INKING THE
SPECIMEN
SPECIMEN
·
Various Water/organic fluids insoluable inks and
colored powders can be used to mark critical points on the specimen.
Various Water/organic fluids insoluable inks and
colored powders can be used to mark critical points on the specimen.
·
These dyes and powders may help orient both the
gross specimen and the histologic section. For example, colored tattoo powder
sprinkled on the outer surface of a cystic mass can be used to distinguish
between the outer and inner aspects of the cavity.
These dyes and powders may help orient both the
gross specimen and the histologic section. For example, colored tattoo powder
sprinkled on the outer surface of a cystic mass can be used to distinguish
between the outer and inner aspects of the cavity.
·
Similarly, India ink can be painted on the
surgical margins so that they can be easily recognized at the time of
histologic examination.
Similarly, India ink can be painted on the
surgical margins so that they can be easily recognized at the time of
histologic examination.
·
Indeed, many times the critical distinction of
whether a neoplasm extends to the surgical margin depends entirely on the
absence or presence of ink.
Indeed, many times the critical distinction of
whether a neoplasm extends to the surgical margin depends entirely on the
absence or presence of ink.
·
Given the important implications of an inked
surface, these inks should be carefully and judiciously applied to the gross
specimen.
Given the important implications of an inked
surface, these inks should be carefully and judiciously applied to the gross
specimen.
·
Keep in
mind that just as the effective use of inks can facilitate the
histologic interpretation, the careless and improper use of these inks can
befuddle the microscopic findings.
Keep in
mind that just as the effective use of inks can facilitate the
histologic interpretation, the careless and improper use of these inks can
befuddle the microscopic findings.
·
The implications of sloppily applied ink that runs
across a surface where it does not belong will be disastrous.
The implications of sloppily applied ink that runs
across a surface where it does not belong will be disastrous.
·
The following guidelines outline the proper
application of inks:
The following guidelines outline the proper
application of inks:
o
If possible, apply ink before sectioning the
specimen.
If possible, apply ink before sectioning the
specimen.
o
Do not use excessive ink.
Do not use excessive ink.
o
Dry the surface of the specimen with paper
towels before applying ink.
Dry the surface of the specimen with paper
towels before applying ink.
o
When applied to a dry surface, ink is more
likely to stick to the desired surface and less likely to run onto other areas
of the specimen.
When applied to a dry surface, ink is more
likely to stick to the desired surface and less likely to run onto other areas
of the specimen.
o
Allow the ink to dry before further processing
the specimen.
Allow the ink to dry before further processing
the specimen.
o
Do not cut across wet ink, as the knife is
likely to carry the ink onto the cut surface.
Do not cut across wet ink, as the knife is
likely to carry the ink onto the cut surface.
Cassette Dimensions
Inside
dimensions for a screened cassette are: 2.5 x 2.0 x 0.3cm
dimensions for a screened cassette are: 2.5 x 2.0 x 0.3cm
Inside
dimensions for a standard slotted cassette are: 3.0 x 2.5 x 0.3cm
dimensions for a standard slotted cassette are: 3.0 x 2.5 x 0.3cm
Routine
tissue sections submitted in standard slotted cassettes should be no larger
than 2.5 x 1.5 x 0.3cm to allow for proper processing.
tissue sections submitted in standard slotted cassettes should be no larger
than 2.5 x 1.5 x 0.3cm to allow for proper processing.
Screened Cassettes
• Distinct
advantages to using screened cassettes with small tissue biopsies;
advantages to using screened cassettes with small tissue biopsies;
1.Negates
the need to wrap samples, a big time saver.
the need to wrap samples, a big time saver.
2.Positive
seal created when properly closed.
seal created when properly closed.
3.Prevents
cross-contamination with other tissues during processing
cross-contamination with other tissues during processing
Cost is a
major Disadvantage
major Disadvantage
For Small
Biopsies
Biopsies
• Number of
Pieces Each Container – To the best of your ability, give an accurate count.
Check the container (to include the lid!) and req. for a reference to the
number of pieces submitted.
Pieces Each Container – To the best of your ability, give an accurate count.
Check the container (to include the lid!) and req. for a reference to the
number of pieces submitted.
Often
samples are fragmented. In this case, count the number of significant pieces,
give size(s), and add the descriptor “fragmented”. Additional Descriptors for
Number
samples are fragmented. In this case, count the number of significant pieces,
give size(s), and add the descriptor “fragmented”. Additional Descriptors for
Number
• Additional
descriptors for number of pieces; Multiple(>10) – Give aggregate dimensions
with average size each. Do not submit more than 5 per cassette. Myriad – too many to count (fragments), give
aggregate dimensions. Filter thru screened cassette.
descriptors for number of pieces; Multiple(>10) – Give aggregate dimensions
with average size each. Do not submit more than 5 per cassette. Myriad – too many to count (fragments), give
aggregate dimensions. Filter thru screened cassette.
• State the
size(s) of the tissue(s) received: Always stated in the context of mm.’s or
cm.’s Do not use inches. If you start the case using mm.’s, then use mm.’s
throughout. If you start the case with cm.’s, then use cm.’s throughout. Ex.
0.4cm or 4mm. Whole cm.-Do not use
decimal point and zero.
size(s) of the tissue(s) received: Always stated in the context of mm.’s or
cm.’s Do not use inches. If you start the case using mm.’s, then use mm.’s
throughout. If you start the case with cm.’s, then use cm.’s throughout. Ex.
0.4cm or 4mm. Whole cm.-Do not use
decimal point and zero.
•
Referencing the size(s) of the piece(s): If only one, self explanatory. If two
or more of the same size, then state as: __ mm. or cm. each. If two of
different sizes, then state as: __ and __ mm. or cm. each.
Referencing the size(s) of the piece(s): If only one, self explanatory. If two
or more of the same size, then state as: __ mm. or cm. each. If two of
different sizes, then state as: __ and __ mm. or cm. each.
If three or
more with different sizes, then state as: ranging from __ mm. or cm. to __mm.
or cm.
more with different sizes, then state as: ranging from __ mm. or cm. to __mm.
or cm.
Cores – • Whenever possible, give exact
count of tissue cores. Not necessary to give the diameter of the cores in most
cases, but always give the length of each core.
count of tissue cores. Not necessary to give the diameter of the cores in most
cases, but always give the length of each core.
• Indicate
formalin exposure times with cores.
formalin exposure times with cores.
Biopsy Tissue Configurations
Irregular
/Fragmented/ Cores/Polypoid/Sessile/Pedunculated
/Fragmented/ Cores/Polypoid/Sessile/Pedunculated
Punch
Biopsies(Derms)- • Elipses(Derms)/• Shaves (Derms)
Biopsies(Derms)- • Elipses(Derms)/• Shaves (Derms)
To Cut or Not To Cut!
• Most diagnostic
cases do not require additional cutting or inking.
cases do not require additional cutting or inking.
• Polyps
>5mm should have their bases inked and be bisected.
>5mm should have their bases inked and be bisected.
• Punch
biopsies >4mm should also be bisected.
biopsies >4mm should also be bisected.