Читать книгу Veterinary Surgical Oncology - Группа авторов - Страница 34

As discussed above, following an excisional biopsy, the surgical margins of the mass should be clearly indicated in some way so that the histopathologist can accurately evaluate the mass for complete excision. Several methods have been proposed to do this including specialized sectioning techniques, suture markers, inking, and the submission of adjacent tissue as a separate sample (Rochat et al. 1992; Mann and Pace 1993; Seitz et al. 1995). Inappropriate sectioning can result in neoplastic cells being noted at the cut margin and a false positive result can occur. Sutures can be used to mark a particular area of interest or for tumor orientation, but sutures need to be removed before sectioning to prevent microscopic artifact (Mann and Pace 1993). A sample of tissue surrounding the surgical wound can also be submitted for evaluation. However, this increases the size of the wound bed and added expense may be seen due to the submission of extra biopsy samples.

In general, the marking of tumor margins with inks or dyes is recommended. Several types of inks and dyes have been evaluated including merbromin, laundry bluing, India ink, alcian blue, typists’ correction fluid, commercial acrylic pigments, and artists’ pigment in acetone (Rochat et al. 1992; Mann and Pace 1993; Seitz et al. 1995; Chiam et al. 2003). Alcian blue has been shown to be the best marking material; however, India ink and commercial kits (Davidson Marking System, IMEB Inc., San Diego, CA) are reasonable alternatives (Seitz et al. 1995). One of the benefits of the commercial kits is that multiple colors are provided. When using these kits, all the margins can be marked in different colors, but at a minimum, the lateral margin can be marked in one color and the deep margin in a different color. Yellow, black, and blue colors are considered the best to use while red, violet, and green are less ideal (Seitz et al. 1995; Milovancev et al. 2013).