It pays to know what you’re looking for

Dear AAPA Members,

We are continuing our “It Pays to Know” campaign next focusing on the role of certified pathologists’ assistants (PAs) as experts in differentiation of grossly normal versus diseased tissue. First of all, what does it mean to say something is grossly normal? In Surgical Pathology, “gross” means visible to the naked eye or at a macroscopic level. This contrasts with microscopic or visible only with a microscope. PAs are trained to know how grossly normal tissue from anywhere in the human body are supposed to look. During training, PAs are also exposed to common diseased specimens. Experienced PAs are able to provide differential diagnoses based on the gross appearance of specimens.

So why is grossly differentiating normal versus diseased tissue so important for patients? Well, when whole organs or large portions of tissues are submitted for pathologic evaluation, it may require a significant and unnecessary amount of time and resources to microscopically evaluate the entire organ or submitted tissues. Microscopic evaluation of the entire submitted specimen is not necessary if a majority of the specimen is grossly similar in appearance. Trained PAs are able to perform a comprehensive macroscopic evaluation on specimens and only submit necessary and pertinent representative sections that will allow for accurate microscopic diagnoses and staging of cancer cases.

For example, in the gross image below of two ovaries, both patients feel fine but only one actually is. It takes a PA to know that the smaller ovary is grossly normal, and the larger ovary is grossly malignant. With that knowledge, appropriate samples from each ovary will be submitted for microscopic examination. Alongside pathologists, PAs provide quality healthcare that saves lives.

We encourage you to keep an eye out for the new “It pays to know what you’re looking for” posts on the AAPA’s social media platforms (Facebook, Instagram, Twitter, and LinkedIn), and share them on your own pages! Continue promoting the value of certified pathologists’ assistants by using the hashtags #grossinggenius and #savinglives. By getting you, our members, involved, we can help the AAPA reach a much wider audience outside of our membership.