Menu
Warning! You won't be able to use the quotation basket until you enable cookies in your Web browser.
Warning! Your Web browser is no longer supported. Please upgrade to a modern browser.

Steps to Better Grossing

From patient to pathologist, preparing tissue specimens for histological examination requires care, skill and sound procedures. This guide provides practical advice on best practice techniques and simple ways to avoid common errors.

Tips for better grossing are highlighted in this guide. We hope each step provides a valuable reminder of good histology practice and also helps with troubleshooting when unacceptable results do occur.

Get Knowledge Pathway updates delivered directly to your inbox.

If you have viewed this educational webinar, training or tutorial on Knowledge Pathway and would like to apply for continuing education credits with your certifying organization, please download the form to assist you in adding self-reported educational credits to your transcript.

Apply for self-reported educational credits

Check Fixation Status

Specimens are dealt with promptly (especially large specimens that may otherwise be inadequately fixed).

No consideration given to optimizing the fixation of problem specimens.

Specimens in the large containers should be checked as soon as possible to ensure they will be adequately fixed.
Prepare Thin Slices

Prepare Thin Slices

Care is always taken to prepare uniform, thin slices from large specimens (3–4 mm maximum thickness). This is particularly important with dense tissues.

Slices are sometimes 6 mm (or more) thick and are often uneven.

Shown here are uniform, thin (2–3mm) slices of a tumor ready for processing. They should process effectively and should section without difficulty.
Check Fixation Status

Avoid Specimen Trauma

Care is taken to avoid traumatizing delicate specimens, particularly those that are incompletely fixed (handle carefully, do not crush, always use sharp blades).

Specimens are handled roughly without any consideration as to their state of fixation. Sometimes blunt blades are used in dissection.

 

Section of H&E stained lung showing obvious local trauma due to very forceful grasping with forceps. Fresh or partly fixed tissue is most susceptible to damage, but even well-fixed tissue can be damaged by rough handling.
Avoid Cross-contamination

Avoid Cross-contamination

Each specimen is handled on a clean surface avoiding the possibility of specimen-to-specimen contamination.

Sometimes the surface of the cutting board is not properly cleaned between specimens. This is of concern when the same specimen types are cut up one after the other. You do not want to have carry over from a specimen that is malignant to one that is benign.

Section of H&E stained lung containing a piece of foreign tissue (liver) impacted into the surface at cut-up.
Avoid Specimen Trauma

Take Care with Biopsy Pads

Fresh or incompletely fixed specimens are not placed between foam biopsy pads, particularly needle-core specimens (biopsy pad artifact is avoided).

Sometimes small, fresh or incompletely fixed specimens are placed between biopsy pads, put into a cassette and then fixed. This can produce a characteristic artifact.

 

The triangular spaces visible in this section result from local pressure effects caused by the cellular structure of the foam pads when applied to fresh or very briefly fixed tissue.
Take Care with Biopsy Pads

Choose Appropriate Cassettes

Choose appropriate cassettes for the specimen type being processed. Tissue fragments shrink during processing and, if cassette perforations are too large, fragments may escape into processing reagents or, worse still, transfer over to another specimen.

A “one size fits all” approach is used when placing specimens into cassettes.

 

A. Some of the smaller tissue fragments seen here may escape through the holes in the cassette. This will become even more likely as the tissue shrinks during processing.
B. Cassettes with fine perforations are available for small tissue fragments.
Choose Appropriate Cassettes

Avoid Overloading Cassettes

Cassettes are never overloaded with tissue thus allowing ready access to processing reagents and preventing distortion of specimens. If the volume of tissue is too great a second cassette is used.

Cassettes are often crammed full of tissue thus preventing access of processing reagents. Sometimes specimens are distorted in the process.

These cassettes are over-loaded. If processing goes ahead the specimens will be distorted and it is likely that the processing will be incomplete.
Avoid Overloading Cassettes

Clearly Label Cassettes

Cassettes are always clearly labeled. Accurate identification of specimens is of paramount importance.

Sometimes it is difficult to read the labels on cassettes. A bit of guess work may be required.

These illegible cassette labels are totally unacceptable.
Clearly Label Cassettes

Download 101 Steps to Better Histology now!

Leica Biosystems Knowledge Pathway content is subject to the Leica Biosystems website terms of use, available at: Legal Notice. The content, including webinars, training presentations and related materials is intended to provide general information regarding particular subjects of interest to health care professionals and is not intended to be, and should not be construed as, medical, regulatory or legal advice. The views and opinions expressed in any third-party content reflect the personal views and opinions of the speaker(s)/author(s) and do not necessarily represent or reflect the views or opinions of Leica Biosystems, its employees or agents. Any links contained in the content which provides access to third party resources or content is provided for convenience only.

For the use of any product, the applicable product documentation, including information guides, inserts and operation manuals should be consulted. Leica Biosystems and the editors hereby disclaim any liability arising directly or indirectly from the use of the content, including from any drugs, devices, techniques or procedures described in the content.

Copyright © 2020 Leica Biosystems division of Leica Microsystems, Inc. and its Leica Biosystems affiliates. All rights reserved. LEICA and the Leica Logo are registered trademarks of Leica Microsystems IR GmbH.

Want us to feature your writing?

We are looking for more great writers to feature here. Send us a submission and we'll be in touch!

Send your Writing!

Like what you see?

Get more Knowledge Pathway content like this delivered directly to your inbox. Unsubscribe at any time.