NP CC Comment Bugstain

NP CC GROSS EYE DESCRIPTION

GROSS EXAMINATION (performed at UPMC Presbyterian):

Part 1. " ##### ," in formalin. Received is an enucleation specimen that is identified as the right ## left eye by the insertion of the inferior oblique muscle. The globe measures ### mm in the anterior-posterior, horizontal, and vertical meridians, respectively. The ## mm cornea is diffusely cloudy. The ## iris displays a ## mm pupillary opening. The conjunctival/scleral surface shows #####. A ## mm segment of optic nerve with a diameter of ## mm is attached. The eye fails to transilluminate OR Transillumination of the eye reveals an area of opacity from ### to ###, ## mm behind the ### and extending to the ##. The opacity has a maximum anterior-posterior dimension of ## mm and a maximum vertical dimension of ## mm. The eye is cut in the horizontal plane #### or the oblique plane defined by the ####-## axis. DESCRIBE LENS, CILIARY BODY, RETINA, ANY HEMORRHAGE IN AQUEOUS OR VITREOUS. The central section of the eye is submitted in Block 1A for sectioning from the superior ## inferior face.

np cc foreign body (to be used for all gross only parts)

The specimen submitted as **** has been subjected to gross examination only. If additional studies such as microscopic examination and/or retention/return of the specimen is desired, please notify the case pathologist within two weeks of the signout date on the report. This is particularly important as specimens are routinely discarded after a prescribed period of time. Thank you for involving us in the care of this patient.

NP CC cornea micro

Microscopic examination of three H&E stained levels and one PAS stained section reveals the histopathologic changes listed in the Diagnosis Section. PAS stain reveals that xxxxxxx.

NP CC comment bugstain

The degree of acute inflammation present is not unexpected in traumatized tissues. If special stains for bacterial and fungal organisms are desired, it is suggested that the case pathologist be notified within two weeks of the signout date of this report.

NP CC donor ring (I am trying to get the PAs to submit these in a separate block designated donor ring, in which case this will not be needed. They often mistake this tissue for synthetic material because the sclera is white and opaque)

The donor ring was subjected to gross examination only, as it does not represent tissue derived from the patient. If microscopic examination is requested for clinical reasons, please contact the case pathologist within two weeks of the signout date of this report. This is particularly important as specimens are routinely discarded after a prescribed period of time.

NP CC eye consult (Should be inserted by Christina on accessioning – please fillin hatch marks and delete phrases as appropriate for an individual case)

Received for consultation from #####, MD, is a single specimen container labeled with the patient' s name and the outside pathology number #####, which contains an intact formalin-fixed eyeball, sent from #######.

The following materials were reviewed in conjunction with the pathologic specimen: ##surgical pathology report, ##medical history and physical examination, ## radiologic report, and ##operative report.

NP CC outside lab (came up once in a blue moon for neuropath specimen, but having worked out the appropriate wording…)

The information contained in this addendum is from the report of a reference laboratory (Oncotech, Tustin, CA), which performed Drug Resistance Assay on this metastatic brain tumor (Oncotech ID No. xxxxx). The original report is kept on file in the Division of Neuropathology (412-647-9417).

The assay shows that the tumor cells display "extreme drug resistance" to Gemcitabine, with "intermediate drug resistance" to Cisplatin and Carboplatin, and "low drug resistance" to Taxol, Topotecan, Taxotere, Etoposide, and Navelbine. As noted on the report, "The Oncotech EDR assay is a drug resistance assay. Use of the Oncotech EDR Assay to identify and/or select clinically active agents is not recommended."

The following quick-texts are templates for specific diagnoses. THEY MUST BE UPDATED with appropriate additions and deletions to fit the case material. For convenience, the microscopic description will also insert. Please modify the micro to reflect the case and Cut & Ppaste it into the Microscopic Examination area.

NP CC failed graft

CORNEA, XXXX EYE, TRANSPLANT:

1.PERIPHERAL SCAR WITH DISJOINTED SEGMENT OF DESCEMET' S MEMBRANE CONSISTENT WITH HISTORY OF PRIOR GRAFT

2.BULLOUS KERATOPATHY WITH PAUCITY OF CORNEAL ENDOTHELIAL CELLS

Examination of three H&E stained levels and one PAS stained section reveal the histopathologic findings detailed in the Diagnosis section. PAS stain shows thickening of the epithelial basement membrane and highlights peripheral breaks in Descemet' s membrane consistent with prior penetrating procedure.

np cc fuchs'

CORNEA, XXXXXX EYE, TRANSPLANT:

FUCHS' CORNEAL DYSTROPHY WITH SECONDARY BULLOUS KERATOPATHY

Microscopic examination of three H&E stained levels of the cornea reveal subepithelial bullae. Endothelial cells are present; however, Descemet' s membrane is markedly thickened. PAS stain confirms the presence of posterior and intramembranous guttata.

NP CC PBK

CORNEA, XXXXXXX EYE, TRANSPLANT:

BULLOUS KERATOPATHY WITH PAUCITY OF CORNEAL ENDOTHELIAL CELLS

CHRONIC KERATITIS, MILD, PERIPHERAL

Examination of three H&E stained step levels reveal cornea with subepithelial bullae. Corneal endothelial cells are not readily identified. PAS stain shows XXXXXXXX of the epithelial basement membrane. Descemet' s membrane is of normal thickness without guttata.

NP CC trabeculectomy

PART 1. EYE, XXXX, TRABECULECTOMY:

FRAGMENT OF DEEP LIMBAL TISSUE CONSISTENT WITH TRABECULECTOMY SPECIMEN

PART 2. EYE, RIGHT, "IRIS,", TRABECULECTOMY:

FRAGMENT OF IRIS TISSUE

Examination of H&E stained sections of Parts 1 and 2 reveal histologically unremarkable peripheral deep corneal/limbal tissue and iris tissue.