วัตถุประสงค์เชิง พฤติกรรม เมื่อสิ้นสุดการเรียนการสอน นักศึกษาสามารถ 1. ทราบวิธีการเก็บสิ่งส่งตรวจ ทางพยาธิวิทยาชนิดต่างๆ 2. สามารถเลือกใช้วิธีการเก็บ สิ่งส่งตรวจทางพยาธิวิทยาได้ อย่างถูกต้องเหมาะสม

SPECIMENS IN PATHOLOGY 1.Surgical Pathology Specimen 2.Cytopathology Specimen 3.Autopsy Specimen 4.Clinical Pathology Specimen

SURGICAL PATHOLOGY SPECIMEN 1.Biopsy specimen - Excisional biopsy (removal of entire lesion) (removal of entire lesion) - Incisional biopsy (part of lesion) (part of lesion)

SURGICAL PATHOLOGY SPECIMEN 2.Resection specimen - from surgical procedures

Handling of Surgical Specimen 1.Fresh tissue - avoid crushing - keep in refrigerator at 4  C - avoid wrapping with dry gauze - wrap in gauze soaked with normal saline - put in plastic bag, glass or metal containers and seal

Handling of Surgical Specimen 2. Fixed specimen - fixation in fixative (10% buffered formalin, alcohol, Zenker solution, B-5 solution etc.) - put the specimen in glass, plastic or metal containers with fixative and seal - put the gauze on top in case of floating specimen - volume of fixative: 10 times of the specimen - rate of fixation 1mm/hour

Handling of Cytological Specimen 1.Papanicolaou smear - put in 90% alcohol - spray fixation (alcohol)

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Handling of Cytological Specimen 2. Fine Needle Aspiration (FNA) - immediately put in 90% alcohol - spray fixation (alcohol) - air dry

Handling of Cytological Specimen 3. Fluid (exfoliative cytology) -Fluid from cavities (pleural, pericardial, peritoneal, cerebrospinal- CSF, vitreous or aqueous humor, joint, any cavity) - Fluid from cavities (pleural, pericardial, peritoneal, cerebrospinal- CSF, vitreous or aqueous humor, joint, any cavity)

Autopsy Specimen 1.Whole body for autopsy 2.Necropsy 3.Limited autopsy : part (s) of organ (s) or specific organ(s)

Clinical Pathology Specimen 1.Blood 2.Serum or plasma 3.Urine 4.Fluid from cavities (pleural, pericardial, peritoneal, cerebrospinal-CSF, vitreous or aqueous humor, joint, any cavity)

Laboratory Investigation in Dermatopathology 1. Special stains for skin smear - Acid fast bacilli stain (AFB) - Gram’s stain - etc.

Laboratory Investigation in Dermatopathology 2. KOH preparation (20%) 3. Skin smear for dark field examination for syphilis 4. Skin scraping for scabies

Laboratory Investigation in Dermatopathology 5. Tzanck smear for diagnosis of herpetic infection or bullous disease - for diagnosis of herpetic infection or bullous disease - new vesicle, open the roof with sharp blade - scrape at vesicle base - air dried - stain with Wright or Giemsa stains

Multinucleated giant cell, HSV infected

Viral cytopathic cells

Laboratory Investigation in Dermatopathology 6. Culture 7. Wood light examination - high pressure mercury arc producing UV at 360 nm (UVA)

Laboratory Investigation in Dermatopathology 8. Skin biopsy (excisional or incisional biopsy) - for diagnosis - for follow up - punch biopsy, shave biopsy