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- 请前辈们讲讲 规范化取材. 我辈等洗耳恭听
呼吸系统
喉：分，全）喉标本一个，大小……表面有无组织粘连，沿一侧剖开，于（声门上，声门下，声门）可见…..个….（结节状，溃疡型，菜花型）的肿物，大小。。。切面。。。是局限与黏膜内，还是侵及肌层….几分之几，如有颈部淋巴清扫，分颈前，颈部，颈后淋巴依次查找，可触及…枚淋巴结，直径…切面…
肺脏：（一个肺叶，部分肺叶）标本一个，大小……胸膜外（充血，粘连，渗液）沿支气管走行或临床已打开，距支气管切缘….处可见（某病变，肿物）大小…切面…与周围组织关系….是否于胸膜粘连.仔细查找支气管周围可触摸到….枚淋巴结，直径…切面…….
泌尿系统：多囊肾（带，不带）输尿管的肾脏标本一个，大小：….表面有无肾上腺，肾筋膜，脂肪囊，被膜，与肾脏有无粘连，沿肾门对侧打开，于肾脏（上极，下极，中极）皮髓质内，是（靠近被膜，靠近肾盏），可见多个囊腔，直径…….囊内含什么物质（清亮液体，淡红液体，干酪样坏死物，结石）囊壁是否光滑肾盏，肾盂是否扩张（轻度，中度，重度）输尿管长……..直径……..沿一侧打开，粘膜有无改变
肾积水
肾恶性肿瘤：（带，不带）输尿管的肾脏标本一个，大小：…. 表面有无肾上腺，肾筋膜，脂肪囊，被膜，与肾脏有无粘连，沿肾门对侧打开，于肾脏（上极，下极，中极）皮髓质内，是（靠近被膜，靠近肾盏），可见肿物，（多灶，一处）大小…..切面……与周围组织有无粘连，浸润，有否挤压周围组织，肿瘤周围皮髓质有无明显病理改变，肾盏，肾盂是否扩张（轻度，中度，重度）或萎缩，输尿管长……..直径……..沿一侧打开，粘膜有无明显病理改变，仔细查找肾门周围组织有无淋巴结，大小…直径…切面…
肾上腺：（部分，全切）肾上腺标本一个，大小:…..被膜…..切面灰黄灰褐色,于皮质,髓质内可见病变,如为肿物,,大小…切面….有周围组织关系
膀胱L(带，不带)输尿管(或切缘)的(全,不全) 膀胱标本一个,大小….表面有无其他组织粘连,沿一侧<1>或<Y>型打开,于(粘膜上,三角区)可见(结节状,菜花状,)的肿物,切面颜色…质地….是否浸润肌层(如浸润写几分之几)两侧输尿管长…..直径….沿一侧打开,粘膜有无病理改变
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In United States, we have a book most people use for gross specimen examination and taking sections. College of American Pathologists also publish protocols. But i am not crazy about these books and publications. To really learn how to exam and taking sections from a resected specimen, you really need to have a specimen in front of you and a senior person who knows how to handle it to teach you. Then you need to read the slides and do tumor staging. In this way, you understand why you need to gross a specimen like that. It takes 4-5 well supervised residency training to master the art of grossing. Not to scare you, really it is not easy to cut a resected specimen, and it is very important to do it the right way.
