Summer Rotations

This summer we get to go to the gross room three times over the course of the semester. During my first rotation, I had a few technical difficulties with my log on not working for our dictation system but I still grossed the most “complex” case I have done so far so I still got a lot out of this rotation. 

In case anyone is wondering how the gross room works, a patient presents in the clinic with symptoms and if the doctor thinks they symptoms are severe enough, a surgery will be scheduled if applicable.  The specimen removed during surgery gets sent to surgical pathology or the gross room.  It gets entered into the system and assigned a specimen number and it gets passed onto the Pathologists’ Assistant for gross examination.  We examine the specimen, and here at Ruby, we speak into a microphone, and there is a computer program that types what we say into a word document.  (This is the program I was having issues logging onto so I typed my dictation manually) While doing our gross examination, we look for areas of concern and cut thin sections to be submitted to histology where it gets processed and cut and placed on a microscope slide and sent to the pathologists for microscopic examination along with the report from the PA.

The case I grossed was a right thyroid lobe for follicular carcinoma which is a malignant process.  The bad thing about follicular carcinoma is that it looks grossly similar to follicular adenoma which is a benign process.  This means we need to sample these specimens heavily so the Pathologists has the information necessary to make the call whether it really is cancer or if it is benign (which would be good for the patient).  This particular specimen had a lesion that was well-circumscribed with a fibrous capsule.  This means the borders of the lesion were visible with a rim of tissue.  When this happens, we have to submit the entire capsule of the lesion….this took 36 cassettes to accomplish!  They are wanting to see if the lesion extends beyond the capsule because this would indicate a malignant process.  Just one of the many reasons our job is important!

This summer we also have rotations in tissue bank, autopsy, and we get to see a kidney biopsy procedure for electron microscopy.  I had my autopsy rotation last week.  It was definitely a learning experience. The purpose of this rotation is just so everyone gets a chance to see an autopsy so we are prepared for our class in the fall.  It is different from the gross room because we are seeing the whole body at one time and we get to see how different disease processes affect each system and not just the piece of tissue on our grossing station. 

This week I went on my tissue bank rotation.  Unfortunately, there weren’t any cases for us to observe, but we got a really good explanation of what tissue bank is and what happens.  Basically, different researchers at the hospital tell the tissue bank staff what kind of samples they are looking for to conduct their research.  The tissue bank staff looks at the surgery schedules daily to see if there are surgeries coming up that would yield that kind of sample, and if there are, they have to receive the consent of the patient to collect a sample after the gross room is done with it.  They only get a sample if the Pathologist Assistant or the Pathologist thinks there is enough extra that they would not need for patient care.  Once they collect the sample they freeze it for the different research projects.  

Classes are about the same with a lot of studying and reading but everything is going well!!