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.
The process of cutting up specimens is known as grossing (North American term), cut-up or macroscopic cut-up (Australian term).
- Usually referred to simply as opening.
- May go by the term freshing.
- The first part of a gross pathologic assessment.
- Orient the specimen.
- Paint with ink - if applicable.
- A good general rule is: ink before you think.
- Cut open for fixation - if not immediately blocked.
- +/-Insert paper towels in the cuts (book marking) for fixation.
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
- Foreign bodies.
- Femoral head with osteoarthritis - no fracture & no history of cancer.
- Calcific aortic stenosis.
How to gross
Principles of grossing
This article is discusses generalities in grossing.
|Abdominal pannus||often gross only|
|Aortic valve||may be gross only|
|Mitral valve||may be gross only|
|Femoral head||may be gross only|
|Knee replacement||Soft tissue pathology|
|Cystoprostatectomy||indication: urothelial carcinoma|
|Partial cystectomy||indication: urachal carcinoma|
|Partial nephrectomy||indication: renal cell carcinoma|
|Prostate chips||indication: BPH|
|Total nephrectomy for tumour|
|Nephroureterectomy||indication: urothelial carcinoma|
|Partial colectomy for diverticular disease|
|Lower anterior resection for cancer|
Gross pathology spot diagnoses
This is a long list of things that can be identified with a reasonable certainty on gross.
- 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.