“Macroscopy”: A Proposal for More Inclusive and Accurate Terminology

To the Editor.—I am writing to suggest a small but significant change in the language used in our academic pathology journals. Specifically, I would like to suggest that pathologists use the term “macroscopy” instead of “grossing” to describe the process of examining tissue specimens.

The term “grossing” has long been used in pathology to refer to the initial examination and preparation of tissue specimens for microscopic analysis. However, this term has negative connotations and can be off-putting, insensitive, or perceived as inappropriate to patients and nonpathologists. In addition, the word “gross” is often associated with unpleasant or repulsive things, and using this term to describe a crucial step in the diagnostic process can be unintentionally stigmatizing. Therefore, although I understand that the term “grossing” has a specific meaning in our field, I believe it is important to choose positive and medically appropriate language whenever possible, especially when patients have more access to medical records.

By contrast, the term “macroscopy” accurately describes the process of examining tissue specimens at a macroscopic level while avoiding any negative connotations. Macroscopy is hardly a new term, because it is used in Spanish-speaking pathology practices. Using this term would help to pivot the language used in our field toward a more positive, respectful, and accurate representation of the critical work that we do. “Macroscopy” carries importance, a call for expertise and accuracy on par and complementary, not inferior, to microscopic descriptions. “Gross description” becomes “macroscopic description,” and “gross” becomes “macro” as an abbreviated form. The verb “to gross” becomes “to macro.” The noun “grosser” should be avoided, and instead, the resident is “on macros/macroscopy.”

As medical professionals, it is our responsibility to communicate in a way that is clear, accurate, and respectful to all parties involved. By using more positive language, such as “macroscopy,” we can help reduce stigma and promote a more professional and medically appropriate communication as an approach to patient care. I urge the pathology community to consider adopting the term “macroscopy” as a replacement for “grossing” in all academic and clinical settings. By doing so, we can create a more inclusive and compassionate culture in our field and better serve the needs of our patients.