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Optimal processing of ESD specimens to avoid pathological artifacts.

L Reggiani Bonetti1,2, R Manta3, M Manno4

  • 1Institute of Pathology of Modena Az., Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy. reggiani.luca@policlinico.mo.it.

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Summary
This summary is machine-generated.

Cellulose acetate support improves histological assessment of en bloc endoscopic submucosal dissection (ESD) specimens. This method enhances evaluation of precancerous gastrointestinal lesions and surgical margins.

Keywords:
Cellulose acetateCrushing artifactsEndoscopic submucosal dissectionHistological assessmentHolesStretching artifacts

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Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Endoscopic Procedures

Background:

  • En bloc endoscopic submucosal dissection (ESD) is a novel treatment for gastrointestinal precancerous and neoplastic conditions.
  • Accurate histological assessment of ESD specimens is crucial for patient management.

Purpose of the Study:

  • To evaluate the histological quality of en bloc ESD specimens.
  • To compare different methods of specimen preparation for histological analysis.

Main Methods:

  • Fifty-three ESD specimens were analyzed.
  • Specimens were prepared using either cellulose acetate support or pinning on polystyrene/cork.
  • Consecutive 2 mm thick sections were stained and assessed for artifacts (crushing, shearing, stretching).

Main Results:

  • Specimens prepared with cellulose acetate support showed minimal artifacts (Global Artifact Score 0-1), indicating adequate quality.
  • Specimens prepared with nails exhibited significant artifacts (shearing, crushing, stretching), with only 1 of 13 deemed adequate.
  • Positive deep surgical margins were found in 15% of cases, and lateral margins in 23%.

Conclusions:

  • Cellulose acetate support is effective for preserving the integrity of en bloc ESD specimens.
  • This method facilitates accurate histological assessment, including margin status and en bloc evaluation of lesions.
  • Utilizing appropriate specimen preparation techniques is vital for reliable pathological diagnosis after ESD.