"Grossing" is one of the first words a new resident, histotechnologist or lab purchaser hears, and one of the least explained. This guide describes what grossing is, who does it, what happens at the bench step by step, and where photography fits. If you want the equipment side instead, start with what a grossing station is.
What is grossing in pathology?
Grossing is the examination of a tissue specimen with the naked eye before any part of it goes under a microscope. The person grossing looks at the whole specimen, measures and weighs it, describes what they see, marks the edges with ink, photographs it, and cuts out the small pieces that will be turned into slides. The name comes from "gross anatomy": what can be seen without magnification.
It is the only point in the process where the specimen is seen whole. Once it is cut, the pieces cannot be put back. That is why grossing is done carefully, and why a written description and a photograph are made before the first cut.
What does grossing mean in pathology?
In practice, "grossing" means two things at once. It is the examination itself, and it is the written record of that examination, called the gross description. The gross description states the type of specimen, its size and weight, its color and texture, where any abnormal area sits and how big it is, and which pieces were taken for slides. The pathologist reads this description alongside the slides when the final report is written.
A good gross description lets someone who never saw the specimen understand it. A photograph does the same job faster, which is why most labs now photograph specimens as part of grossing.
What is tissue grossing in histology?
Histology is the laboratory work that turns tissue into stained glass slides. Tissue grossing is where histology begins. The pieces selected at the grossing bench are placed in small labeled plastic cassettes, and those cassettes move on to processing, embedding in wax, sectioning and staining.
From the histology side, grossing is judged by what arrives in the cassette: the right piece of tissue, cut to a thickness that will process evenly, placed in the right orientation, with a label that matches the case. A photograph taken at the bench shows exactly where each cassette's tissue came from, which answers most questions later.
Who does the grossing?
- Pathologists gross complex specimens, such as cancer resections where the margins decide the diagnosis.
- Pathologists' assistants are trained specifically to gross and handle most of the volume in larger labs.
- Residents gross under supervision as part of their training.
- Histotechnologists and grossing technicians handle small, routine specimens in many labs, within the limits set by the lab director.
The grossing process, step by step
- Accessioning. The specimen arrives in fixative with a requisition form. It is logged, given a case number, and labels are printed.
- Identification check. The name and number on the container are matched to the form before anything is opened. Mix-ups at this step are the hardest to recover from.
- Examination and measurement. The specimen is laid out on the cutting board, measured in three dimensions and weighed if needed.
- Inking. The outer surface is painted with colored inks so the slides later show which edge is which and whether the disease reaches the margin.
- Photography. The whole specimen is photographed, often with a ruler in the frame, before and after it is cut open. A camera mounted over the board, fired by a foot pedal, lets this happen without putting the knife down or touching anything with gloved hands.
- Sectioning. The specimen is cut open and examined inside. The person grossing chooses the sections that best show the disease and the margins.
- Cassetting. Each selected piece goes into a labeled cassette. The gross description records which piece is in which cassette.
- Dictation. The gross description is dictated or typed, then the cassettes go to histology.
Where photography fits
Photographs are taken at step five, and often again after sectioning. They serve four purposes: they support the written description, they show the histology team and the pathologist where each cassette came from, they document the specimen for the patient's record and for teaching, and they protect the lab if a question comes up months later.
The camera has to work with wet, gloved hands and a knife on the board. That is why imaging grossing tables mount the camera on a column above the surface, light the specimen from the sides with daylight-balanced LEDs, and use a foot pedal to capture. The pathology grossing camera guide covers what to look for in the camera itself.
Common grossing problems and how labs avoid them
- Lost orientation. Once a specimen is cut, it is easy to forget which side was which. Inking before cutting and photographing after inking solves this.
- Sections too thick. Pieces thicker than the cassette will not process evenly. Standard practice is to keep sections thin enough that the cassette lid closes without pressure.
- Label mismatches. Printing cassette labels from the case number at the bench, rather than hand-writing them, removes most errors.
- Missing photographs. If taking a photo means putting the knife down and picking up a handheld camera, it gets skipped. A fixed camera with a foot pedal makes the photograph part of the routine.
Where the Photodyne 700 Series fits
Photodyne builds the imaging bench for grossing: a work surface, a camera column, 5500 K LED side lighting, a foot pedal and the software that files each photograph by case. The tabletop Model 702 and Model 703 and the mobile-cart Model 701 are built in Los Angeles, and current prices are listed on the products page. For how the bench fits into the rest of the lab's day, read the histology grossing table workflow guide.
Frequently asked questions
What is grossing in pathology?
Grossing is the naked-eye examination of a tissue specimen before it is made into slides. The specimen is measured, described, inked, photographed and cut into the small pieces that histology will process. It is the only step where the specimen is seen whole.
What does grossing mean in pathology?
It refers both to the examination and to the written gross description that comes out of it. The description records the specimen's size, weight, appearance, any abnormal areas and which pieces were taken for slides, and the pathologist reads it alongside the slides.
What is tissue grossing in histology?
Tissue grossing is the start of the histology process: the selected pieces of tissue are placed in labeled cassettes at the grossing bench, then go on to processing, embedding, sectioning and staining. Good grossing gives histology the right piece, at the right thickness, in the right orientation, with a photograph showing where it came from.
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