Alberhasky M T
Department of Pathology, Greenview Hospital, Bowling Green, Kentucky 42101.
Am J Clin Pathol. 1989 Oct;92(4):452-7. doi: 10.1093/ajcp/92.4.452.
Histologic diagnosis of a nonpalpable breast lesion requires the following: (1) mammographically directed excision of the suspect lesion, (2) recovery of the target lesion from the tissue specimen, and (3) demonstration of the lesion in histologic section. Recovery of lesional tissue is a function of localization within the specimen, whereas histologic demonstration is a function of localization within the paraffin block. Both localizations are pitfalls enroute to accurate diagnosis of the small mammographic lesion. A technique of specimen analysis is presented that uses a specimen holder to assure precise localization of the lesion within the biopsy tissue. The excised specimen is immobilized within the holder, which incorporates a reference grid visible in the specimen radiograph and on the holder surface. The target lesion can be localized in the reference grid of the specimen radiograph and then excised from the corresponding area of the specimen, which remains in the holder until presented to the gross pathologist. Localization of the lesion within a specific paraffin block(s) will permit additional histologic levels for optimal examination while minimizing histologic work load. The advantages of this approach are discussed and contrasted with variations of standard gross technique.
（1）在乳腺X线引导下切除可疑病变；（2）从组织标本中找到目标病变；（3）在组织切片中显示病变。病变组织的获取取决于其在标本中的定位，而组织学显示则取决于其在石蜡块中的定位。这两种定位都是准确诊断乳腺X线小病变过程中的陷阱。本文介绍了一种标本分析技术，该技术使用标本固定架来确保病变在活检组织中的精确定位。切除的标本固定在固定架内，固定架上有一个参考网格，在标本X线片和固定架表面都可见。目标病变可在标本X线片的参考网格中定位，然后从标本的相应区域切除，标本留在固定架中，直到交给大体病理学家。将病变定位在特定的石蜡块中，可在尽量减少组织学工作量的同时，获得更多的组织学层面以进行最佳检查。本文讨论了这种方法的优点，并与标准大体技术的变体进行了对比。
