Specimen Transport, Accessioning and Gross Dissection

Question 1

What is the most common transport and storage condition

Answer 1

neutral buffered formalin

Question 2

Why is formalin the worlds most popular fixative

Answer 2

1. inexpensive, readily available, stable
2. allows for a wide variety of testing to be done
3. it is tolerant

Question 3

Gluteraldehyde

Answer 3

a superior fixative for PNS specimens and electron microscopy

Question 4

Bouin solution

Answer 4

excellent for tissue to be trichrome stained or for simultaneously fixing and decalcifying small fragments of tissue

Question 5

Ethanol

Answer 5

required when uric acid demonstration is requested

Question 6

When is fresh/frozen tissue used

Answer 6

molecular diagnostic techniques

Question 7

When can cold isotonic saline be used to transport tissues

Answer 7

for kidney and muscle biopsies as long as transport takes less than an hour

Question 8

What is michels medium

Answer 8

a non-fixative solution that preserves tissue antigenicity for immunofluorescent methods

Question 9

Why can aldehyde fixatives not be used for immunoassays

Answer 9

they may create autofluorescence

Question 10

What is RPMI

Answer 10

a solution specifically designed to support the growth and maintenance of human lymphocytes

Question 11

How many identifiers are required on the paraffin block

Answer 11

one

Question 12

What happens if there is a major specimen integrity issue

Answer 12

must not be processed without first having the submitting physician take full responsibility for the deficiency using a ‘waiver of responsibility’ document

Question 13

What does the accession number tell us

Answer 13

S for surgical, A for autopsy
first number indicates the year
second number is the tallly of specimens recieved
A, B, C ect dictates what sample container it came from and the number after is what cassette number it is

Question 14

What does gross dissection allow the lab to do

Answer 14

1. efficiently process larger samples by submitting a smaller representative portion
2. document what is recieved
3. prepare samples for embedding
4. ensure accurate diagnosis by documenting about the specimen

Question 15

What are the main steps to grossing

Answer 15

Set up, Checking the req and containers, dictation, orientation, describe and dissect and submit for processing

Question 16

What are the essential tools for grossing

Answer 16

forceps, scalpel handle and blades, ruler, cleaning brush, tissue dyes, acetic acid, container of formalin, biopsy bags and filter paper

Question 17

What are the required things in every gross dictation

Answer 17

accession number, patient name, clinical history, type of specimen, number of containers, collection date and time, fixation date and time, description of sample, submission details

Question 18

When should specimen orientation be determined

Answer 18

prior to cutting

Question 19

What are the standard sections for appendix

Answer 19

proximal end and distal tip as well as any irregular areas and representative cross sections

Question 20

What are the standard sections for placenta

Answer 20

membranes, cross section of the umbilical cord, any irregularities, atleast 2 full thickness sections

Question 21

What are the standard sections for Gallbladder

Answer 21

a cross section of the cystic duct, lymph nodes, section or two of the fundus, any irregularities

Question 22

What is a common cause of poor tissue processing

Answer 22

over filled cassettes

Question 23

What type of skin samples must be transported in Michels medium

Answer 23

samples suspicious for bullous pemphigoid

Question 24

What is an excisional biopsy

Answer 24

where the entire area of interest is contained within the biopsy

Question 25

What is an incisional biopsy

Answer 25

where only a portion of the area of interest is contained within the biopsy

Question 26

What is a shave biopsy

Answer 26

a scalpel is used to remove only the uppermost layers of the skin. These samples tend to be flat with irregular edges

Question 27

When are shave biopsies most often used

Answer 27

papilloma, skin tags, macules/papules, superficial dermatitis, seborrheic or actinic keratosis and some cases of basal cell carcinoma or squamous cell carcinoma

Question 28

What are punch biopsies

Answer 28

a hollow circular tool is used to remove a circular core of skin including the epidermis and a substantial portion of dermis

Question 29

When are shave biopsies most often used

Answer 29

when dealing with lesions which affect the dermis: most inflammatory conditions, vesicular lesions, dysplastic nevi, ulcers and nodular basal cell carcinoma or squamous cell carcinoma

Question 30

What are elliptical excisions

Answer 30

a scalpel is used to excise a wide ellipse of skin with the lesion in the center including the dermis as well as potential subcutaneous tissue

Question 31

When are elliptical excisions used

Answer 31

when melanoma is suspected or any other neoplastic process

Question 32

When are skin samples cut

Answer 32

0.3cm or less: do not cut
0.4-0.7cm: bisect
0.8-1.1cm: trisect
1.2 or more: serially section in 2-3mm slices