Tumors and other pathologic specimens received from the surgeon
should be fully described as to _size_, _form_, _weight_,
_consistence_, _color_, _relation to surrounding tissues_
(encapsulated, well-defined borders, growth by infiltration or
expansion, zone of inflammation, etc.), _character of cut-surface_
(color, moisture, translucency, smooth or elevated, homogeneous,
character of cell-scraping, evidences of structure, etc.).
Accompanying all pathologic material sent to the pathologist should
be concise and accurate notes giving the name, sex, age, nationality,
occupation and status of the patient, anything in the individual
or family history bearing upon the condition, the source of the
specimen, its exact location and relations, manner of growth and
character of operation. The pathologist should have full data upon
which to construct his diagnosis. A very common idea among surgeons
is that the specimen alone should be sufficient for the pathologist,
and that other data are not necessary for the formation of his
opinion. Many other considerations than the mere histologic picture
presented by a specimen enter into the formulation of a pathologic
diagnosis, if it is to bring to the aid of the surgeon all that a
pathologist’s knowledge and experience can give. This is particularly
true when the pathologist, as is usually the case, is asked to give a
prognosis. Both in hospital service and in private surgical practice
it is best to have printed history forms to be filled out and to be
sent to the pathologist with each specimen.
Another factor seriously interfering with the efficiency of the
pathologist’s work is the failure of the surgeon to see that the
material removed for diagnosis is properly taken care of before it
reaches the pathologist. Tissues removed for examination should
never be allowed to dry. They should not be exposed to the air, but
should either be placed at once in a fixing fluid or covered with
damp cloth. Curettings should be placed for a moment upon a pad of
gauze to remove the excess of blood, and the fragments of tissue
are then picked up and put into the fixing solution. When sent by
mail or express fresh tissues should be wrapped in damp cloth and
then in rubber cloth; or if the distance is great they should be put
into fixing fluids. A sufficient quantity of the latter should be
used, or decomposition may take place before the specimen reaches
the pathologist. All material for bacteriologic examination should
be removed under proper precautions, put into sterilized vessels,
properly sealed and sent to the pathologist under proper precautions.
PART II.
THE TREATMENT OF THE MATERIAL.
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