Gross processing or "grossing" is the process by which

pathology Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...

specimens undergo examination with the bare eye to obtain

diagnostic Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine "cause and effect". In systems enginee ...

information, as well as cutting and tissue sampling in order to prepare material for subsequent

microscopic The microscopic scale () is the scale of objects and events smaller than those that can easily be seen by the naked eye, requiring a lens or microscope to see them clearly. In physics, the microscopic scale is sometimes regarded as the scale be ...

''examination.''

Responsibility

Gross examination of surgical specimens is typically performed by a

pathologist Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in th ...

, or by a

pathologists' assistant A pathologists’ assistant (PA) is a physician extender whose expertise lies in gross examination of surgical specimens as well as performing forensic, medicolegal, and hospital autopsies. General overview PAs work under the indirect or dire ...

working within a pathology practice. Individuals trained in these fields are often able to gather diagnostically critical information in this stage of processing, including the stage and margin status of surgically removed tumors.

Steps

The initial step in any examination of a clinical specimen is confirmation of the identity of the

patient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other heal ...

and the

anatomical Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...

site from which the specimen was obtained. Sufficient clinical data should be communicated by the clinical team to the pathology team in order to guide the appropriate diagnostic examination and interpretation of the specimen - if such information is not provided, it must be obtained by the examiner prior to processing the specimen. There are usually two end products of the gross processing of a surgical specimen. The first is the gross description, a document which serves as the written record of the examiner's findings, and is included in the final pathology report. The second product is a set of tissue blocks, typically postage stamp-sized portions of tissue sealed in plastic cassettes, which will be processed into slides for microscopic examination. Since only a minority of the tissue from a large specimen can reasonably be subject to microscopic examination, the success of the final

histological Histology, also known as microscopic anatomy or microanatomy, is the branch of biology which studies the microscopic anatomy of biological tissues. Histology is the microscopic counterpart to gross anatomy, which looks at larger structures vis ...

diagnosis is highly dependent on the skill of the professional performing the gross examination. The gross examiner may sample portions of the specimen for other types of ancillary tests as diagnostically indicated; these include

microbiological culture A microbiological culture, or microbial culture, is a method of multiplying microbial organisms by letting them reproduce in predetermined culture medium under controlled laboratory conditions. Microbial cultures are foundational and basic diagn ...

flow cytometry Flow cytometry (FC) is a technique used to detect and measure physical and chemical characteristics of a population of cells or particles. In this process, a sample containing cells or particles is suspended in a fluid and injected into the flow ...

cytogenetics Cytogenetics is essentially a branch of genetics, but is also a part of cell biology/cytology (a subdivision of human anatomy), that is concerned with how the chromosomes relate to cell behaviour, particularly to their behaviour during mitosis an ...

, or

electron microscopy An electron microscope is a microscope that uses a beam of accelerated electrons as a source of illumination. As the wavelength of an electron can be up to 100,000 times shorter than that of visible light photons, electron microscopes have a hi ...

Perpendicular versus ''en face'' sections

Two major types of sections in gross processing are perpendicular and ''en face'' sections: *Perpendicular sections allow for measurement of the distance between a lesion and the surgical margin. *''En face'' means that the section is ''tangential'' to the region of interest (such as a lesion) of a specimen. It does not in itself specify whether subsequent microtomy of the slice should be performed on the peripheral or proximal surface of the slice (the peripheral surface of an ''en face'' section is closer to being the ''true'' margin, whereas the proximal surface generally displays more area and therefore generally has greater sensitivity in showing pathology, also compared to perpendicular sections). :*A shaved section is a superficial ''en face'' slice that contains the entire surface of the segment.

Responsibility

Steps

Perpendicular versus ''en face'' sections

See also