RT Journal Article
SR Electronic
T1 Macroscopic examination of pathology specimens: a critical reappraisal
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 164
OP 168
DO 10.1136/jcp-2023-209045
VO 77
IS 3
A1 Varma, Murali
A1 Collins, Laura C
A1 Chetty, Runjan
A1 Karamchandani, Dipti M
A1 Talia, Karen
A1 Dormer, John
A1 Vyas, Monika
A1 Conn, Brendan
A1 Guzmán-Arocho, Yaileen D
A1 Jones, Adam V
A1 Pring, Miranda
A1 McCluggage, W Glenn
YR 2024
UL http://jcp.bmj.com/content/77/3/164.abstract
AB Meticulous macroscopic examination of specimens and tissue sampling are crucial for accurate histopathology reporting. However, macroscopy has generally received less attention than microscopy and may be delegated to relatively inexperienced practitioners with limited guidance and supervision. This introductory paper in the minisymposium, Macroscopy Under the Microscope, focuses on issues regarding macroscopic examination and tissue sampling that have been insufficiently addressed in the published literature. It highlights the importance of specimen examination and sampling, discusses some general principles, outlines challenges and suggests potential solutions. It is critical to get macroscopy right the first time as it may not be possible to rectify errors even with expert histological assessment or to retrospectively collect missing data after the specimen retention period. Dissectors must, therefore, receive adequate guidance and supervision until they are proficient in macroscopic specimen examination. We emphasise the importance of the clinical context, optimal specimen fixation, succinct and clinically relevant macroscopic descriptions, macrophotography and judicious tissue sampling. We note that current recommendations based on the number of blocks to be submitted per maximum tumour dimension are ambiguous as the amount of tissue submitted in a cassette is not standardised and it is unclear whether ‘block’ refers to a tissue block or a paraffin block. Concerns around potential oversampling of ‘therapeutic’ specimens that could result in overdiagnosis due to detection of incidentalomas are also discussed. We hope that the issues discussed in this paper will engender debate on this clinically critical aspect of pathology practice.