Grossing Technology Today and Tomorrow

Izak B. Dimenstein, MD, PhD, HT (ASCP)

Disclosures

Lab Med. 2020;51(4):337-344. 

In This Article

Abstract and Introduction

Abstract

Objective: To describe the perspective of grossing technology and highlight the prospective of its development in histology laboratory.

Methods: Analysis of different components of grossing technology.

Results: Increased requirements for a specimen's turnaround time and the advancements in modern processing equipment make the triage of workflow a significant part of a grossing person's responsibilities. The implementation of digital pathology in morphology studies practice requires standardization of fixation, the thickness of gross section, and optimal embedding orientation. To meet tomorrow's challenges, grossing technology should work on embedding automation and gross digital pathology to record gross sections corresponding the microscope slide. Specialization of grossing stations might be beneficial to the quality of processing and smooth workflow productivity. The emerging grossing technologist subspecialty requires development of a special training program.

Conclusion: Grossing technology can contribute to new challenges in modern histology laboratory, assuring high-quality microscope slides for the pathologist's diagnosis and research evaluation.

Introduction

In surgical pathology, macroscopic specimen examination is called "grossing." The term grossing is taken from the Latin grossus (rough) and refers to that which is visible to the naked eye. The closest synonym to grossing is "sampling" by the essence of its action. However, grossing is a more general term, while the term narrows the scope of the procedure to choose the optimal sample for examination. The grossing person is sampling in the grossing room. The British term for grossing is "cut-in," but sometimes, it is called "histological dissection." In research and experimental bone pathology, this procedure is defined as "dissection" when the material is harvested from experimental animals by researchers.

An increase in surgical pathology tests, especially biopsies, and cost containment concerns has brought histotechnologists to the grossing table to a greater extent than before. A new subspecialty, that of the grossing histotechnologist, has emerged. Computerized specimen accession, ancillary studies, and especially pressure for more rapid turnaround time (TAT) have changed the nature of work in the grossing room.

Current changes in the surgical pathology histology laboratory require a different approach to grossing technology which is not limited to grossing techniques. Grossing technology encompasses surgical pathology laboratory procedures from the specimen receipt until the specimens are loaded into the microwave-assisted tissue processing instruments with sampling as the main step between. Grossing technology includes the specimen triage by preservation, priority of processing, details of sampling, workflow management, and the subsequent embedding follow-up.

This article highlights the current challenges in grossing technology and possible future developments. The material is presented from the perspective of the author's experience as a grossing technologist in a surgical pathology laboratory at an academic institution. It also reflects the experience of work as a pathologist and as a pathologist's assistant in community hospitals. The author maintained the website "Grossing Technology in Surgical Pathology" (http://grossing-technology.com/) since 2002, which is now named the "Gross Pathology" website.

The article is not a review or scientific study but rather a conceptual presentation of grossing technology in a modern histology laboratory with emphasis on surgical pathology. The references are part of the author's publications on grossing technology.

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