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'''Gross pathology''' is the macroscopic assessment of pathology specimens.  It is an essential part of pathologic assessments.
[[Image:Renal oncocytoma.jpg|right|thumb|A kidney tumour ([[renal oncocytoma]]) at the time of grossing.]]
'''Gross pathology''', also simply '''gross''', refers to the macroscopic pathology, and the macroscopic assessment of pathology specimens.  It may include preparation of tissue for a microscopic examination.  It is an essential part of pathologic assessments.


There is usually institutional policy with regard to which specimens can be "gross only".<ref name=pmid10050786>{{Cite journal  | last1 = Zarbo | first1 = RJ. | last2 = Nakhleh | first2 = RE. | title = Surgical pathology specimens for gross examination only and exempt from submission: a College of American Pathologists Q-Probes study of current policies in 413 institutions. | journal = Arch Pathol Lab Med | volume = 123 | issue = 2 | pages = 133-9 | month = Feb | year = 1999 | doi = 10.1043/0003-9985(1999)1230133:SPSFGE2.0.CO;2 | PMID = 10050786 }}</ref>
The process of cutting up specimens is known as '''grossing''' (North American term), '''cut-up''' or '''macroscopic cut-up''' (Australian term).
 
==Specimen opening==
:Usually referred to simply as ''opening''.
:May go by the term ''freshing''.
*The first part of a gross pathologic assessment.
 
===Components===
#Orient the specimen.
#Paint with [[marking ink|ink]] - if applicable.
#*A good general rule is: ''ink before you think''.
#Cut open for fixation - if not immediately blocked.
#+/-Weigh.
#+/-Insert paper towels in the cuts (book marking) for [[fixation]].
 
==Gross only==
Gross only specimens are examined only at the grossing bench; no microscopy is done. Which specimens are considered "gross only" typically depends on institutional policy.<ref name=pmid10050786>{{Cite journal  | last1 = Zarbo | first1 = RJ. | last2 = Nakhleh | first2 = RE. | title = Surgical pathology specimens for gross examination only and exempt from submission: a College of American Pathologists Q-Probes study of current policies in 413 institutions. | journal = Arch Pathol Lab Med | volume = 123 | issue = 2 | pages = 133-9 | month = Feb | year = 1999 | doi = 10.1043/0003-9985(1999)1230133:SPSFGE2.0.CO;2 | PMID = 10050786 }}</ref>
 
===Common gross only specimens===
*Teeth.
*Foreign bodies.
*[[Femoral head]] with [[osteoarthritis]] - no [[hip fracture|fracture]] & no history of cancer.
*[[Calcific aortic stenosis]].
 
==How to gross==
===Principles of grossing===
{{Main|Principles of grossing}}
This article is discusses generalities in grossing.
 
===Dermatopathology===
{| class="wikitable sortable"
! Specimen
! Comments
|-
| [[Abdominal pannus grossing|Abdominal pannus]]
| often [[gross only]]
|}
 
===Cardiovascular===
{| class="wikitable sortable"
! Specimen
! Comments
|-
| [[Aortic valve grossing|Aortic valve]]
| may be [[gross only]]
|-
| [[Mitral valve grossing|Mitral valve]]
| may be [[gross only]]
|}
 
===Orthopedic===
{| class="wikitable sortable"
! Specimen
! Comments
|-
| [[Femoral head grossing|Femoral head]]
| may be [[gross only]]
|-
| [[Knee replacement specimen grossing|Knee replacement]]
| [[Soft tissue pathology]]
|}
 
===Genitourinary===
{| class="wikitable sortable"
! Specimen
! Comments
|-
| [[Cystoprostatectomy]]
| indication: urothelial carcinoma
|-
| [[Orchiectomy]]
|
|-
| [[Partial cystectomy]]
| indication: [[urachal carcinoma]]
|-
| [[Partial nephrectomy]]
| indication: [[renal cell carcinoma]]
|-
| [[Penectomy]]
|
|-
| [[Prostate biopsy]]
|
|-   
| [[Prostate chips]]
| indication: [[nodular hyperplasia of the prostate|BPH]]
|-
| [[Radical cystectomy]]
|
|-
| [[Radical prostatectomy]]
|
|-
| [[Total nephrectomy for tumour]]
|
|-
| [[Nephroureterectomy]]
| indication: [[urothelial carcinoma]]
|}
 
===Gastrointestinal===
{| class="wikitable sortable"
! Specimen
! Comments
|-
| [[Partial colectomy for diverticular disease]]
|
|-
| [[Lower anterior resection for cancer]]
|
|}
 
===Gynecologic===
{| class="wikitable sortable"
! Specimen
! Comments
|-
| [[Hysterectomy for fibroids]]
|
|-
| [[Cervical cone]]
|
|-
| [[Hysterectomy for endometrial hyperplasia]]
| see also ''[[hysterectomy for endometrial cancer]]''
|-
| [[Hysterectomy for endometrial cancer]]
| see also ''[[hysterectomy for endometrial hyperplasia]]''
|-
| [[Radical hysterectomy for cervical cancer]]
|
|-
| [[Vulvectomy]]
|
|}
 
==Gross pathology spot diagnoses==
{{Main|Gross pathology spot diagnoses}}
This is a long list of things that can be identified with a reasonable certainty on gross.


==See also==
==See also==
*[[Basics]].
*[[Basics]].
*[[EIT]].
*[[Tissue loss]].


==References==
==References==
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==External links==
==External links==
*[http://www.artandmedicine.com/Index.html Old (black & white) gross pathology (artandmedicine.com)].
*[http://www.artandmedicine.com/Index.html Old (black & white) gross pathology (artandmedicine.com)].
*[https://www.rcpa.edu.au/Manuals/Macroscopic-Cut-Up-Manual Cut-up manual from the RCPA (rcpa.edu.au)].
*[http://www.qmul.ac.uk/bartspathology/specimens/index.html Barts Pathology Museum (qmul.ac.uk)].
*[http://pathinfo.wikia.com/wiki/Specimen_Grossing_Manual Grossing Manual - Pathology Resident Wiki (wikia.com)].
*[https://grosspathology-sites.uchicago.edu/ Gross Pathology - U of Chicago (uchicago.edu)].


[[Category:Basics]]
[[Category:Gross pathology]]
Michael
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