grossing of bone specimens

GROSSING OF BONE:

GROSSING OF BONE

GROSSING OF BONE:

GROSSING OF BONE Type of resection: Segmental/en block resection Amputation

GROSSING OF BONE:

GROSSING OF BONE Indications for amputation: Bone tumors Malignant Soft tissue tumors Gangrene

PROCEDURE:

PROCEDURE Measure the specimen Orient according to radiographic/ clinical information Assess soft tissue margins , preferably ink margins, & sample margins using perpendicular sections from those areas where there is gross or radiologic suspicion of involvement Examine for lymph nodes & submit for histologic examination

Slide 5:

5. Remove all soft tissues to expose tumor 6. Cut bone along a plane determined by radiographs to expose most of the bone tumor(in general sectioning parallel to the long axis of the bone is preferred as it is more adequately shows anatomic relationship relative to tumor) 7. Alternatively freeze entire specimen. Cut on a band saw & gently remove bone dust from cut surface with a surgical scrub brush. 8. Inspect cut surfaces, measure the tumor & describe its extent 9. Assess distance from resection margins

Slide 6:

10. Sample bone resection margins. This can be done by scooping marrow from the end margin before any manipulation of the tumor. 11. Describe status of the cortex. i.e endosteal scalloping, permeation of the cortex, penetration, breakthrough, soft tissue extension. Etc 12. Describe characteristics of the tumor. 13. For many specimens. A radiograph or a photograph of the cut surface is often helpful for orientation & educational purposes. Cut additional 5-6 mm thick slabs parallel to the initial bisected cut.

Slide 7:

14. Sample an entire cut surface of the most representative slab of tissue 15. Section orientation is often best illustrated by a map based on a diagram, photograph or specimen radiograph 16. Cut additional random sections from the opposite(peripheral) sides of slab, &/ or cut additional sections for the remaining slabs.

Description:

Description Type of amputation: side of extremity Length & circumference of extremity; including at the level of tumor Tumor characteristics: Location: bone involved; diaphysis , metaphysis or epiphysis? Medulla, cortex or periosteum? Epiphyseal line apparent? Does the tumor involve articular cartilage & joint cavity? Does it extend into soft tissue? Is periosteum involved by the tumor

Description:

Description Tumor characteristics: 2. Features of Tumor: Size Shape Color Borders Consistency Does it appears to be bone forming Cartilagenous Fibrous Myxoid Cystic changes Distance of tumor to osseous margin of resection

Description:

Description Appearance of bone away from tumor; satelite lesions? Appearance of remaining extremity if abnormal; skin, sub cut fat, muscle, major vessels & nerves, other bones, joints Appearance & approx. no of lymph node found.

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS TELANGIECTATIC OSTEOSARCOMA OSTEOGENIC SARCOMA

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS INTRAOSSEOUS OSTEOSARCOMA JUXTA CORTICAL OSTEOSARCOMA

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS PERIOSTEAL OSTEOSARCOMA MULTIPLE CHONDROMAS

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS OSTEOCHONDROMA OF FEMUR CHONDROBLASTOMA OF HUMERUS

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS CHONDROMYXOID FIBROMA OF FEMUR CHONDROSARCOMA OF FEMUR

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS PERIPHERAL CHONDROSARCOMA OF FEMUR DEDIFFERENTIATED CHONDROSARCOMA

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS CHONDROSARCOMA OF SCAPULA GIANT CELL TUMOR IN FEMUR

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS EWING’S SARCOMA CHORDOMA

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS MULTICENTRIC EPITHELIOID HEMANGIOENDOTHELIOMA INVOLVING FEMUR & TIBIA FIBROSARCOMA OF TIBIA

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS METASTATIC DEPOSITS OF RENAL CELL CARCINOMA IN MEDULLARY CAVITY OF FEMUR SOLITARY BONE CYST OF HUMERUS

GROSS PHOTOGRAPHS:

GROSS PHOTOGRAPHS LARGE ANEURYSMAL BONE CYST OF ULNA ANEURYSMAL CYST OF ULNA- CUT SECTION