Anatomical pathology laboratory processes

This article gives an overview of anatomical pathology laboratory processes, simply lab processes.

Processes

Accessioning.
- Laboratory assistant:
  - Data entry - clinical history.
  - +/-Case assignment.
Grossing.
- Pathology assistant/pathology resident/pathologist.
  - Gross report.
  - Tissue blocks.
Processing of tissue.
Embedding of tissue.
Cutting.
- Histotechnologist.
  - Slides.
Staining.
- Routinue stains.
- Special stains.
- Immunostains.
Case assembly and distribution.
Diagnosis.
- Pathologist.
  - Tasks:
    - More tissue.
    - Levels/deepers.
    - Special stains.
    - Immunostains.
    - Write report.
      - Consult other pathologists - in house of outside.
      - Discuss with clinician.

Patient identifier, i.e. medial record number (MRN) or medical care plan (MCP) number.
- First name.
- Middle name(s).
- Last name.
- Date of birth.
- Sex.
Clinician identifiers.
- Who ordered the test.
- Where the case is sent to - ordering physician, other physicians.
Specimen descriptors:
- How many parts, i.e. how many containers.
  - One container = at least on diagnosis.
  - Anatomical site of the parts, e.g. kidney biopsy.

The above information is all contained on the requisition.

Case identifier, e.g. 12:SU123.
- 12 = year.
- SU = surgical case.
- 123 = case number.

Main article: Grossing

Description of each part:
- Specimen dimensions, +/-weight, type of tissue.
- Identification of gross pathology - and characterization/description.
- Submission of tissue - in "blocks".
  - Each block is described in the gross report.

Tissue is sent through the tissue processor - processing dependent on tissue type.
- Date, time, batch recorded.

Tissue is oriented and surrounded by wax.
- Histotechnologist doing this is recorded.

Tissue is cut from the block.
- Pieces of tissue sent to the pathologist are tracked as "levels".
- Who cut the tissue is tracked.

This is done with automated processors.
- When and by who they are run is tracked.