Gross Examination of Soft Tissue Specimen
The role of preoperative
biopsy is to distinguish a benign from a malignant tumour.
specific subtyping is less important at this stage.
The tumour may have heterogenous areas (fibrous pseudocapsule and surrounding reactive tissue), which may lead to sampling errors.
Trucut biopsy and FNA can be useful in establishing whether there is local
recurrence of the tumour.
If the tumour is malignant a definitive surgery should be performed immediately including the biopsy site and tract to prevent possible spread of tumour from the biopsy site.
The following important information should be included in the report:
1. Grade of the tumour
3. Positive margin or distance of the tumour from the nearest margin.
4. Depth of the tumour
5. Extent of necrosis
6. Relation of the tumour to other important structures
7. Cytology and growth pattern
Ink all the margins (use minimum 2 colours).
-Extent of necrosis (more than 50% necrosis indicates bad prognosis.) ;
-Mucoid slimy areas ;
-Gritty areas of calcification ;
-Cystic changes ;
-Areas of haemorrhage.
Distance of the tumour from various margins and vital structures.
(Clearly describe the fascial margins and the surgical cut margins.)
Sections are taken
Ideally one section of the tumour taken for every centimeter of the maximum diameter of the tumour.
-Viable tissue with necrosis.
-Tumour with surrounding structures.
-Any unusual area.
Fresh tissue should be kept for further studies-
3. Flow cytometry
4. Molecular studies
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