Pathology Macroscopy Course

Lesson 1 • Specimen Types and Sources

Categorises biopsy, excision, and resection specimens by organ system and clinical indication. Recognises how specimen type dictates handling protocol.

Lesson 2 • Documentation and Chain of Custody

Establishes protocols for specimen labelling, accessioning, and tracking from receipt to archive. Errors at this stage compromise diagnostic validity and medicolegal standing.

Lesson 3 • Laboratory Safety and Infection Control

Covers personal protective equipment, chemical hazards, and biohazard waste management in the gross room. Compliance with safety standards protects staff and specimen integrity.

Lesson 4 • Role of Macroscopy in Diagnosis

Defines macroscopy's position in the diagnostic chain from clinical request to histology. Contextualises gross examination as the gateway to tissue sampling decisions.

Lesson 1 • Principles of Tissue Fixation

Explains chemical mechanisms of cross-linking fixatives and their effect on tissue morphology. Fixation choice affects antigen preservation for immunohistochemistry and molecular assays.

Lesson 2 • Specimen Weighing, Measuring, and Photography

Standardises metric measurement, weight recording, and gross photography before and after sectioning. Consistent documentation supports audit, teaching, and medicolegal review.

Lesson 3 • Inking and Margin Identification

Applies multicolour inking systems to identify surgical margins before sectioning. Correct inking is essential for accurate margin status reporting in oncological specimens.

Lesson 4 • Fresh Specimen Triage

Covers decision-making for fresh tissue allocation before fixation, including frozen section and biobanking. Triage sequence must be completed rapidly to preserve tissue viability.

Lesson 1 • Standardised Reporting Templates

Introduces synoptic and narrative reporting formats aligned with professional college protocols. Templates reduce omission rates and facilitate cancer registry data extraction.

Lesson 2 • Describing Lesion Characteristics

Trains precise language for colour, texture, consistency, borders, and necrosis. Accurate lesion descriptors guide the pathologist's differential diagnosis before microscopy.

Lesson 3 • Dictation and Digital Reporting Workflow

Covers voice dictation, structured data entry, and laboratory information system integration. Efficient workflow reduces transcription errors and turnaround time.

Lesson 4 • Structure of a Gross Description

Presents the logical sequence: specimen identification, external features, cut surface, and lesion characterisation. A consistent structure ensures no critical feature is omitted.

Lesson 1 • Margin Sampling Techniques

Covers radial, shave, and perpendicular margin sectioning methods and their diagnostic implications. Method selection depends on specimen geometry and clinical margin-status requirements.

Lesson 2 • Lymph Node Dissection and Sampling

Describes manual and fat-clearing methods for lymph node retrieval and sectioning protocols. Adequate node counts are required for accurate pathological staging.

Lesson 3 • Sampling Protocols for Small Specimens

Addresses entirely submitted biopsies, polyps, and small excisions requiring complete embedding. Small specimen handling prevents loss of diagnostically critical tissue.

Lesson 4 • Principles of Representative Sampling

Explains statistical and biological rationale for sampling number, location, and size. Sampling decisions directly affect sensitivity for detecting focal lesions and margin involvement.

Lesson 1 • Oesophageal and Gastric Specimens

Covers opening technique, tumour location mapping, and proximal and distal margin assessment. Serosal involvement and lymph node stations are critical staging parameters.

Lesson 2 • Appendix and Anal Canal Specimens

Covers appendectomy sectioning for perforation, tumour, and mucinous lesions, plus anal margin assessment. Pseudomyxoma peritonei risk requires careful mucinous lesion characterisation.

Lesson 3 • Small Intestine Resections

Addresses mesenteric orientation, mucosal pattern assessment, and stricture or perforation documentation. Crohn disease and ischaemia require specific gross feature recognition.

Lesson 4 • Polyp and Endoscopic Resection Handling

Standardises handling of polypectomy specimens, EMR, and ESD resections for margin and depth assessment. Submucosal invasion depth determines need for surgical resection.

Lesson 1 • Uterus and Cervix Specimens

Covers hysterectomy opening, endometrial tumour mapping, and parametrial margin assessment. Cervical and lower uterine segment involvement alters FIGO staging.

Lesson 2 • Ovary, Fallopian Tube, and Vulva

Addresses ovarian cyst handling, capsule integrity assessment, and fallopian tube fimbria sectioning. Capsule rupture and surface involvement are critical staging features for ovarian carcinoma.

Lesson 3 • Kidney and Adrenal Specimens

Covers radical nephrectomy orientation, renal sinus fat assessment, and adrenal gland evaluation. Renal vein and sinus involvement are key pT3 staging determinants.

Lesson 4 • Prostate Gland Macroscopy

Applies whole-mount or standard sectioning protocols, apex and base margin sampling, and seminal vesicle assessment. Extraprostatic extension and positive margins drive adjuvant therapy decisions.

Lesson 1 • Breast Excision and Mastectomy

Covers specimen orientation, multicolour inking, serial bread-loaf sectioning, and nipple assessment. Margin status and tumour size are the primary determinants of surgical adequacy.

Lesson 2 • Bone and Amputation Specimens

Applies decalcification planning, tumour-to-margin distance measurement, and growth plate assessment in bone resections. Amputation specimens require systematic level-by-level examination.

Lesson 3 • Sentinel and Axillary Lymph Nodes

Standardises sentinel node serial sectioning and axillary clearance node retrieval for breast cancer staging. Isolated tumour cells vs. micrometastases require precise measurement.

Lesson 4 • Soft Tissue Tumour Macroscopy

Covers orientation, pseudocapsule assessment, and heterogeneous area sampling in soft tissue sarcomas. Tumour grade correlates with necrosis extent, requiring systematic necrosis quantification.

Lesson 1 • Teaching and Competency Assessment

Designs structured training programmes, direct observation tools, and competency sign-off frameworks for trainees. Objective assessment ensures consistent macroscopic skill standards across the laboratory.

Lesson 2 • Lung, Pleura, and Mediastinum

Covers lobectomy inflation-fixation, bronchial margin assessment, and pleural invasion evaluation. Visceral pleural invasion upstages T1 tumours and requires targeted sampling.

Lesson 3 • Liver, Pancreas, and Biliary Specimens

Addresses Whipple resection orientation, bile duct margin assessment, and hepatic resection margin measurement. Multiple critical margins in pancreaticoduodenectomy require systematic colour-coded inking.

Lesson 4 • Quality Assurance in the Gross Room

Establishes audit cycles, error classification, and corrective action protocols for macroscopic practice. Systematic QA reduces diagnostic errors and supports accreditation requirements.