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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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==Parameters== | ==Parameters== | ||
===All specimens=== | ===All specimens=== | ||
*How it was received, e.g. 10% formalin, fresh. | *How it was received, e.g. 10% [[formalin]], fresh. | ||
*Label, e.g. "ECC". | *Label, e.g. "ECC". | ||
*Dimension - at the very least one. | *Dimension - at the very least one. | ||
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===Other parameters=== | ===Other parameters=== | ||
*Mass (weight). | *Mass (weight). | ||
*Inking. | *[[Inking]]. | ||
*Tumour: | *Tumour: | ||
**Size. | **Size. | ||
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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== | ||
It makes sense to consistently submit blocks in a certain order. This avoids mix-ups that can lead to problems. | It makes sense to consistently submit blocks in a certain order. This avoids mix-ups that can lead to problems, and may avoid that important things are forgotten. | ||
===A set of blocking conventions=== | ===A set of blocking conventions=== | ||
====Block ordering==== | |||
*[[Surgical margins]] are submitted 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. | |||
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==== | |||
*Left before right. | *Left before right. | ||
*Anterior before posterior. | *Anterior before posterior. | ||
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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. | ||
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*[[Gross pathology]]. | *[[Gross pathology]]. | ||
*[[Specimen opening]] - also known as ''freshing''. | *[[Specimen opening]] - also known as ''freshing''. | ||
*[[Marking ink]]. | |||
[[Category:Gross pathology]] | [[Category:Gross pathology]] | ||