Grossing Technology Today and Tomorrow

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


Lab Med. 2020;51(4):337-344. 

In This Article

Grossing Stations

The design of the grossing station was introduced in the 1980s. All grossing station variants are generally similar, with small deviations from the basic Grosslab model. Only an experienced eye can distinguish these clones, and only careful reading of specifications can catch some differences. However, the type of specimens, workflow, and safety issues have changed significantly in modern histology laboratories.

Three types of grossing station design would reflect the modern histology laboratory requirements, as follows: a more or less standard grossing station, a heavy-duty grossing station, and a specialized biopsy grossing station.[17]

A heavy-duty/bone table has already been developed.[18] It can be used for bone grossing, processing bulky specimens, as well as for specimen disposal preparation. Obviously, only facilities with a high volume of bone or large specimens can afford such a station. Moreover, a special room would be optimal for this station.

While the heavy-duty/bone table follows only the rational implementation of grossing bones and other large-specimen requirements, specialized equipment for grossing biopsy specimens should reflect modern tendencies in surgical pathology (different actions for biopsy specimen triage according to the priorities of timing, workflow consideration, and ancillary studies).

The island-type disposition appears to be optimal for a biopsy specimen grossing station.[1] Positioning the station in the middle of the grossing room opens more options for its use for multiple functions, which is the core of modern biopsy specimen grossing processing.[1] The main methodological principle is in triage specimens in subspecialties of dermatopathology, gastroenterology, and others, depending on the laboratory profile.

Figure 4 demonstrates a semicircular-shaped grossing station. The open-space design of the station, with variants to customize it to the particular laboratory where it is used, seems to be optimal for laboratories with a prevalence of biopsy specimens in their workload volume. The blue and green lines reflect variants of separate accession locations or embedding areas, depending on the laboratory design.

Figure 4.

Drawing of biopsy specimen grossing station island configuration.

There are some consequences in deviating from the traditional wall location for a biopsy specimen grossing station. The island stations take up more floor space, with fewer variants in effective ventilation, although being prefilled with a fixative container dramatically changed the formalin exposure. There are also some plumbing difficulties.

Large specialized laboratories, reference laboratories, and surgical pathology laboratories in academic institutions should be the first interested in specialized stations, especially for biopsy specimen grossing. The tendency toward consolidation of surgical pathology laboratories will remain, and they will need a different type of equipment, such as specialized grossing stations.

The trends with specialized grossing table development are difficult to predict. Perhaps the biopsy grossing station will be combined with some tissue processors in 1 unit, which makes sense for productivity considerations, especially owing to the embedding automation, which is looming on the horizon of histology processing. Practice might require different types of specialized grossing tables. The 2 variants presented here are only a step in this direction. For example, it is reasonable to have grossing tables for specialized surgical pathology laboratories, like dermatopathology or urology, although the manufacturers already try to customize grossing tables for such laboratories. Grossing tables, or sections of them, which provide maximally possible sterility of processing in the grossing room, would be beneficial for microbiology tests and advanced technologies, especially in molecular biology. Although the polymerase chain reaction (PCR)–based diagnostic molecular tests currently use paraffin-embedded and frozen tissue for manual and laser-capture microdissection techniques, microdissection will gradually be assigned to the specially trained grossing person that would require a specialized grossing table. This option is still far away from the current practice, but it underlines the rationality of specialized grossing tables premise today and in the future.