Gross pathology

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.

A kidney tumour (renal oncocytoma) at the time of grossing.

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

1. Orient the specimen.
2. Paint with ink - if applicable.
   • A good general rule is: ink before you think.
3. Cut open for fixation - if not immediately blocked.
4. +/-Weigh.
5. +/-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.

Common gross only specimens

• Teeth.
• Foreign bodies.
• Femoral head with osteoarthritis - no fracture & no history of cancer.
• Calcific aortic stenosis.

How to gross

Principles of grossing

Main article: Principles of grossing

This article is discusses generalities in grossing.

Dermatopathology

Specimen	Comments
Abdominal pannus	often gross only

Cardiovascular

Specimen	Comments
Aortic valve	may be gross only
Mitral valve	may be gross only

Orthopedic

Specimen	Comments
Femoral head	may be gross only
Knee replacement	Soft tissue pathology

Genitourinary

Specimen	Comments
Cystoprostatectomy	indication: urothelial carcinoma
Orchiectomy
Partial cystectomy	indication: urachal carcinoma
Partial nephrectomy	indication: renal cell carcinoma
Penectomy
Prostate biopsy
Prostate chips	indication: BPH
Radical cystectomy
Radical prostatectomy
Total nephrectomy for tumour
Nephroureterectomy	indication: urothelial carcinoma

Gastrointestinal

Specimen	Comments
Partial colectomy for diverticular disease
Lower anterior resection for cancer
Abdominoperineal resection grossing

Gynecologic

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

Thoracic

Specimen	Comments
Lung lobectomy grossing

Gross pathology spot diagnoses

Main article: Gross pathology spot diagnoses

This is a long list of things that can be identified with a reasonable certainty on gross.

See also

• Basics.
• EIT.
• Tissue loss.

External links

• Old (black & white) gross pathology (artandmedicine.com).
• Cut-up manual from the RCPA (rcpa.edu.au).
• Barts Pathology Museum (qmul.ac.uk).
• Grossing Manual - Pathology Resident Wiki (wikia.com).
• Gross Pathology - U of Chicago (uchicago.edu).