue processing. Thinking Before Dissection • Prior to fixation it may be relevant to reserve some tissue from the specimens • Some samples need fixation and then decalcification in EDTA. • Some specimens are only examined by means of macroscopic assessment, possibly with photography • E.g. Gallstones, foreign bodies etc • The specimens should be analyzed with only one container open at any one time. • The request and specimen identity should be checked. Characteristics of the sample should be described e.g. size, shape, colour, apparent abnormalities • E.g. description in the form of the number of pieces and the size (SI units, usually mm) of the largest piece of tissue. An example could be ‘three pieces of brown tissue, the largest 3 mm diameter’.
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