MT- Chapter 1 : Specimen Handling and Identification / Chapter 2 : Methods of Fresh Tissue Examination

Question 1

Frequently used by clinical laboratories

Answer 1

Bar codes / Log books

Question 2

Log books should include :

Answer 2

The time it was received
The date it was received
Full name of the patient
Sample submitted
Type of specimen
Accessioning code

Question 3

The specimen container label and the accompanying request form should include

Answer 3

Patient’s name,
Age or birth date,
A medical record number.

Question 4

The request form should have :

Answer 4

provisional diagnosis and brief clinical details.

Question 5

What is the purpose of Workup sheets?

Answer 5

It is used as a guide for the Pathologist and to check on what specific concern of that doctor

Question 6

It is a list that has been done during excision and incision of the sample

Answer 6

Workup sheets

Question 7

It includes Infos about what is the problem during the take out of specimen in the human body

Answer 7

Workup sheets

Question 8

Incorrect identification of any specimen results in the :

Answer 8

wrong diagnoses and incorrect treatment.

Question 9

Major components in grossing a specimen:

Answer 9

o Reliable and rapid transfer of the specimen from surgery to pathology
o Accurate identification of the specimen
o Description of additional specimens received from the same patient
o Gross description of the specimen’s normal and abnormal features
o Recording the sites from which blocks of tissue are taken
o Recording markers that help with the correct orientation
o Identifying special studies requested and/or needed.

Question 10

Specimen from Dermatology

Answer 10

1) Core Biopsies
2) Shave Biopsies of Skin
3) Excisional Biopsy
4) Re – excision Specimens
5) Non – skin Specimen (Excisional biopsies)

Question 11

Larger core biopsies

Answer 11

• (4mm)
• should be bisected eccentrically
  and embedded with cut surfaces down.

Question 12

Small core biopsies

Answer 12

• (2mm)
• should be embedded totally
  without cutting it.

Question 13

Depending upon the size of the biopsy, it may be bisected,

trisected, or cut into sections.

Answer 13

Shave Biopsies of Skin

Question 14

Most specimens of skin or other epithelial surfaces should be
cut

Answer 14

Shave Biopsies of Skin

Question 15

In Shave Biopsies of Skin, all aliquots are embedded on

Answer 15

edge

Question 16

o Care should be taken with any pigmented lesions of the skin.

Answer 16

Shave Biopsies of Skin

Question 17

Method of choice for surgical removal of melanomas but may

be sometimes removed by shaving.

Answer 17

Excisional Biopsy

Question 18

What is the purpose of examining biopsies of skin?

Answer 18

Biopsies of the skin are examined to ensure that the lesion has been completely removed and the original clinician’s diagnosis was correct.

Question 19

In excisional biopsy, it can oriented using:

Answer 19

sutures or dyes

Question 20

Original site of a lesion may need to be re-excised if:

Answer 20

o The margins are invaded by tumor

o Too close to the tumor: melanoma / basal cell carcinoma

Question 21

Operative specimens

Answer 21

tumors,
unidentifiable inflammatory masses,
tissues

Question 22

Operative specimens are removed prior to:

Answer 22

transplantation,
traumatic,
congenital malformations,
or cosmetic surgical specimens.

Question 23

why all specimens must be examined carefully?

Answer 23

because specimens may harbor unsuspected malignant tumors.

Question 24

Important determinants of neoplastic specimens:

Answer 24

o Overall size of the tumor
o Depth of invasion into or through the tissue walls
o Involvement of margins and lymph nodes

Question 25

What is the purpose of formalin?

Answer 25

To preserve the integrity of the specimen

Question 26

specimens should be transferred to a fixative within:

Answer 26

within 1 hour

Question 27

Teasing or Dissociation

Answer 27

A process whereby a selected tissue specimen is immersed in a watch glass containing isotonic salt solution, carefully dissected or separated, and examined under the microscope

Question 28

Other name for Squash Preparation

Answer 28

Crushing

Question 29

Smear Preparation

Answer 29

The process of examining sections or sediments, whereby cellular materials are spread lightly over a slide by a wire loop or applicator, or by making an apposition smear with another slide.

Question 30

Smear Preparation includes:

Answer 30

a) Streaking
b) Spreading
c) Pull – apart
d) Touch Preparation (Impression smear)

Question 31

Streaking

Answer 31

with an applicator stick or platinum loop, the material is rapidly and gently applied in a direct or zigzag line throughout the slide, attempting to obtain a relatively uniform distribution of secretion.

Question 32

Spreading

Answer 32

a selected portion of the material is transferred
to a clean slide and gently spread into a moderately thick film by teasing the mucous strands apart with an applicator stick

Question 33

Advantage of Spreading

Answer 33

This method is a little more tedious but with the advantage of maintaining cellular interrelationships of the materials to be examined.

Question 34

Spreading is recommended for:

Answer 34

Recommended for smears preparations of fresh sputum

and bronchial aspirates and for thick mucoid secretions.

Question 35

Pull – apart

Answer 35

 done by placing a drop of secretion or sediment upon one slide and facing it to another clean slide.
 The material disperses evenly over the surface of the two slides.
 Slight movement of the two slides in opposite directions may be necessary to initiate the flow of materials.
 The two slides are then pulled apart with a single uninterrupted motion, and the specimen is placed under the microscope for immediate examination or applied with vital stains.

Question 36

Touch Preparation (Impression smear)

Answer 36

a special method of smear preparation whereby the surface of a freshly cut piece of tissue is brought into contact and pressed onto the surface of a clean glass slide, allowing the cells to be transferred directly to the slide for examination.

Question 37

Advantage of Touch Preparation :

Answer 37

Cells may be examined without destroying their actual intercellular relationship.

Question 38

normally utilized when a rapid diagnosis of the tissue in question is required.

Answer 38

Frozen Section

Question 39

Frozen Section is recommended when:

Answer 39

recommended when lipids and nervous tissue

elements are to be demonstrated

Question 40

Applications of Frozen Section:

Answer 40

1. Rapid pathologic diagnosis during surgery
2. Diagnostic and research enzyme histochemistry
3. Diagnostic and research demonstration of soluble
   substances such as lipids and carbohydrates
4. Immunofluorescent and immunohistochemical staining
5. Some specialized silver stains particularly in
   neuropathology

Question 41

Pull-Apart is useful for:

Answer 41

Useful for preparing smears of thick secretions such as serous fluid, concentrated sputum, enzymatic lavage samples from GIT, and blood smear.

Question 42

Liquid Nitrogen is generally used in:

Answer 42

histochemistry and during operative procedures

Question 43

Most rapid of the commonly available freezing agents

Answer 43

Liquid Nitrogen

Question 44

Disadvantage of Liquid Nitrogen:

Answer 44

Soft tissue is liable to crack due to rapid expansion

of the ice within the tissue – producing ice crystals or freeze artifacts

Question 45

Problem of using Liquid Nitrogen:

Answer 45

The use of liquid nitrogen can cause a vapor phase to form around the tissue acting as an insulator that causes uneven cooling of tissue (particularly in muscle biopsies) and makingdiagnostic interpretation difficult.