Several types of gynecological (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 you will follow the same general guidelines for most GYN specimens as for other similarly shaped and sized tissue specimens, it is beneficial to understand a little about the surgical procedures used to obtain these specimens and the standard dissection methods.
Cone biopsies
- This procedure is a conical excision of the cervical canal using a laser or cold blade.
- The broader 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 noon.
- Sections are usually submitted sequentially and designated by their clock face orientation in the gross description.
- These sections should be embedded so that perpendicular sections will be shown on 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 perpendicularly or 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 most significant surface area to be shown in one plane.
- Wipe forceps and all surfaces well after these specimens; transferring the loose bloody fragments to other specimens is easy.
- Embed all fragments concerning the ink present with inked edges facing all in the same direction.
