Grossing Updates November 2018

Bladder margins:

As ureter margins are not-infrequently missed at triage, please verify with a PA that you have properly acquired ureter margins at triage prior to immersion in formalin.

https://grosspathology-sites.uchicago.edu/page/cystectomy-or-cystoprostatectomy

Triage:

As a corollary to this – please remember that, at triage, you are the first person to see, handle, and cut patient tissue. Any uncertainty in handling a fresh specimen should be run by an attending pathologist and/or PA.

The purpose of triage is to gather all information and sections that are best acquired prior to fixation – weights, measurements, photographs, margins, etc.

Photographs:

Please photograph all tumor resection specimens. This does not just include the outer surface of a specimen. Equally *if not more* important is a photograph of a representative section of the cut surface.
For questions on photography, please see Nicole and linked pdf (tips and reminders on good practice for photography).

Gross only specimens:

Please do not forget to fill in final diagnosis and send to attending pathologist.

https://grosspathology-sites.uchicago.edu/page/gross-only

Thyroid inking and sectioning:

Inking of thyroid isthmus has been changed to reflect the importance of the CUT surface of the isthmus (isthmic margin).

Bottom line: only ink the CUT surface of the isthmus orange (do not bleed orange ink onto peripheral “capsule”). Section perpendicular to this margin for lobectomies/hemithyroidectomies. Please view the updated page and graphics.

https://grosspathology-sites.uchicago.edu/page/thyroid

ENT frozens from Main Specimen:

If you are asked to take frozens from a main resection specimen for a head and neck case, it is beneficial to patient care that you treat the specimen as if it were a permanent specimen, section as you normally would for a permanent, and then GROSS after the frozen is performed, without transferring to a different grosser the next day. The person who sectioned the specimen for frozen should just gross it same-day, as most of the work has already been done, and occasionally, orientation gets lost in translation.

Specimen Labels:

The OR/Epic stickers are difficult to remove from containers, so if a larger container is needed, the best policy is to keep the original labelled container with the case.

Place new CoPath stickers on the new container with correct case and part number.  If this happens after techs leave, find blank sticker up front and hand write label with your initials.

The key is that after grossing, remember to transfer the remnant tissue back into the original container with the white EPIC sticker AND our yellow CoPath sticker.  We need to keep the original EPIC sticker with the specimen.  The techs are finding a lot of specimen containers with only our CoPath stickers. 

If you have trouble putting the specimen back into the original container or removing the EPIC sticker, please ask a tech or PA for help, as this is a CAP requirement.