Gross processing: Difference between revisions
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{{Top | <noinclude>{{Top | ||
|author1=[[User:Mikael Häggström|Mikael Häggström]] | |author1=[[User:Mikael Häggström|Mikael Häggström]] | ||
|author2= | |author2= | ||
}} | }}</noinclude> | ||
Following are general notes on selection and trimming in pathology. | Following are general notes on selection and trimming in pathology. | ||
{{Comprehensiveness|otherlegend=yes}} | <noinclude>{{Comprehensiveness|otherlegend=yes}}</noinclude> | ||
==Priority== | |||
{|class=wikitable align=right | |||
|+ Priority | |||
| | |||
1. More invasive intraoperative consultations<br>(such as open surgery)<br> | |||
2. Less invasive intraoperative consultations<br>(such as skins)<br> | |||
3. Fresh lymph nodes<br> | |||
4. Fresh breast tissue (should be in<br>formalin within an hour from surgery)<br> | |||
5. Other fresh tissue<br> | |||
6. Tissue in formalin | |||
|} | |||
For '''prioritizing''' when you have more than one thing ongoing at the same time, the list at right can be used. | |||
==Fresh specimens== | ==Fresh specimens== | ||
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*Generally '''weigh''' entire organs, after having any attached tissue trimmed away if feasible. | *Generally '''weigh''' entire organs, after having any attached tissue trimmed away if feasible. | ||
*{{Moderate-begin}}Note the color of the sample, even when unremarkable, but do not linger on deciding it.{{Moderate-end}}<ref group=note>The color of gross specimens generally has very limited clinical significance.</ref> | *{{Moderate-begin}}Note the color of the sample, even when unremarkable, but do not linger on deciding it.{{Moderate-end}}<ref group=note>The color of gross specimens generally has very limited clinical significance.</ref> | ||
*Generally, use '''[[inking]]''' for resection margins where | *Generally, use '''[[inking]]''' for resection margins where '''[[tumor]]''' radicality is important. {{further|inking|linebreak=no}} | ||
*{{Moderate-begin}}On fatty or greasy surfaces, apply '''vinegar''' to emulsify and remove the fat, dry the specimen and then ink. Otherwise, vinegar can be used either before or after inking to "dry" it.{{Moderate-end}} | *{{Moderate-begin}}On fatty or greasy surfaces, apply '''vinegar''' to emulsify and remove the fat, dry the specimen and then ink. Otherwise, vinegar can be used either before or after inking to "dry" it.{{Moderate-end}} | ||
*{{Moderate-begin}}Preferably '''photograph''' or make a drawing where slices have been taken.{{Moderate-end}}<ref name=Roychowdhury>{{cite web|url=https://www.pathologyoutlines.com/topic/breastmalignantgrossing.html|title=Grossing (histologic sampling) of breast lesions|author=Monika Roychowdhury|website=Pathologyoutlines.com}} Topic Completed: 1 August 2012. Revised: 19 September 2019</ref> | *{{Moderate-begin}}Preferably '''photograph''' or make a drawing where slices have been taken.{{Moderate-end}}<ref name=Roychowdhury>{{cite web|url=https://www.pathologyoutlines.com/topic/breastmalignantgrossing.html|title=Grossing (histologic sampling) of breast lesions|author=Monika Roychowdhury|website=Pathologyoutlines.com}} Topic Completed: 1 August 2012. Revised: 19 September 2019</ref> | ||
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*{{Moderate-begin}}At least for larger samples, consider looking for '''medical imaging''' or '''biopsy reports''' in order to better guide the process.{{Moderate-end}}<ref name=chicago>{{cite web|url=https://voices.uchicago.edu/grosspathology/head-neck/thyroid/#primary-column|title=Gross Pathology Manual By The University of Chicago Department of Pathology}} Updated 2-14-19 NAC.</ref> | *{{Moderate-begin}}At least for larger samples, consider looking for '''medical imaging''' or '''biopsy reports''' in order to better guide the process.{{Moderate-end}}<ref name=chicago>{{cite web|url=https://voices.uchicago.edu/grosspathology/head-neck/thyroid/#primary-column|title=Gross Pathology Manual By The University of Chicago Department of Pathology}} Updated 2-14-19 NAC.</ref> | ||
*Fix '''bone''' in formalin prior to decalcification. Use reminders so not to forget bone that is decalcifying. | *Fix '''bone''' in formalin prior to decalcification. Use reminders so not to forget bone that is decalcifying. | ||
*'''Plan''' in which order to cut different parts so as to be able to take all relevant sections. Generally sample relevant surgical margins and smaller parts first, as these may be harder to find or even be fragmented later on. | |||
==Cutting== | ==Cutting== | ||
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==Marking cassettes== | ==Marking cassettes== | ||
Use only hard pencil (or specially purchased histology markers), as marks made with pens, Sharpie markers, or scientific freezer-safe markers can get dissolved in tissue processing.<ref>{{cite web|url=https://unclineberger.org/pathologyservices/instructions/histopathology-services/|title=Histopathology Services|website=UNC School of Medicine|accessdate=2021-11-15}}</ref> | Use only hard pencil (or specially purchased histology markers), as marks made with pens, Sharpie markers, or scientific freezer-safe markers can get dissolved in tissue processing.<ref>{{cite web|url=https://unclineberger.org/pathologyservices/instructions/histopathology-services/|title=Histopathology Services|website=UNC School of Medicine|accessdate=2021-11-15}}</ref> | ||
<noinclude> | <noinclude> | ||
==By organ or organ system== | ==By organ or organ system== | ||