The journey of a tissue specimen pathology examination – where is my report?

Author: Jin Yudi Chongqing University Affiliated Cancer Hospital

Reviewer: Jia Yongxing, Executive Editor of Popular Medicine Magazine, Shanghai Science and Technology Press

Many patients are curious about the whereabouts of the specimens removed from their bodies, and sometimes they are confused about the time it takes for pathology reports to be issued, which can take up to a week or even longer. Let's understand the above questions together!

Hello everyone, I am a tissue specimen, my name is Gaga

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Since tissue specimens are essentially a mass of meat or a bunch of cells, only the rough outline of the cells can be seen under a microscope, and it is impossible to determine whether there are any lesions. Therefore, after the pathology department receives the specimens, it needs to perform a series of processes such as fixation, embedding, slicing and staining to finally form the slices in the hands of the pathologists for diagnosis.

Each of the above steps takes dozens of minutes or even one or two days to complete. In addition, there are a large number of patients and a large number of specimens. In order to make the diagnosis of each specimen as accurate as possible, the pathologist needs to look at them carefully under a microscope with the naked eye. This is also the reason why it takes a long time to issue a pathology report.

The general process of issuing a pathology report:

1. Receive, verify and fix

One day, Gaga was cut off by a knife.

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Since tissue ischemia and hypoxia can cause cell autolysis, pathologists cannot observe the morphology and structure of cells, which will affect pathological diagnosis. Therefore, tissue specimens must be placed in a 10% neutral formalin solution within 30 minutes after being cut from the human body, and fixed in a sealed specimen bag or specimen box before being sent to the pathology department.

After the quack is cut, it should be placed in a sealed specimen bag or specimen box containing 10% neutral formalin solution within 30 minutes.

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Gaga was sent to the pathology department

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After being received and verified by the pathology department, the tissue samples will continue to be stored in 10% neutral formalin solution for fixation.

After verification, Gaga will continue to be soaked in 10% neutral formalin solution

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2. Material collection and dehydration

After 24 hours, the tissue samples are fully cut and then sent to a dehydrator to remove excess water, after which they can be stored for a long time.

24 hours later, Gaga was sent to the "chopping board" where the pathologist was about to cut him up.

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3. Embedding and sectioning

After dehydration for at least 13 hours, the tissue samples were embedded in liquid paraffin; after the liquid paraffin dried, the tissue samples were cut into thin slices.

After being air-dried for at least 13 hours, Gaga was embedded in liquid paraffin.

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4. Staining

The sliced ​​tissue samples are stained with hematoxylin-eosin and then labeled to complete the pathological section.

Gaga is stained with pigments such as hematoxylin-eosin

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5. Film reading and report

The pathologist will place the slices under a microscope, carefully look for diseased cells, and ultimately issue a pathology report based on what is seen under the microscope.

6. Immunohistochemistry

If hematoxylin-eosin staining cannot reveal diseased cells, immunohistochemical staining can be performed.

Immunohistochemical staining refers to the process of combining fluorescent or colorable chemicals with antibodies, using the specific binding reaction between antigens and antibodies in immunology (similar to a key opening a lock). After binding, cells can show a specific color, and the presence of target antigens in cells or tissues is detected. If present, it is positive.

This process will last 1 to 2 days.

Finally, the pathologist issues an immunohistochemistry report based on the proportion of stained components in the immunohistochemical staining sections under the microscope.

After reading this, I believe all your questions have been answered!