gms | German Medical Science

Introduction: Lasermicrosurgery of tumors of the upper aerodigestive tract is often done by the so-called piecemeal technique, i.e. tumors are removed in several pieces. In this situation the basal margins of resection specimens have to be marked by the surgeon to facilitate orientation of the pathologist. Steiner and Ambrosch originally recommended marking by a pen, which has the disadvantage that it has to be renewed by the pathologist before further work-up of specimens. This may result in a wrong assessment of resection margins.

Method: On the unfixed specimen the surgeon marks the deep resection margin with the histological dye WAK-HM-G-1 (WAK-Chemie Medical GmbH, Steinbach, Germany). The dye is applied without dilution by a small cotton bud under microscopic vision. After swabbing excesses of the dye, the specimens are fixed in formalin, sectioned perpendicular to the marked margin and stained with hematoxylin and eosin.

Result: The dye-marking remains stable during histological processing and does not run to other margins of the specimen. In the histological section the basal margin can be identified by a thin green strip which contrasts well with the HE stain (Figure 1 [Fig. 1]).

Conclusion: The procedure allows a reliable and distinct marking of lasermicrosurgical resection specimens. Its key benefit is that the surgeon alone determines definitely which margins are investigated by the pathologist.