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HISTOPATH > PRE-ANALYTICAL FACTORS&GROSS EXAMINATION > Flashcards

PRE-ANALYTICAL FACTORS&GROSS EXAMINATION Flashcards

1
Q
  • Occurs during operation when blood supply of tissue is cut
    off
  • During this period, the tissue is alive and active, but will undergo progressive metabolic stress due to hypoxia
  • Affected by the whole surgical procedure (complexity of procedure, ability of surgeon, modality of intervention)
  • Beyond the control of the histopathology lab
A

Warm Ischemia Time

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1
Q
  • Time interval between surgical intervention and proper fixation of
    the removed specimen
A

schemia Time

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1
Q
  • Interval between tissue removal from the patient and arrival
    in the pathology laboratory for grossing
  • If prolonged, temperature of specimen will gradually reach the external temperature, and autolysis and drying of the surface may occur
  • Extensions may contribute to poor fixation
A

Cold Ischemia Time

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1
Q
  • All parts to be examined must be initially fixed

_____ thick tissues may be fixed for_____

A

Pre-Analytic Fixation
3-5mm, 6-48hrs

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1
Q

Submitted specimens must be put in a container labeled with
______,______and must be accompanied with a duly accomplished pathology requisition
form.

A

patient’s name and specimen source/site,

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2
Q
  • 1st and most important step in HP outside the tissue processing
    procedures
A

Specimen Accessioning

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3
Q

Specimen Accessioning
- Indicating codes may be used for the following

A

o Surgical
o Autopsy
o Cytology

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4
Q

Sample Format of Accession Number:

A

Indicating Code – Year – ID Number of Specimen

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5
Q

Consists of describing the specimen and placing all or parts of it
into a plastic cassette, in preparation for tissue processing

A

GROSS EXAMINATION

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6
Q

Cutting Tools:

A

o Scissors
o Forceps
o Blade holders
o Blades - disposed in sharps container

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7
Q

what specimen category?

 Specimens only requiring transfer from container to tissue cassette. No dissection required

 May need to be placed in filter paper first before placing in cassette because of their small size

e.g. endometrium, colonic series, breast core biopsies

A

A

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8
Q

Gross Table or Gross Workstations

A

 Sink
 Tabletop
 Water supply
 Irrigation system
 Fume extraction/ventilation system
 Water disposal unit

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8
Q

what specimen category?

 Specimens requiring transfer and routine sample dissection: sampling, counting, weighing, or slicing

e.g. small lipoma, small skin biopsy, cervical LLETZ (Large Loop Excision or Transformation Zone)

A

B

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8
Q

what specimen category?

 Specimens requiring complex dissection and
sampling methods

e.g. thyroid, breast cancer, testis (seminoma), uteri

A

E

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9
Q

what specimen category?

 Dissection and sampling required needing a moderate level of assessment

e.g. Pigmented skin lesions, skin w/ markers, large
intestine (Crohn’s), large glands tumors

A

D

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10
Q

what specimen category?

 Simple dissection required with sampling needing a low level of diagnostic assessment and/or preparation

e.g. Prepuce (fore skin in male) / Folds in clitoris
(female) Gall bladder, hemorrhoids, appendix

A

C

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11
Q

Identify orientation markers used by surgeons, if available

A

inks, nicks, sutures

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12
Q

Describe all notable characteristics in gross examination:

A

type of specimen, shape, color, texture, consistency, dimensions, weight

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12
Q

used to identify and orient the specimen’s
components, distinguish samples, for embedding
instructions

A

INKS

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12
Q

represented by LL: long lateral; or SS – short
superior

A

sutures

13
Q

indicates laterality

A

Nicks

14
Q

Specimen must fit easily into the standard cassette, which
measures _______

A

3 x 2.5 x 0.4 cm

14
Q

size of specimens?

Cut at an interval of 1 cm thickness (termed
as ______) to ensure that pathologic
areas or tumoral areas are identified

A

Large specimens
breadloafing

14
Q

Weight of intact organs are rounded to the nearest____. (In
some cases, weight is more important than histopathologic characteristics. Examples are hyperplastic tissues.)

A

0.1g

14
Q

Dimensions (length, width, depth) are rounded to nearest____ cm. For multiple pieces, indicate size of the largest piece

A

1.0

14
Q

size of specimens?

Cut serially about 2 mm thick to look for small
lesions. Lesions are then sampled for
histologic exam. Filter paper may be used in
wrapping small samples

A

Small specimens

15
Q

When possible, edges of tissue should be

A

squared

16
Q

____are embedded in the cassette. They should labelled
with accession number using _____. Markers and pens will dissolve upon processing

A

Paper tags
pencil

16
Q

If printed, ____must be used.

A

dot matrix

17
Q

is fixed first before grossed

 Tied at the Circle of Willis and suspended
 Must not touch side of container to avoid deformity
 In 10% NBF for 2-3 weeks

A

Brain

17
Q

Polyps: Base (the area where cautery arteries are located) is
always inked.

o _____: Bisected and placed in one cassette
o ______: sides are trimmed away from the stalk, and stalk is placed in a separate cassette

A

Colon Cancers
Small polyps
Large polyps

18
Q

Inject fixative first then gross.

A

Eyes

18
Q
  • Vertical orientation is always maintained (using markers)
  • Punch biopsies are submitted whole
  • Tissues greater than 4mm are dissected
  • ______: serially cut along the short axis at 2 to 3 mm interval.
    The two most distal sections or tips are submitted in two separate cassettes. Remainder is submitted in one or more cassettes
A

Skin ellipses

19
Q

Wash in running water then immerse in tissue softeners

A

Hard Tissues

20
Q

Must be cut open longitudinally and fixed with cottons inside

A

Hollow Structures

21
Q
  • most important component of tumor resections because they are essential for prognosis and planning therapeutic options
  • Should be received fresh and not immersed in formalin
  • Node is bivalved, and entirely submitted
A

Lymph Nodes

22
Q

usually first lymph node to be involved
during metastasis. Entirely submitted. However, large specimens may be bisected, and submitted in one or two cassettes

A

Sentinel lymph nodes

23
Q

Note for weight, size of breast and axillary dissection, skin ellipse,
nipple scar, basal margins

A

Mastectomy

24
Q

Additional processes such as IHC, flow cytometry, cytogenetics
and molecular genetics is often done. These may require fresh,
frozen, or specially processed tissues

A

Pediatric SPX

25
Q
  • Aka “gross worksheet”
  • Guides histotechnician in assuring that all blocks are processed
  • Must be properly filled up; filled for future reference
A

Specimen Worksheet

25
Q

Identify:
► Site & size of tumor
► Location & structure invaded by tumor
► Vascular invasion
► Presence of lymph node
► Distance from resection margin

A

Specimen with Tumor

26
Q

Specimen Worksheet
Contains the following:

A
  • Accession number
  • Number of sections and blocks
  • “Comments” column (for special requests & etc.)
  • Gross description
27
Q

what color scheme?
SUPERIOR

A

Blue

28
Q

What color scheme?
INFERIOR

A

Green

29
Q

What color scheme?
POSTERIOR

A

BLACK

30
Q

What color scheme?
MEDIAL

A

Red

31
Q

What color scheme?
ANTERIOR

A

Yellow

32
Q

What color scheme?
LATERAL

A

Orange

33
Q

Commonly used color scheme

A

Black
Blue
Orange

HISTOPATH (4 decks)

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