Difference between revisions of "Skin lesions"

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I. Table of Contents 2 II. Instructions for the sampler handling the sample 2
 
I. Table of Contents 2 II. Instructions for the sampler handling the sample 2

Revision as of 09:07, 9 September 2019

Author: Mikael Häggström [note 1]



I. Table of Contents 2 II. Instructions for the sampler handling the sample 2 III. Anamnestic referral information 2 IV. Cutting principles 2 1. General cut-out instructions 2 2. Punch biopsies 3 3. Curettage 3 4. Plan or tangential excision ('shave') 3 5. Skin Excisions 3 6. Wedge sections 4 7. Extended Excisions 4 8. Polypoid lesions 5 9. Subcutaneous preparations 5 V. Section 5 WE. Summary 5

Fixation

Standard examination: Buffered 4% formaldehyde.[1]

  • Immunofluorescence: For example Michel's solution[1]
  1. REDIRECT Template:Fixation - general notes

3. Specimen vessels shall be labeled with the patient's name, social security number, anatomical location and the nature of the specimen (size of punch biopsy shall be indicated). If several samples are taken at the same time, these should be numbered. III. Anamnestic referral information 1. Relevant information on medical history. Clinical description of the change (s) (anatomical location, number, distribution, color, size, configuration). 2. Relevant previous PAD. 3. Nature of the prepathesis: punch biopsy (size should be specified), skin scratching (curretage), plane or tangential excision (shave), skin excision, wedge resection, dilated excision, subcutaneous preparation. Possible suture markings. 4. Clinical diagnosis and questioning. 2 IV. Utskärningsprinciper 1. General cut-out instructions All preparations, and any changes, are preferably measured and described with a sketch. Touch to mark resection surfaces, especially if the change is diffusely delimited. Specify how the cut is made. Use Arabic numerals to mark fractions if the sample includes more than one preparation. Use letters to mark embedded disks. Indicate whether material is saved, preferably with + on the sketch. 2. Punch biopsies 10 mm punch biopsies are treated as oval skin excision. 3. Skin scraping (curettage) Enter approximate amount. Embed everything. 4. Plan or tangential excision ('shave') 5. Skin excisions A. Non-sutured oval excisions a. Change <15 mm Well delimited - embed the whole change in the form of cross-sections as below. Indicate whether material is saved, preferably with + on the sketch. 9 - 15 mm + + <5 mm Embed in full and orient so that the incisions are perpendicular to the skin surface. If a clear change, orient the preparation so that the smallest margin to the resection surface can be assessed. <5 mm Embed on edge so that the incisions are perpendicular to the skin surface. <4 mm + + 4 - 8 mm 5 - 8 mm Divide, embed with dividing surfaces down. If a clear change, orient the preparation so that the smallest margin to the resection surface can be assessed. NOTE! Shared punch biopsies should not be trimmed. + ≥ 5 mm Slab, embedded on edge representative slabs. + + 3 Diffused delimited - embed the entire change in the form of cross-sections as below, embed the end pieces. b. Change> 15 mm, regardless of appearance - special cut. Embed relevant parts of the change in the form of cross-sections taken where the margin to the resection surface is the least. Optionally embed the end pieces. B. Suture labeled skin preparations Suture labeled skin preparations should be documented with a sketch. Mark at least one resection surface with color and indicate on the sketch. Embed the entire change and end pieces, preferably in the form of individual discs. End pieces may be needed. is excluded if a well-defined change. Exception: larger resectates that may be treated individually. 6. Wedge sections Wedge sections should be oriented and documented in sketch. Select the two resection surfaces with different colors. Divide, embed with dividing surfaces down. + + A B C B C D A A E B C A A E D <4 mm 4 - 8 mm 9 - 15 mm Disc so that the entire resection area is represented. Embed with dividing surfaces facing down. NOTE! If the preparation is very irregular at the edges and it is not possible with whole disc from the resection surface take parallel vertical or horizontal discs. ≤ 8 mm A B > 8 mm A B D C B C D E A 4 7. Extended excisions A. Previously NOT radically removed malignant tumor a. scars ≤ 20 mm Embed the entire scar in the form of transverse discs and marks with under-marking. This also applies to suture-marked preparation, which is documented with sketch. b. scars> 20 mm - special cut B. Previously RADICALLY removed malignant melanoma

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. 1.0 1.1 Katarzyna Lundmark, Krynitz, Ismini Vassilaki, Lena Mölne, Annika Ternesten Bratel. Handläggning av hudprover – provtagningsanvisningar, utskärningsprinciper och snittning (Handling of skin samples - Instructions for sampling, cutting and incision. KVAST (Swedish Society of Pathology). Retrieved on 2019-09-09.

Image sources