The Biomedical Scientist Guide to Cut Up

Welcome

Welcome to this guide to the dissection of histopathology specimens and the background medical sciences.

The cut up of a histopathological specimen is a vital component of the process of making a histopathological diagnosis yet its importance is often underestimated and downplayed. Errors and oversights made during cut up are often difficult or impossible to correct because the processes of dissection and block taking are typically destructive of a specimen.

For all specimens except biopsies and small to medium-sized skin excisions, the specimen will be sampled rather than being embedded in its entirety. If the relevant features of the macroscopic specimen are not discerned, the blocks that are taken may fail to demonstrate the salient aspects of the pathology and even if the microscopic appearances of the resulting slides are recognised correctly, the diagnosis will still be wrong because the real pathology has been missed or misrepresented. The cut up must also be guided by an understanding of what examination of the specimen is intended to achieve and of the diseases that may be present in the specimen.

The macroscopic description of the specimen has a varible contribution to the final histopathological diagnosis. In diseases such as inflammatory bowel disease the macroscopic features may well be crucial in making a definite conclusion. Even if the macroscopic properties of the specimen are diagnostically largely superseded by the microscopic appearances, accurate description and identification of the macroscopic features is essential in order to be able to handle the specimen correctly and take appropriate blocks.

This guide to cut up aims to describe the cut up of various types of specimens and to supply the basic pathological background to them in order to place them in a clinical context that enables the specimens to be dissected with an undestanding of what information is required from the histopathology report and why.

In time-honoured fashion the material will be divided into sections on general histopathology and organ-specific pathology

Background

This material is derived from an intranet-based html resource that was created to assist in the preparation of Biomedical Scientists for the IBMS Expert Diploma in Specimen Dissection. As such it attempts to provide an overview of the diseases that are likely to be encountered when dissecting histopathology specimens and the underlying basic medical sciences.

The emphasis is on the presentation of diseases, their histopathological features and their epidemiology. Investigation is dealt with in only superficial terms and observations on treatment are largely restricted to those relevant to specimen dissection or of unusual interest.

It is perhaps sad that such things are necessary but please read the Disclaimer .