Several types of GYN specimens are routinely submitted to clinical histology laboratories such as cervical loop electro-cautery excision (LEEP) procedures, cervical cone, endometrial curettage, and vulvar biopsies. Although for most GYN specimens you will follow the same general guidelines as for other similarly shaped and sized tissue specimens, it is especially helpful to understand a little about the surgical procedures used to obtain these specimens and also the common methods for dissection used.
Cone biopsies
- This procedure is a conical excision of the cervical canal using a laser or cold blade.
- The wider part of the cone is the ectocervix, and the tapered tip contains the endocervical margin.
- The ectocervix by convention is described as a clock face, with the most superior midpoint of the anterior lip designated at 12 o'clock.
- Sections will usually be submitted sequentially and designated in the gross description by their clock face orientation.
- These sections should be embedded so that perpendicular sections will be shown of the cut surface.
Cervical LEEP
- These related procedures remove less tissue than a cone biopsy and are obtained by electro-cautery of the cervical transformation zone.
- The specimen may be divided either perpendicularly or by using a radial dissection method.
Endometrial curettage
- Curettage is a scraping method, in this case of the endometrial lining.
- The specimen obtained will consist of bloody fragments.
- These may be submitted in biopsy bags to contain the fragments during tissue processing.
- The surface of the bags or paper should be scraped lightly to remove as much material as possible.
- Embed to keep the fragments centralized in the block face and to arrange for the greatest surface area to be shown in one plane.
- Wipe forceps and all surfaces well after these specimens; it is easy to transfer the loose bloody fragments to other specimens.
- Embed all fragments with respect to the ink present with inked edges facing all in the same direction.
