Principles of gross pathology

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This article discusses principles of grossing. It serves as an introduction to the topic and covers what is the minimum for a specimen.

Parameters

All specimens

  • How it was received, e.g. 10% formalin, fresh.
  • Label, e.g. "ECC".
  • Dimension - at the very least one.
  • Number of pieces - counted if less or equal to six, estimated if more.
  • Appearance, e.g. fibrofatty tissue, tan tissue.

Other parameters

  • Mass (weight).
  • Inking.
  • Tumour:
    • Size.
    • Distance to margins.
    • Border, e.g. infiltrative, well-circumscribed.
    • Colour.
    • Firmness.
    • Necrosis.
    • Hemorrhage.

Blocking principles

It makes sense to consistently submit blocks in a certain order. This avoids mix-ups that can lead to problems. The following conventions are arbitrary. The first pair can be remembered by... the first in the alphabet is first.

Blocking conventions

  • Left before right.
  • Anterior before posterior.
  • Clockwise and starting at 12 o'clock.

Measurement principles

  • It is preferable to make distance measurements to one reference point - this avoid 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.

See also