Re: [Histonet] who grosses and embeds?

From:"Joe Nocito"

Dr. R,
you bring up an excellent point. We have one pathologist that refuses to cut 
shave bxs, vas deferens, fallopian tubes, temporal arteries and other small 
specimens. I have instructed my embedders that they have to cut these 
specimens for proper orientation. Is this considered grossing?
    As far as grossing sheets, every lab that I have worked in, plus the lab 
that I started, always had a grossing sheet. It's almost mal-practice not 
to. How could you tell if a specimen has special instructions or not such as 
a renal bx?
    Just my 3 cents worth.

Histology Manager
Pathology Reference Lab
San Antonio, TX
----- Original Message ----- 
Sent: Tuesday, June 27, 2006 1:46 PM
Subject: [Histonet] who grosses and embeds?

> The question of who is allowed to gross what surgical pathology specimens
> seems to keep coming up. Right now the regulatory agencies seem to be 
> leaning
> toward making the pathologist do it all.
> In contrast, nobody seems to be interested in the embedder - who in effect
> re-grosses small biopsy specimens. When I was a resident (around 1970) we 
> used
> to fill out a sheet - listing the number of biopsy specimens for example - 
> that
> the embedder consulted while embedding. I've worked in maybe forty 
> surgical
> pathology services since then (as a locum tenens pathologist, mostly) and 
> I
> don't think I've ever seen an embedding sheet again.
> It's quite disconcerting when the endoscopist describes three specimens, I
> receive two, and the next day there's only one piece of tissue on the 
> slide.
> It seems to me that the College of American Pathologists (CAP) should make 
> it
> a Phase II (immediate remediation required) to embed small specimens 
> without
> an embedding sheet.
> Cowpath, Tantrum, and other surgical pathology data bases should be able 
> to
> generate a compact case list that the count of specimens could be 
> handwritten
> onto - Cowpath at least requires that a compact specimen log be 
> handwritten.
> And pathology residents should be required to come in during the wee hours
> and learn how to embed!
> Bob Richmond
> Knoxville TN and Gastonia NC
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