title: Recommendations for gross examination and sampling of surgical specimens of the spleen.
abstract: This review examines handling and processing of spleen biopsies and splenectomy specimens with the aim of providing the pathologist with guidance in optimizing examination and diagnosis of splenic disorders. It also offers recommendations as to relevant reporting factors in gross examination, which may guide diagnostic workup. The role of splenic needle biopsies is discussed. The International Spleen Consortium is a group dedicated to promoting education and research on the anatomy, physiology, and pathology of the spleen. In keeping with these goals, we have undertaken to provide guidelines for gross examination, sectioning, and sampling of spleen tissue to optimize diagnosis (Burke). The pathology of the spleen may be complicated in routine practice due to a number of factors. Among these are lack of familiarity with lesions, complex histopathology, mimicry within several types of lesions, and overall rarity. To optimize diagnosis, appropriate handling and processing of splenic tissue are crucial. The importance of complete and accurate clinical history cannot be overstated. In many cases, significant clinical history such as previous lymphoproliferative disorders, hematologic disorders, trauma, etc, can provide important information to guide the evaluation of spleen specimens. Clinical information helps plan for appropriate processing of the spleen specimen. The pathologist should encourage surgical colleagues, who typically provide the specimens, to include as much clinical information as possible.
authors.affiliation: Clarient Diagnostic Services, 31 Columbia, Aliso Viejo, CA, 92656. Electronic address: domalley@clarientinc.com.
authors.forename: Dennis P
authors.initials: DP
authors.lastname: O'Malley
authors.affiliation: Pathology Service, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114. Electronic address: alouissaint@partners.org.
authors.forename: Abner
authors.initials: A
authors.lastname: Louissaint
authors.affiliation: TriCore Reference Laboratories, 1001 Woodward Place NE, Albuquerque, NM, 87102. Electronic address: mvasef@salud.unm.edu.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Vasef
authors.affiliation: Joint Pathology Center, 606 Stephen Sitter Ave, Silver Spring, MD, 20910. Electronic address: aaron.auerbach.civ@mail.mil.
authors.forename: Aaron
authors.initials: A
authors.lastname: Auerbach
authors.affiliation: MD Anderson Cancer Center/University of Texas, Room 4.2115b, Clark Clinic, 1515 Holcombe Blvd, Houston, TX, 77030. Electronic address: Roberto.miranda@mdanderson.org.
authors.forename: Roberto
authors.initials: R
authors.lastname: Miranda
authors.affiliation: Department of Pathology, USC Keck School of Medicine, 2011 Zonal Ave HMR 209, Los Angeles, CA, 90033. Electronic address: brynes@usc.edu.
authors.forename: Russell K
authors.initials: RK
authors.lastname: Brynes
authors.affiliation: Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, CB no. 7525, Chapel Hill, NC, 27599. Electronic address: Gfedoriw@unch.unc.edu.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Fedoriw
authors.affiliation: Yale Department of Pathology, 310 Cedar St, New Haven, CT, 06520. Electronic address: david.hudnall@yale.edu.
authors.forename: S David
authors.initials: SD
authors.lastname: Hudnall
mesh_terms: D001706:Biopsy / Q000379:methods*; D044963:Biopsy, Fine-Needle / Q000379:methods / Q000592:standards; D062005:Biopsy, Large-Core Needle / Q000379:methods / Q000592:standards; D017408:Guidelines as Topic; D006801:Humans; D013048:Specimen Handling / Q000379:methods* / Q000592:standards; D013154:Spleen / Q000473:pathology* / Q000601:surgery*; D013156:Splenectomy / Q000379:methods* / Q000592:standards
keywords: gross examination; histology; pathology; sampling; spleen