Initial Specimen Evaluation

Brief overview of grossing steps:

Double Check

After a specimen is accessioned, it is "double checked" - usually by a technician or PA that has neither accessioned the case nor will be grossing it. Occasionally, a double check can be performed by the person grossing it. Residents may be asked to double check. 

Container Number

Survery the number of containers (1, 2, 3...) and corresponding letters of the containers (A, B, C...).

  • The first line of your gross description should always be: Number of Containers: [x] 
  • Dragon Command is "Container"

Container Description

For each container, the handwritten description on the label is what you dictate into CoPath. Check that this is identical to (or close to) what is typed into the requisition from Epic.

Fresh vs Formalin

Check the container to see if the specimen is fresh or submerged in formalin.

  • If the Operating Room used formalin, you should see a large white label ("10% FORMALIN in large letters). These specimens should be dictated as "Received in formalin."
  • If the Gross Room uses formalin, you should see a smaller label with a red biohazard symbol (and "10% FORMALIN" in smaller letters). These specimens should be dictated as "Received fresh and placed in formalin."
  • If you gross the specimen fresh and NO formalin is used prior to your placing tissue in cassettes, these specimens should be dictated as "Received fresh."
  • If a specimen came for frozen section (intraoperative consultation), these specimens should be dictated as "Received fresh for intraoperative diagnosis."
Formalin Stickers

Grossing

Refer to manual for common specimen types. Ask questions. Take pictures.

Block Submission

Scan each block into Vantage. Type (S16-12345 A1) if barcode does not scan.

Submit blocks in appropriate racks in ALPHANUMERIC order. Count the number of blocks in your cassette summary, and count the blocks as you place them in the racks to make sure these total numbers match.

Pathologist Verification

Before exiting a case, make sure of the following:

  • Your name is entered as Gross Pathologist.
  • The proper attending and resident are entered as Case Pathologists. If you are grossing specimens that you expect to come out the following week, change the attending and resident to those covering the following week so that the slides go directly to their boxes.
  • The proper attending and resident/PA are entered as Intraoperative Pathologists. If the signature on the frozen worksheet differs from that in CoPath, change it.  See Intraoperative Consultation for details.