Gross pathology

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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.


  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.[1]

Common gross only specimens

How to gross

Principles of grossing

This article is discusses generalities in grossing.


Specimen Comments
Abdominal pannus often gross only


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


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


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


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


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

Gross pathology spot diagnoses

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

See also


  1. Zarbo, RJ.; Nakhleh, RE. (Feb 1999). "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.". Arch Pathol Lab Med 123 (2): 133-9. doi:10.1043/0003-9985(1999)1230133:SPSFGE2.0.CO;2. PMID 10050786.

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