PRE-ANALYTICAL FACTORS&GROSS EXAMINATION Flashcards
- 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
Warm Ischemia Time
- Time interval between surgical intervention and proper fixation of
the removed specimen
schemia Time
- 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
Cold Ischemia Time
- All parts to be examined must be initially fixed
_____ thick tissues may be fixed for_____
Pre-Analytic Fixation
3-5mm, 6-48hrs
Submitted specimens must be put in a container labeled with
______,______and must be accompanied with a duly accomplished pathology requisition
form.
patient’s name and specimen source/site,
- 1st and most important step in HP outside the tissue processing
procedures
Specimen Accessioning
Specimen Accessioning
- Indicating codes may be used for the following
o Surgical
o Autopsy
o Cytology
Sample Format of Accession Number:
Indicating Code – Year – ID Number of Specimen
Consists of describing the specimen and placing all or parts of it
into a plastic cassette, in preparation for tissue processing
GROSS EXAMINATION
Cutting Tools:
o Scissors
o Forceps
o Blade holders
o Blades - disposed in sharps container
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
Gross Table or Gross Workstations
Sink
Tabletop
Water supply
Irrigation system
Fume extraction/ventilation system
Water disposal unit
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)
B
what specimen category?
Specimens requiring complex dissection and
sampling methods
e.g. thyroid, breast cancer, testis (seminoma), uteri
E
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
D
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
C
Identify orientation markers used by surgeons, if available
inks, nicks, sutures
Describe all notable characteristics in gross examination:
type of specimen, shape, color, texture, consistency, dimensions, weight
used to identify and orient the specimen’s
components, distinguish samples, for embedding
instructions
INKS
