The Journey of Removed Tumors: From Surgical Removal to Pathological Analysis
The Post-Surgery Process: Key Steps in Handling Removed Tumors
When surgeons remove tumors during surgical procedures, these specimens undergo a rigorous process before being used for diagnostic purposes, further research, or disposal. This article delves into the detailed journey of removed tumors, from the moment they are encountered during surgery to their eventual finality.
Initial Steps: Fixation in Formalin
Following removal, the resected tumor is immediately placed into a specimen jar or container that is filled with formalin, a solution consisting of formaldehyde and water. This action, known as fixation, stabilizes the tissue, preserving it for further examination. In some cases, the tumor might be placed into an empty container, and formalin is added later, but the principle remains the same. Formalin ensures that the tissue does not begin to degrade, allowing for optimal examination by pathologists.
The Journey to the Pathology Laboratory
Once the tumor is safely placed in formalin, it must be transferred to the pathology laboratory for further processing. Along with the tumor, a requisition sheet accompanies the specimen, which includes necessary information for the registration process. In the pathology lab, the specimen is registered, and a pathologist or pathology technologist examines it. This initial examination is known as a gross description, where the pathologist notes the overall appearance of the specimen, including any visible abnormalities. Critical sections of the tumor are then dissected and carefully selected for further analysis.
Preparation for Microscopic Examination
The selected portions of the tumor are embedded in a paraffin wax block. This process involves fixing and dehydrating the tissue, followed by the embedding in wax. Once the tissue is embedded, ultra-thin sections, typically measured in micrometers, are cut using a machine known as a microtome. These slices are then placed onto glass microscope slides, stained to enhance visibility, and sealed (coverslip) for preservation. This meticulous procedure ensures that the tissue is prepared for a detailed microscopic examination by the pathologist.
The Final Analysis: Pathological Report and Staining
Upon view through the microscope, the pathologist determines the type of tumor, assigns a grade if applicable, and stages the tumor based on its characteristics. A formal pathology report is then compiled, detailing the findings and providing crucial information to the surgeon and other treating physicians. This report is vital for understanding the nature and severity of the tumor, which can guide subsequent treatment decisions.
Timeline of the Process
The entire process from surgery to the final report can vary in duration. In cases where no additional special studies are required, the process might take only a couple of days. However, if specialized tests are needed to classify the tumor, it could take up to one to two weeks. The complexity of the case and the availability of diagnostic resources significantly influence the timeline.
Final Disposal or Storage
Once the pathological analysis is complete, the remaining material is typically discarded. The discarded material is treated as biological waste and sent to an incinerator for safe disposal. However, some materials may be retained for possible future reference or for inclusion in biobanks. Tissues that are preserved in formalin are usually stored for the duration of the patient’s life, allowing for future reviews should the need arise. The remaining fresh material, if any, may be stored in a frozen state for quick diagnostics or further research.
When dealing with tumors obtained post-autopsy, any remaining pieces are returned to the body for burial or disposal according to the wishes of the patient's family and following appropriate protocols.
The journey of the removed tumor is a multifaceted process involving strict protocols to ensure accuracy, safety, and scientific integrity. By understanding these steps, clinicians and researchers can better appreciate the importance of careful post-surgical handling of tumor specimens.