LESSON 1: INTRODUCTION TO TISSUE PROCESSING EXCISIONAL BIOPSY
Open removal of the tissue including some
HISTOTECHNIQUES normal tissue
Preparation, processing and staining of tissue Removal of the entire are in question
sections for microscopic study to be interpreted Ensure complete removal of the lesion (breast,
by the pathologist. skin, muscle and lymph nodes)
The processes involved in producing a Confirm that the diagnosis is correct
microscopic slides from specimen examined in PUNCH BIOPSY
the pathology laboratory Removal of 3 to 4mm cylindrical core of tissue
HISTOPATHLOGY: samples or size of pencil eraser.
Study of disease at the tissue level With the use of sharp hollow instrument
Diagnosis of study of disease of the tissue under Then tissue check under the microscope to look
the microscope for any signs of disease.
HISTOPATHOLOGIST: is responsible in the Punch biopsy may be used for certain types of
diagnosis and helping clinicians manage patient cancer: skin cancer, vulvar and cervical cancer.
care. o Sample: 2mm; large 4mm
SPECIMENS: o Lesion should be at the center.
AUTOPSY MATERIALS: POST-MORTEM (DEAD) SHAVE BIOPSY
o Examined to determine the cause of Removal of small fragments of tissue from a
death surface.
SURGICAL MATERIALS Diagnostic test were thin small part of the skin
o Otherwise referred to as surgical or is remove using sharp blade.
biopsy materials : examined to provide Then the skin is examined other microscope
a diagnosis. Can only be use of abnormal growth or
o Alive persons, to help doctors proper abnormal areas that are on the top or outer
diagnosis and treatment layer of the skin,
FINE NEEDLE ASPIRATION – type of biopsy procedure. o Epidermis
Removal of cells from the area of abnormality o And the outer most part of the dermis
Also known as FNA procedure DDX: types of non – melanoma cancer such as
Considered as the simplest and least invasive basal cell carcinoma and squamous cell
method of collecting biopsy carcinoma.
Method of collection for fluid – containing CURETTINGS:
tumors Removal of tissue or growth from body cavities.
CORE NEEDLE BIOPSY: Spoon shape instruments having a sharp or
Removal of cells and small amount of blunt edges that is entirely use to scrape tissue
surrounding tissue then tested. surface.
Can remove more tissue than fine needle Sample obtain using curette are called
biopsy. CURETTINGS
Can provide more information about the cells
Difference between fine needle and core needle STORAGE:
biopsy Specimen: 1month to 1 year
o Needle used in core biopsy is slightly Tissue blocks: 3 to 10 years
larger than FNA, than can remove a Slides: indefinite
small cylinder of tissue about 1 – 16 Record (request form and results forms):
inch in diameter, and half inch long. permanent
o Done with local anaesthesia in the clinic
INCISIONAL BIOPSY: FACTORS TO BE CONSIDERED IN CHOOSING METHOD:
Removal of cells with more surrounding tissue Structural and chemical components to be
Only removes only a part of lump or suspicious studied
tissue. Nature and amount of sample to be evaluated
Doctor uses a scalpel to removes small area of
the skin.
The need to provide answer immediate o Pull-Apart – for the preparation of
diagnosis to aid and provide proper diagnosis blood and bone marrow smears. (spx.
and treatment. Thick secretions like Gastric lavage,
METHOD OF PREPARATION AND EXAMINATION serous fluid and blood)
o Touch preparation – or impression one
DIAGNOSTIC LABORATORIES slide is allowed to touch a surface of the
sample, intercellular relationship is
FRESH TISSUE EXAMINATION maintained
No fixative required Frozen section
Examined using a Brightfield or phase-contrasts Prepared using freezing microtome or cryostat
microscope For rapid diagnosis during surgery
Stained with supravital or differential dyes For delicate specimens
The choice of tissue examination method would o Lipid, nervous tissue elements
depend on the following conditions:
o Cell structures and chemical component PRESERVED TISSUE EXAMINATION: INITIAL STAGE IN
o The urgency of the results TISSUE PROCESSING
o Amount and the nature of the tissue
ADVANTAGES: TISSUE Accessioning/identification
Observation of physiologic processes or Performed by the medical technologist
protoplasmic activities (motion, mitosis, Check label and request form
phagocytosis and pinocytosis) The specimen is given a label (numeric or alpha-
Relatively simple and easy to perform numeric) which allows easy
DISADVANTAGES: accessioning/identification
Limited use Request form should have a provisional
Liable to develop changes observed after death diagnosis and brief clinical details
(putrefaction and autolysis)
GROSS EXAMINATION AND SAMPLING:
METHODS THAT ARE DONE WITH FRESH TISSUE: Performed by the pathologist
Describing the sample macroscopically
TEASING Weight and dimensions of the sample are
Dissections or separation of tissue components determined
in NSS or ringers solution
Examined as stained or unstained TISSUE PROCESSING
Anatomical relationship is destroyed Fixation
SQUASH or CRUSHING Dehydration
Tissue (<1mm) is sandwiched between two Clearing
slides Infiltration
Stain is applied on one side of the slide and Embedding
allowed to spread via capillary actions Sectioning (+ floating, fishing-out, drying)
SMEARING: Staining
For cytological studies, especially for the Mounting
diagnosis of cancer Labelling
For section or sediments
Performed using a wire loop, applicator stick or DIFFERENT METHODS UNDER RESEARCH
another zigzag manner LABORATORIES:
o Streaking – uniform distribution in a
direct or zigzag manner MICROINCINERATION:
o Spreading – thick or mucoid specimens, Used to located the presence and position of
teasing on a slide (eg. Sputum, brochial mineral elements in tissue (calcium, potassium,
aspirates, thick mucosal secretions by magnesium)
an applicator stick in circular manner) Two duplicate sections of alcohol-fixed tissues
o Maintains intercellular relationship
Organic matter is vaporized by heating and
nature and mineral ash position is examined
micrsocopically.
AUTORADIOGRAPHY
Injection of radioactive isotopes into organs
fix Section Mount + photographic
emulsion (Ag halide) Stain
Determines the relationship and location of the
isotopes and cells to be studied
Provides qualitative and quantitative
information.
Thymidine, uridine and amino acid.
Radioactive phosphorus P32is used as
radioactive label.
