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United States Government Work, uncopyrighted, public-domain,
DRAFT COPY ONLY. This document does not necessarily represent the views
or policies of any United States Government agency.
This document is provided "as is", without warranty of any kind,
express or implied, including but not limited to the warranties
of merchantability, fitness for a particular purpose and
non-infringement. In no event shall the authors be liable
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or in connection with the document or the use or other dealings
made with the document.
PRINCIPLE OF THE TEST.
Handling and processing a brain specimen.
SPECIMEN REQUIRED.
Tissue Specimen and filled-out
Tissue Examination Form (USSF515).
REAGENTS, INSTRUMENTATION.
1. Dissection Instruments.
STEP-BY-STEP DESCRIPTION.
1. Clinical and radiologic findings are essential
in evaluating central nervous system tissue.
Always check the clinical record and the radiologic report
on CPRS before examining central nervous system tissue.
2. Central nervous system specimens are typically small,
and the need for orientation and extensive specimen dissection
is unusual.
3. Since the specimen is small, care must be taken
to preserve all of it.
4. Do not use up all of the tissue by freezing it.
Many important morphologic details may be lost due to freezing artefact.
5. If a substantial portion of tissue must be frozen for
an intraoperative consultation, then contact the surgeon and determine
whether additional tissue will be submitted for permanent sections.
6. Cytologic preparation (PRESS PREPARATIONS) are essential
in the evaluation of brain lesions.
A minute portion, 1 mm, of fresh specimen is placed on a glass slide,
and smeared on an opposing slide with substantial pressure
from the thumb and index finger.
7. The slides are separated and immersed IMMEDIATELY in 95% ethanol.
8. Slides are fixed for 60 seconds in 95% alcohol, then routinely
stained in hematoxylin and eosin.
9. FROZEN SECTIONS,
if required, should be made on rapidly frozen tissue,
since ice crystals formed on slowly frozen tissue may obscure diagnosis.
See also: Frozen section policies:
25,
26,
27,
41,
86.
10. All central nervous system specimens are submitted entirely.
REFERENCES.
1. Rosai J.
Rosai and Ackerman's Surgical Pathology. Ninth Edition.
St Louis: C.V. Mosby. 2004;:.
ISBN: 0323013422, 3080 pages.
2. Mills SE, Carter D, Greenson JK, Oberman HA,
Reuter VE, Stoler MH, eds.
Sternberg's Diagnostic Surgical Pathology. Fourth Edition.
New York: Lippincott Williams & Wilkins. 2004;:.
ISBN: 0781740517, 3089 pages.
3. Westra WH, Hruban RH, Phelps TH, Isacson C.
Surgical Pathology Dissection. An Illustrated Guide.
Second Edition. With a Forward by Askin FB.
New York: Springer. 2002.
ISBN 0-387-95559-3, 258 pages.
4. Lester SC.
Manual of Surgical Pathology.
New York: Churchill Livingstone.
A Harcourt Health Sciences Company. 2001;:.
ISBN 0-443-07918-8, 336 pages.