University Pathologists - Services - Specimen processing

· Registration and Accessioning

- Two histology clerks register patient's data in our computer system and assign a unique number to each case and the specimen container.
- Once the data is entered, it remains in our patients' database indefinitely, allowing expeditious demographic and diagnosis retrieval for future specimen accessioning and comparison analysis.

· Specimen grossing

- The tissue is examined macroscopically by three highly experienced pathologists' assistants, who record the specimen type, size, the presence of abnormal lesions and their relation to the resection margins.
- Skin specimens are inked for more accurate evaluation of the surgical margins.
- The large surgical specimens are sectioned and representative 2-3 mm thick tissue samples are placed in plastic cassettes that are labeled with the same identifying number. All biopsies are submitted entirely with specific orientation instructions.

· Tissue processing

- The samples are placed in an automated tissue processor that runs overnight. The cassetted tissue is subjected to different solutions of alcohol for optimal microscopic examination.
- The run cycle is completed the following morning.

· Tissue embedding and cutting

- After being removed from the tissue processor, the tissue sections are placed in metal cassettes filled with molten paraffin. At this stage, the tissue orientation in the paraffin blocks is of paramount importance to ensure accurate microscopic examination.
- After the paraffin blocks are cooled, the tissue is ready to be cut into 5 micrometers thin transparent histologic sections using specialized microtomes.
- The sections are floated on a water bath and then placed on glass slides.
- This entire process is manually performed by our licensed and highly experienced histotechnologists (possessing between 10 and 25 years of experience).

· Staining and coverslipping

- All slides are routinely stained with hematoxylin and eosin (H&E) using an automated stainer. In addition, all upper gastrointestinal biopsies are routinely stained with Giemsa and AB/PAS stain, a procedure that markedly decreases the turnaround time for this specimen type.
- After staining, the slides are automatically covered with thin glass coverslips, to prevent tissue damage and to provide the optical quality necessary for microscopic examination.

· Microscopic examination

- The histological sections are interpreted by highly skilled, board - certified pathologists, and additional ancillary studies are performed if deemed necessary.

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