RU2820066C1 - Plate for fixation of histological preparations of tumour of parotid salivary gland - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment, namely to a plate for fixation of histological preparations of a tumour of a parotid salivary gland. Plate for fixation of histological preparations of a tumour of the parotid salivary gland is characterized by the fact that it is made of polylactide in the form of a flat disc of a round shape with diameter of 100 mm and thickness of 4 mm, having a mesh frame with a rim with width of 4 mm. Mesh frame is formed by strips crossing at a right angle, in the central part of the strip with thickness of 2 mm squares with side of 10 mm are formed, inside which the strips with width of 1 mm form squares with side of 5 mm. On the mesh frame with a line with width of 6 mm, a contour of the profile of the human head is applied, on which on one side of the plate there is a marking R – right, on the other L – left, indicating the corresponding side of the patient's head, from where the histological preparation was removed.

EFFECT: optimization of the morphological assessment of all resection margins of material during surgical removal of the parotid salivary gland tumour.

1 cl, 2 dwg

Description

The invention relates to medicine, in particular to maxillofacial surgery, oncology and pathological anatomy. Can be used to facilitate interaction between the maxillofacial surgeon/oncologist and the pathologist when studying gross specimens of parotid tumors.

Today, various methods of chemical fixation of biopsy and autopsy (including surgical) material are known, but the most common is placing the material in a container with a 10% solution of neutral buffered formalin in a tissue: fixative ratio of at least 1: 20. The procedure for taking the material by a doctor is by a clinician and the cutting of material by a pathologist is regulated by Order of the Ministry of Health of Russia No. 179 N, dated March 24, 2016, “On the rules for conducting pathological examinations.”

When sending specimens of tumors removed during surgery on the parotid salivary gland to the pathology laboratory, it becomes difficult to mark all the edges of the specimen. The fact is that a macropreparation containing a tumor of the parotid salivary gland, as a rule, has a round shape and after placing it in a container with a fixing solution, landmarks indicating the location of the block of removed tissue in the parotid salivary gland may be absent.

Taking into account the polymorphism of tumors of the parotid salivary gland, the structural features of their capsule, and the possibility of malignancy, to assess the correctness of the operation, it is optimal to check all the edges of tumor resection (upper, lower, left, right, external and internal). The standard marking technique by suturing the area of interest with a surgical thread, in the case of 6 marking positions, seems extremely inconvenient. The option of a surgeon sketching a round-shaped specimen also cannot always be regarded as a full-fledged method. The use of histological dyes is carried out directly on the specimen cuttings and requires the presence of a surgeon, which can be problematic from an organizational point of view, and is also not always financially accessible.

The proposed invention is new and has not been described in the patent and scientific and technical literature.

The “Device for teaching micro-operations on the eye” has some similarities with the proposed one (see A.S. USSR No. 930347, G09B23/28, A61F9/00), 05/23/1982).

However, this device is intended only for fixing a cadaveric eye for the purpose of teaching the technique of microsurgical operations on the eye and is not intended to resolve issues of pathoanatomical study of the boundaries of surgical material obtained from a living person.

The objective of the present invention is to optimize the morphological assessment of all resection edges of surgical material during surgical removal of a parotid salivary gland tumor.

This task is achieved by the fact that the plate for fixing histological preparations of a tumor of the parotid salivary gland is made of polylactide in the form of a flat round disk with a diameter of 100 mm and a thickness of 4 mm, having a mesh frame with a rim 4 mm wide, and the mesh frame is formed by strips intersecting at right angles , in the central part, strips 2 mm thick form squares with a side of 10 mm, inside of which strips 1 mm wide form squares with a side of 5 mm, also on the mesh frame with a line 6 mm wide there is a contour of the profile of a person’s head, on which a marking is applied on one side of the plate R - right, on the other L - left, indicating the corresponding side of the patient's head from where the histological specimen was removed.

The essence of the invention: a plate for fixing histological specimens of a tumor of the parotid salivary gland is a rigid flat plastic mesh base made in the shape of a circle. The grid is represented by lines intersecting at right angles. On each side of the plate there is an area marked R (right) and L (left), characterizing the corresponding side of the patient’s head from where the histological specimen was removed. On the plate, a 6.0 mm thick line depicts the contour of the head, which serves as a guide for clear positioning of the removed tissue block, in accordance with the original anatomical location. Plate diameter - 100 mm; thickness 4 mm. The rim around the entire perimeter is 4 mm wide. The lines forming the grid have a thickness of 2.0 mm and 1.0 mm. They are arranged in such a way that in the central part of the plate, lines with a thickness of 2.0 mm form squares with a side of 10 mm, inside of which there are thinner lines with a thickness of 1.0 mm, forming squares with a side of 5 mm.

These parameters (squares with a side of 5.0 and 10.0 mm) are convenient for quickly measuring the size of a macropreparation, which is fixed on the corresponding surface of the plate (left or right) by suturing with several interrupted sutures with standard suture material, in compliance with the original anatomical orientation (Fig. 1 a, b, c; Fig. 2 a, b, c, d).

The invention is illustrated by images:

Fig. 1 plate shown

a - right view;

b - left view;

c - side view.

In fig. 2 a, b, c, d - examples of fixation on the plate of macropreparations that differ in shape, size and location, obtained during surgery for a tumor of the parotid salivary gland, are given.

The method for manufacturing a plate for fixing histological specimens of a parotid salivary gland tumor is 3D printing using the layer-by-layer FDM (Fused Deposition Modeling) method. This method is an additive manufacturing process that is implemented through the extrusion of materials. In FDM, an object is built by depositing molten material according to a predetermined algorithm, layer by layer. The materials used are thermoplastic polymers and are in the form of a thread.

The material used is polylactide (polylactic acid, PLA) - a biodegradable, biocompatible, thermoplastic, aliphatic polyester, the monomer of which is lactic acid (the raw materials for production are corn and sugar cane). Used for the production of products with a short service life; popular in 3D printing as the easiest to use and inexpensive material. https://ru.wikipedia.org/wiki/%D0%9F%D0%BE%D0%BB%D0%B8%D0%BB%D0%B0%D0%BA%D1%82%D0%B8%D0 %B4.

Next, the plate along with the histological specimen of the parotid salivary gland tumor is placed in a standard container of larger diameter filled with 10% buffered formalin. The mesh structure of the plate does not prevent the drug from being soaked in formaldehyde. Considering the flat shape and rigid structure of the plate, further cutting of the drug can be carried out directly on it.

Personnel working with a product that has come into contact with potentially infectious material must follow safety precautions. After completing the operation of this product, it must be decontaminated before destruction, in accordance with the current legislation of the Russian Federation. The product is subject to mechanical destruction with removal of residues as industrial or household waste or incineration.

To illustrate the practical results of the application of the invention, we give an example of a histological conclusion made on a specimen submitted to the laboratory on a plate for fixing histological specimens of a parotid salivary gland tumor.

Patient K., 30 years old.

Clinical diagnosis: “Benign neoplasm of the parotid salivary gland on the left”, D11.0.

Main: “Benign neoplasm of the parotid salivary gland on the left.”

Related: “Chronic obstructive pulmonary disease, unspecified. Bronchial asthma with variable obstruction. Laryngotracheitis. Chronic tonsillitis".

Complications of the underlying disease: none.

Operation: “Subtotal resection of the left parotid salivary gland with tumor, preserving the facial nerve under the control of intraoperative neuromonitoring.”

Laboratory results

Macroscopic description: labeling “Left parotid salivary gland. Tumor node." The salivary gland measures 4.5 x 4.0 x 2.5 cm. The section reveals a yellow-white node with areas of cartilaginous density, irregular shape, measuring 4.0 x 3.5 cm.

Microscopic description: the formation is represented by the structures of a pleomorphic adenoma of mixed structure with a multicentric type of growth, a cellular component with foci of squamous differentiation. The capsule of the formation has focal lymphocytic infiltration.

The resection edges (upper, lower, left, right, outer) are represented by salivary gland tissue and surrounding fibrofatty tissue. On the inner edge, an area is determined where the distance from the formation to the surgical resection margin is 1.0 mm (a series of additional sections is performed).

Background - salivary gland tissue with lipomatosis, a few small focal lymphocytic infiltrates and minimal periductal sclerosis.

The free part of the main duct of the parotid salivary gland has an empty lumen, part of the intralobular excretory ducts has expanded lumens.

2 lymph nodes with signs of sinus histiocytosis are identified (labeling from the lower right section of the macroscopic specimen).

The technical result of the proposed invention is to improve the quality of assessment of surgical material (parotid salivary gland tumor) due to:

1) marking the edges of the preparation (upper, lower, left, right, outer, inner) by placing it on the plate;

2) the possibility of a simplified search for individual anatomical structures (for example, the resected Stenon's duct of the parotid gland, lymph nodes) for an in-depth morphological assessment.

Advantages of the plate for fixing histological specimens of the parotid salivary gland tumor:

- simplicity of structure;

- the ability to estimate the size of the preparation on the plate;

- elementary fixation of the drug on the plate with standard suture material;

- low cost;

- possibility of rapid production;

- the plate does not disrupt the process of impregnation of the macropreparation with the fixing solution;

- the plate, if necessary, can be adapted for other drugs removed from the head area.

Claims (1)

A plate for fixing histological preparations of a tumor of the parotid salivary gland, characterized in that it is made of polylactide in the form of a flat round disk with a diameter of 100 mm and a thickness of 4 mm, having a mesh frame with a rim 4 mm wide, and the mesh frame is formed by strips intersecting at right angles, in the central part, strips 2 mm thick form squares with a side of 10 mm, inside which strips 1 mm wide form squares with a side of 5 mm; also on the mesh frame with a line 6 mm wide there is a contour of the profile of a person’s head, on which the marking R is applied on one side of the plate - right, on the other L - left, indicating the corresponding side of the patient’s head from where the histological specimen was removed.