|
Dear AAPA Members,
Representative sections submitted … representative sections submitted … representative sections submitted. Sound familiar?
There is a patient behind every specimen, and only a small fraction of each specimen will be examined under the microscope in order to provide a potentially life-changing diagnosis. Sections just a few microns thick may determine someone’s treatment plan and prognosis. A simple measurement difference of 0.1 cm may determine whether a patient needs chemotherapy or radiation. Because these very small details can change the course of someone’s life, it is essential that the eyes and hands responsible for these details are expertly trained.
Years of education, palpation, sectioning, gross examination … this is what transforms random tissue sections into representative selectively sampled sections necessary to make an accurate diagnosis. The art of grossing, as we all know, is not simply sectioning through tissue and submitting sections based solely on the specimen type, but also the identification and analysis of gross pathology, clinical history, radiology, and operative reports. As the experts in gross examination and dissection, pathologists’ assistants are the eyes and hands of the pathologist at the gross bench and the connection between the patient’s surgical procedure and their diagnosis. It is the responsibility of the pathologists’ assistant to transform each patient’s past and future into representative sections just a few microns thick.
Selective sectioning from the eyes and hands of a certified pathologists’ assistant can identify the uncommon even in common, simple specimens. Our latest social media posts in our “It Pays to Know” campaign highlight the impact of gross examination and selective sectioning on patient care.
To the untrained eye, a bowel obstruction may be just a bowel obstruction – document viability with representative sections, move on. To the highly trained eye of a certified pathologists’ assistant, however, it’s not that simple. Intestinal intussusception in adults represents only 1-5% of intestinal obstruction, but one glance, one palpation from a certified pathologists’ assistant, and an intussusception is identified. The question is no longer simply Are the margins viable?. To the eye of a PA, the focus is not the bowel obstruction, it’s what caused the obstruction. Is this from a child or an adult? The certified pathologists’ assistant knows that approximately 50% of adult intussusceptions are associated with malignant lesions. Is this part of the small intestine or the colon? The certified pathologists’ assistant can identify the component of the GI tract and knows that the causes of colic intussusception are often malignant disease, whereas the causes of small intestine intussusception are frequently benign. I see a malignant-looking mass. Was a mass identified on imaging? How close is this to the surgical margins? The specimen wasn’t oriented? To the certified PA, the surgical margins are apparent because almost all intussusceptions occur with the intussusceptum originally located proximal to the intussuscipiens. Peristalsis typically pulls the proximal segment distally.
A common, “simple” specimen is never just a specimen; it is part of a patient. How can you possibly pack a patient’s past and future into sections a few microns thick? Ask the experts. The eyes and hands of a certified pathologists’ assistant can be the difference between ischemic bowel due to intussusception, viable margins and ischemic bowel due to intussusception from underlying adenocarcinoma, viable margins. It pays to know the value of a certified pathologists’ assistant.
We continue our advocacy for patient care through our campaign titled “It Pays to Know”, featuring a series of social media posts designed to highlight the value of a certified pathologists’ assistant. Look for these new posts on the AAPA’s social media platforms (Facebook, Instagram, Twitter, and LinkedIn). We encourage you to advocate for the role of the certified pathologists’ assistant in #patientimpact and #savinglives by using these hashtags. By getting you, our members, involved, we can help the AAPA reach a much wider audience outside of our membership.
We look forward to celebrating the value of certified pathologists’ assistants with you on PA Day, April 14th.
It Pays to Know Posters – Print Yours Free Today!
Full color: 17″x11″ | 11″x8.5″
Less ink-intensive: 17″x11″ | 11″x8.5″
For more information on our rebrand and the evolution of the AAPA, visit: https://www.pathassist.org/page/Logo_FAQ
Our Knives Save Lives | Gross is Beautiful | We find the Uncommon in Common Specimens
|
