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Difference between revisions of "Principles of gross pathology"
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Principles of gross pathology (view source)
Revision as of 15:01, 11 October 2019
, 15:01, 11 October 2019→Multiple lesions
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**[[Necrosis]]. | **[[Necrosis]]. | ||
**Hemorrhage. | **Hemorrhage. | ||
**Cystic component. | |||
====Multiple lesions==== | |||
In the context of several (large) lesions it is good practice to: | |||
*Measure the distance between the lesions.‡ | |||
*Take sections showing the interface between the lesions (if possible) ''or'' non-lesional tissue between the lesions.‡ | |||
*Document with images (photographs). | |||
Note: | |||
*‡ If the tissue is studded with too many lesions to count this is impractical. Practically, four or five lesions is a reasonable limit; if more lesions are present the focus should be on (1) the largest lesions, (2) the distance to the margins for the largest lesions and the closest (smaller) lesion(s). | |||
==Report organization== | |||
*A gross report that follows the order in which things are done may reduce omissions. | |||
**The cut-up generally is: (1) identification - patient/specimen type, (2) orientation & measurement, (3) external description/assessment, (4) painting, (5) opening, (6) internal description/assessment, (7) internal measurements, (8) blocking. | |||
**Generally, gross report elements are found in the order they are done at the grossing bench, e.g. identification patient/specimen type is first, blocks are last. | |||
==Blocking principles== | ==Blocking principles== | ||
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===A set of blocking conventions=== | ===A set of blocking conventions=== | ||
==== | ====Block ordering==== | ||
*[[Surgical margins]] are submitted first. | *[[Surgical margins]] are submitted first. | ||
**The rationale for this is: one is less likely to have tumour pickup if they are cut first. | **The rationale for this is: one is less likely to have tumour pickup if they are cut first. | ||
*Representative benign parenchyma is submitted last. | *Representative benign parenchyma is submitted last. | ||
Note: | |||
*It should be clear to people not in the gross room whether it was an ''[[en face margin]]'' or an ''[[on edge margin]]''. | |||
====Laterality and orientation==== | ====Laterality and orientation==== | ||
*Left before right. | *Left before right. | ||
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==Measurement principles== | ==Measurement principles== | ||
*It is preferable to make distance measurements to one reference point - this | *It is preferable to make distance measurements to one reference point - this avoids calculations. | ||
**If the finding is a small tumour/mass (e.g. [[colonic polyp]]) it should be measured to the nearest margin if only one measure is given. | **If the finding is a small tumour/mass (e.g. [[colonic polyp]]) it should be measured to the nearest margin if only one measure is given. | ||