Grossing In Histopathology Workflow And Best Practices

Grossing is the cornerstone of histopathology, linking specimen collection with diagnostic interpretation. It defines how tissues are handled, described, and prepared for microscopic evaluation. This foundational stage establishes consistency and traceability, ensuring every specimen tells a complete diagnostic story. A well-structured grossing workflow underpins both accuracy and safety across pathology operations.

How Good Grossing Practice Determines Outcomes

Good grossing practice forms the foundation of diagnostic precision. The accuracy of this stage determines how tissues are represented, analyzed, and interpreted throughout the pathology workflow. Each aspect of specimen evaluation, from visual assessment to molecular testing, relies on the quality of grossing. 

The following key areas demonstrate how consistent, well-documented techniques directly influence diagnostic outcomes:

• Morphology: Proper orientation and sectioning preserve tissue architecture, allowing accurate identification of cellular structures essential for diagnostic interpretation.
• Staging: Representative sampling ensures precise tumor measurement and depth assessment, supporting accurate disease classification and treatment planning.
• Margins: Clear identification and measurement of specimen boundaries confirm whether lesions are fully excised and guide future surgical or therapeutic decisions.
• Molecular Assays: Clean, uncontaminated sampling supports dependable biomarker and genetic testing, ensuring molecular data accurately reflect disease biology.

When performed with precision and consistency, grossing safeguards the integrity of every subsequent step, thereby improving diagnostic accuracy, patient outcomes, and scientific confidence.

End-To-End Workflow Overview

Each stage of the grossing process plays a critical role in ensuring diagnostic accuracy, traceability, and patient safety. From the moment a specimen arrives in the lab to its final handoff, careful handling and documentation protect specimen integrity and diagnostic confidence.

The following stages outline the complete grossing workflow. Each one carries distinct clinical importance, demonstrating how proper handling, identification, and sampling directly contribute to diagnostic accuracy and patient safety.

Specimen Receipt And Triage

Specimen receipt marks the beginning of the diagnostic process. Proper triage ensures that each sample is correctly identified, prioritized, and assigned for evaluation. Accurate labeling and verification prevent mix-ups and confirm that specimens correspond to the correct patient record. This first step is essential for safety, compliance, and downstream reliability.

Orientation And Inking

Orientation defines how the specimen will be interpreted under the microscope. You must align and position tissues according to anatomic landmarks to preserve relationships between structures. Inking delineates surgical margins and provides visual guidance for microscopic review, ensuring that excision boundaries can be accurately evaluated for completeness.

Macroscopic Description

The macroscopic description captures the visible characteristics of the specimen: its size, shape, color, texture, and any lesions or abnormalities. Clear, consistent language in this step allows pathologists to visualize the specimen even after sectioning and provides an essential record for correlation with microscopic findings.

Sampling

Sampling determines which tissue portions will undergo microscopic evaluation. Representative sections must be selected to include areas of diagnostic interest, margin proximity, and normal adjacent tissue. Careful sampling ensures that no clinically relevant detail is missed and that results accurately reflect the specimen’s pathology.

Cassette Loading

After selection, samples are placed into labeled cassettes for processing. Each cassette must contain the correct tissue fragments with sufficient orientation and spacing to allow complete fixation. Proper loading prevents tissue loss, misidentification, and processing errors, protecting both workflow efficiency and result integrity.

Documentation

Documentation verifies every stage of the grossing process. This includes specimen identifiers, block designations, measurements, and any relevant clinical or procedural notes. Comprehensive documentation ensures traceability, supports regulatory compliance, and provides the foundation for accurate reporting and quality assurance.

Handoff

The final handoff transfers the specimen and documentation to the next stage: tissue processing or histology. Confirming labels, matching records, and validating cassette counts ensure that all materials move forward without error. This final checkpoint safeguards the continuity of patient data and reinforces Mopec’s commitment to safety, reliability, and diagnostic excellence.

Preanalytic Controls That Protect Morphology And Assays

Maintaining strict preanalytic controls is essential for preserving tissue morphology and ensuring the validity of downstream molecular and immunohistochemical testing. These “rules of control” apply throughout the grossing process, protecting specimens from preventable degradation and analytical error.

By consistently applying these measures, you safeguard tissue integrity, maintain diagnostic quality, and ensure that every sample remains suitable for both histologic and molecular evaluation. The following key controls illustrate how consistent handling and documentation preserve diagnostic accuracy and scientific reliability:

• Cold Ischemia And Fixation Timing: Minimize the time from excision to fixation. Prompt immersion in fixative preserves cellular detail and prevents autolysis, which can alter morphology and antigenicity.
• Fixative Volume And Container Size: Maintain a fixative-to-tissue ratio of at least 10:1. Use containers large enough for full immersion and uniform fixation.
• Slice Thickness And Early Opening: Section large specimens early to expose inner tissue surfaces. Uniform slicing ensures even fixative penetration and prevents central tissue degradation.
• Orientation Gate Before Irreversible Cuts: Confirm orientation and margin locations before trimming or inking. This step protects anatomic relationships critical for accurate evaluation.
• Decalcification Controls: Apply decalcification only when required and under controlled conditions. Overexposure can damage tissue architecture and compromise molecular or immunostain results.
• Preserving Tissue For Ancillary Studies: Reserve representative portions for molecular, cytogenetic, or microbiologic analysis before fixation or decalcification to preserve test viability.
• Documentation And LIS Fields: Record fixation start times, reagents, and any deviations in the laboratory information system to ensure traceability and support quality audits.
• Cassette Load Checks: Verify cassette counts, tissue identity, and labels before processing to prevent specimen mix-ups and protect diagnostic integrity.

Adhering to these controls reinforces consistency, safety, and diagnostic confidence—hallmarks of Mopec’s precision pathology approach.

Grossing Techniques That Strengthen Diagnostic Yield

At the bench, precision cutting and careful handling determine how much diagnostic information a specimen can reveal. Applying standardized methods ensures that sections represent all relevant structures and relationships, minimizing errors and maximizing interpretive value.

The following grossing techniques are designed to enhance specimen quality, maintain consistency across operators, and strengthen the pathologist’s ability to evaluate microscopically.

Standardize Inking And Margin Policy

Consistent inking ensures that specimen orientation and excision boundaries remain clear from grossing through microscopic review. A standardized margin policy improves communication, reproducibility, and diagnostic confidence across the lab team.

Best practices include:

• Define A Standard Color Scheme: Assign specific ink colors to anatomic margins (e.g., superior, inferior, medial, lateral) and apply them consistently in all cases.
• Prepare Clean, Dry Surfaces: Gently blot tissue to remove moisture or blood before inking to enhance adhesion and color accuracy.
• Apply Ink Evenly: Use blotting or dabbing instead of brushing to prevent cross-contamination and preserve delicate tissue edges.
• Allow Adequate Drying Time: Let ink dry thoroughly before sectioning or fixation to prevent color diffusion or ink loss.
• Document The Color Key: Record each ink color and its corresponding margin in the gross description. Include a labeled diagram when appropriate.
• Maintain Consistency Across Operators: Follow a uniform ink sequence and labeling convention to ensure comparability across cases and reviewers.

Choose Perpendicular Vs En Face With Stated Rationale

Margin evaluation depends on the cutting approach the pathologist uses at the bench; selecting between perpendicular and en face sections determines what they can assess from the tissue. Each method serves a specific diagnostic purpose, so choosing intentionally—and documenting that rationale—ensures clear, reproducible interpretation.

Best practices include:

• Use Perpendicular Sections When Measuring Clearance: Cut perpendicular to the margin when assessing the exact distance between a lesion and the surgical edge. This view shows depth and proximity.
• Use En Face Sections For Surface Involvement: Trim en face when evaluating whether tumor or epithelium extends to the cut surface. This approach confirms presence or absence, not depth.
• Expose The Margin Cleanly: Use a single, smooth cut to create a continuous plane. Avoid tearing or incomplete cuts that distort tissue alignment.
• Orient the Cut For Pathologist Readability: Position the tissue so that the relationship between tumor and margin remains clear in the block and on the slide.
• Document The Rationale: Record in the gross description whether the section is perpendicular or en face and why that approach was chosen.

Select Planes That Show Deepest Invasion And Closest Margin

Choosing the correct cutting planes determines how well the pathologist can assess tumor depth and excision adequacy. Each section should display the area of deepest invasion and the margin nearest to the lesion for accurate staging and margin interpretation.

Best practices include:

• Identify The Area Of Maximal Invasion: Inspect the specimen to locate the point where the lesion extends most deeply into the underlying tissue.
• Plan The Cut Before Sectioning: Visualize internal orientation and align the specimen so the section captures both the deepest invasion and closest resection margin.
• Use A Single, Continuous Cut: Apply firm, even pressure with a sharp blade to create a clean plane and maintain tissue relationships.
• Include Adjacent Normal Tissue: Incorporate nearby normal structures to help the pathologist compare architecture and assess invasion boundaries.
• Avoid Over-Trimming: Remove only what’s necessary to expose the diagnostic plane. Excess trimming may eliminate critical tissue or margins.
• Document Orientation And Intent: Record which plane was chosen and why, noting how it best demonstrates key diagnostic relationships.

Retrieve Lymph Nodes Systematically And Map Them

Systematic lymph node retrieval ensures accurate staging and complete evaluation of regional spread. Organized dissection and detailed mapping provide clarity for both the pathologist and the surgical team, reducing the chance of missed or misclassified nodes.

Best practices include:

• Follow A Defined Dissection Sequence: Examine fat and soft tissue methodically, progressing from known anatomic landmarks to less-defined regions to ensure full recovery of nodes.
• Use Palpation And Visual Cues: Combine tactile search with visual inspection to locate small or fibrotic nodes, which are often hidden within adipose tissue.
• Record Node Counts And Locations: Document the number and location of retrieved nodes, linking each to a labeled cassette or anatomic site for reference.
• Submit Small Or Suspicious Nodes Entirely: Place tiny or abnormal nodes whole in the cassette to preserve diagnostic features and prevent sampling error.
• Map Node Distribution: Create a simple diagram or written key showing where each node group was found relative to the primary lesion.
• Check For Remaining Nodes After Dissection: Reinspect residual tissue before disposal to confirm that no additional nodes are overlooked.

Protect Small And Friable Tissues With Supports

Small or delicate specimens require special handling to prevent loss, distortion, or fragmentation during fixation and processing. Using proper supports preserves structural integrity, ensuring that every fragment remains available for microscopic evaluation.

Best practices include:

• Use Biopsy Pads Or Sponges: Enclose fragile or minute specimens between labeled pads to prevent loss during fluid exchange and transfer.
• Employ Lens Paper For Tiny Fragments: Wrap slivers of tissue or detached mucosal edges in lens paper to maintain orientation and minimize folding.
• Avoid Overcompression: Secure specimens gently within supports—tight compression can distort morphology or obscure key features.
• Submerge Supports Fully: Ensure pads or papers are completely immersed in fixative so that all enclosed tissue fixes evenly.
• Label Supports Clearly: Mark cassettes or pads to correspond with specimen IDs and block designations for traceability.
• Check Supports After Fixation: Confirm that tissue remains intact and fully contained before transferring to processing to avoid loss.

One Case On The Board At A Time

Limiting the grossing area to a single case at a time prevents specimen mix-ups and maintains traceability throughout the workflow and minimizes cross-contamination, while supporting accurate documentation, and reinforcing chain-of-custody standards.

Best practices include:

• Clear The Board Between Cases: Remove all tools, tissues, and paperwork from the work surface before introducing a new specimen.
• Verify Case Identity First: Confirm patient identifiers, accession numbers, and corresponding requisitions before starting grossing.
• Designate a Clean Work Zone: Maintain distinct zones for cutting, labeling, and documentation to avoid cross-transfer of tissue or fluids.
• Use Dedicated Containers And Tools: Assign labeled containers and instruments for each case to prevent accidental mixing of specimens.
• Document Case Completion: Record the final cassette count and specimen disposition before clearing the workspace.
• Visually Inspect Before the Next Case: Recheck the area for stray tissue fragments or mislabeled containers to maintain specimen integrity.

Two-Person Verification For Labels And Counts

A two-person verification step ensures that specimen identifiers, cassette labels, and counts are accurate before processing. This safeguard prevents misidentification, confirms completeness, and reinforces confidence in the diagnostic chain.

Best practices include:

• Pair Two Qualified Personnel: Assign one individual to call out identifiers and another to confirm visually, ensuring independent verification.
• Check Labels Against Documentation: Compare cassette and container labels with the accession sheet and laboratory information system before sealing or processing.
• Confirm Cassette Counts: Match the physical number of cassettes to what is recorded in the gross description or LIS entry.
• Review Specimen Integrity: Ensure all expected tissue parts are present and accounted for, especially when multiple sites or containers are submitted.
• Record Verification Completion: Document both verifiers’ initials or electronic confirmations in the LIS for traceability and compliance.
• Repeat After Corrections: If any discrepancies are found and corrected, perform a second verification cycle before final submission.

Bench Layout, Ergonomics, And Safety Standards

A well-designed grossing station protects staff, enhances precision, and ensures consistent quality. Correct bench height, lighting, setup, and safety protocols reduce fatigue, minimize hazards, and support accuracy throughout the grossing process. Each element of the workspace should promote comfort, control, and compliance with safety standards.

Bench Height And Ergonomic Posture

Maintaining proper bench height and posture is essential for both comfort and accuracy during grossing. Adjustable benches allow users to work with their elbows at approximately a 90-degree angle, keeping their shoulders relaxed and movements steady. Alternating between sitting and standing helps reduce fatigue, while anti-fatigue mats and footrests support joint alignment during prolonged periods at the bench.

Specimens should be positioned close to the body to minimize reach distance and maintain control. Tools and cassettes should be arranged within easy reach at midline height to reduce repetitive twisting or stretching. These ergonomic practices not only protect musculoskeletal health but also improve cutting precision and consistency over time.

Adequate Lighting And Visibility

Proper lighting is critical to visual accuracy during dissection and description. Bright, diffused illumination prevents harsh shadows and eye strain, ensuring tissue details are interpreted correctly. Adjustable task lighting can be directed onto deep cavities or reflective surfaces, improving visibility and reducing the likelihood of missed findings.

Light sources should have a high color rendering index (CRI) to maintain true color representation of tissue. Positioning lights at effective angles prevents glare on metal instruments and wet specimens. Regular cleaning of lenses and fixtures maintains consistent illumination, enabling clear and detailed assessment throughout each case.

Organized Tool And Cassette Placement

A clean and organized bench promotes efficiency, safety, and traceability. Each instrument—such as knives, forceps, and rulers—should have a dedicated location clearly marked for easy retrieval and replacement. Waste, fixative, and specimen containers must be separated and clearly labeled to prevent cross-contamination or misplacement.

Only one specimen and its related materials should occupy the work surface at a time. Cassettes should be arranged sequentially in submission order to maintain alignment with documentation. Between cases, surfaces and instruments should be wiped down to preserve cleanliness and ensure a contamination-free environment for the next specimen.

Ventilation And Splash Control

Effective ventilation systems are vital for controlling exposure to fixatives, aerosols, and biological material. Downdraft or backdraft ventilation provides continuous airflow that captures vapors at the source, protecting personnel from harmful inhalation. Airflow monitors should be inspected regularly to confirm adequate suction and functionality before starting a case.

Splash guards positioned near sinks and cutting areas protect against fluid splatter, while absorbent mats or pads keep surfaces dry and stable. Proper waste management—directing liquids through approved drains and containers—reduces environmental contamination and supports compliance with laboratory safety standards.

Safe Sharps Handling And PPE Use

Safe handling of scalpels and blades is fundamental to injury prevention. Whenever possible, use retractable or guarded scalpels, and always dispose of used blades immediately in puncture-proof sharps containers without hand contact. Cut-resistant gloves worn over nitrile gloves provide protection without compromising dexterity, allowing for steady, controlled cutting motions while keeping the hands protected.

Comprehensive personal protective equipment (PPE) is required for all grossing activities. Staff should wear gloves, fluid-resistant gowns, protective eyewear or face shields, and appropriate masks. PPE must be inspected before each use and replaced if damaged or contaminated. Consistent use of safety equipment safeguards both personnel and specimen integrity, reinforcing Mopec’s standard for reliable, responsible laboratory practice.

Mopec Grossing Stations That Support Safe Practice

Your grossing workspace must deliver on three key needs: safety, ergonomic design, and workflow efficiency. The Maestro Encore takes these requirements as its starting point and integrates engineering solutions that support your operations every day. Designed to align with diverse laboratory environments and individual user preferences, this station lets you focus on the task without compromise.

Key features include:

• Adjustable Height Platforms: Maintain proper posture while standing or seated, reducing strain and supporting ergonomic best practices throughout long procedures.
• Patented SafeDraft™ Ventilation System: Directs air from the front to the back of the cutting surface to enhance backdraft airflow and minimize formalin exposure.
• Integrated PathCam® Digital Imaging: Built-in 24.1 MP Canon-powered camera provides real-time image capture and seamless LIS integration for effortless documentation and digital pathology.
• Configurable Ensemble Pegboard™ System: Organize accessories, tools, and monitors precisely where you need them, matching your workflow and optimizing reach and visibility.
• Integrated LED Lighting: Adjustable illumination ensures accurate color rendering and visibility, enhancing safety and diagnostic accuracy.
• Durable Stainless-Steel Construction: Ensures long-lasting performance, easy cleaning, and resistance to chemical corrosion.
• TÜV Certification: Guarantees compliance with international safety and performance standards for laboratory equipment.

By choosing a grossing station that aligns with safety protocols, ergonomic best practices, and optimized workflow, you position your pathology team to work more confidently, accurately, and efficiently, while safeguarding user comfort and specimen integrity.

Every Diagnosis Starts At The Grossing Bench

The quality of every diagnosis begins long before a slide reaches the microscope. At the grossing bench, precision, safety, and consistency determine how effectively a specimen tells its story. Each action—cutting, orienting, sampling, and documenting—builds the foundation for diagnostic accuracy and patient trust.

Mopec understands that supporting professionals at this stage means designing workspaces that enhance focus and protect users. Through thoughtful engineering, advanced ventilation, and ergonomic design, Mopec grossing stations enable pathology teams to perform their work with confidence and clarity. When safety, efficiency, and precision come together, the result is more than a well-designed workspace—it’s a platform for better outcomes and stronger science.

Don’t let the first cut decide the wrong outcome. Invest in Mopec grossing stations built to protect your team, your process, and every diagnosis.