Tissue loss

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In pathology, tissue loss is when a section at microscopy appears to represent less tissue then one could reasonably expect from the gross. It is relatively common in small biopsies.

It is estimated that approximately 27% of cases have a mismatch between the number of pieces seen at gross and microscopy.[1] A tissue gain is seen in approximately 25% of cases and a tissue loss is seen in approximately 7% of cases.[1]

This article also discusses tissue gain.

Possible cause of tissue gain

  • Tissue fragmentation.
  • Pseudofragmentation - two piece of tissue appears to be two in the plane of section.
  • Tissue floater.

Work-up

See tissue floater.

Possible causes of tissue loss

  • Tissue floated from the slide.
  • Material submitted is soluble in the processing medium, e.g. mucous.

Work-up

  • Melt the tissue block to looking for the lost tissue.

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Tissue loss

The block (A1) was melted to look for the missing core tissue; however, no tissue was
found.  The missing tissue appears to have been lost during processing or it consisted of
material that is soluble in the processing fluids and dissolved.

No tissue at microscopy

"Bladder tumor", biopsy:
- No tissue is identified at microscopy (see comment)

Comment:
Three levels were examined. A re-biopsy should be considered 
within the clinical context.
Submitted as "Left Upper Lobe, Lung", Biopsy:
- INSUFFICIENT TISSUE FOR ASSESSMENT, see comment.

Comment:
No tissue is seen at microscopy. Two levels were examined.

A re-biopsy should be considered within the clinical context.

See also

References

  1. 1.0 1.1 Owens, SR.; Wiehagen, L.; Simmons, C.; Sikorova, A.; Stewart, W.; Kelly, S.; Nestler, R.; Yousem, SA. (Dec 2011). "Numerical fidelity of endoscopic biopsy fragments in the processing sequence of a university surgical pathology laboratory.". Arch Pathol Lab Med 135 (12): 1561-4. doi:10.5858/arpa.2011-0020-OA. PMID 22129184.