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

To the Editor.—I read with interest the letter to the editor from Jorge E. Novo, MD, in the October 2023 edition of the Archives of Pathology & Laboratory Medicine.¹  I congratulate him for his insightful commentary regarding the use of the term “macroscopy” in lieu of “grossing.” His letter struck a chord with me, and I wholeheartedly endorse his suggestion but offer “macroscopic description” instead of “macroscopy.” In addition, I would like to expand the discourse to underscore the indispensable role and significance of macroscopic photography during specimen dissection.

As a pathologist who has worked on 4 continents over several decades, I have long recognized the critical role that macroscopic photography plays in our field. I have taken hundreds of thousands of pathology photographs and have used a lot of them during clinicopathologic meetings. I cut the specimens to mirror radiologic images, and the images I used at such meetings were highly appreciated because my clinical colleagues found them very valuable.

In contemporary health care institutions, tumor board meetings have become a common and an invaluable forum for interdisciplinary collaboration. Surgeons, oncologists, radiologists, pathologists, and other health care workers come together to discuss complex cases and make crucial decisions regarding patient management. It is during these gatherings that the impact of macroscopic dissection, coupled with high-quality photography, is particularly pronounced.

Pathologists are often asked questions by their colleagues regarding the nature and extent of the disease in a patient. These questions are directly related to patient management and can range from the extent of tumor invasion to the presence of critical anatomic structures. The answers to these questions frequently lie in the macroscopic dissection of the specimen.

Here, the role of photography becomes indispensable. A well-documented series of high-resolution, purposefully taken images can serve as a powerful visual aid during tumor board meetings. These photographs provide a clear and concise representation of the specimen’s macroscopic features, offering an in-depth understanding of the disease process.

Furthermore, photographs facilitate precise communication among team members, ensuring that everyone is on the same page and has a shared visual reference. This is particularly important when discussing complex cases where the treatment strategy may hinge on the exact extent and characteristics of the disease.

In essence, photography during specimen dissection is more than a tool for documentation; it is a critical element that directly influences patient management decisions. By capturing the macroscopic features accurately and comprehensively, pathologists contribute significantly to the success of tumor board meetings and, subsequently, to the overall well-being of the patients under their care.

In light of these considerations, I encourage pathologists to not only adopt the term “macroscopy” but also recognize the pivotal role of photography in the process. Moreover, institutions should invest in the necessary resources and infrastructure to support high-quality imaging during specimen dissection.

I believe that by acknowledging and harnessing the power of photography during macroscopic dissection, we can enhance the accuracy of our reports, provide better support to our colleagues in other specialties, and ultimately improve patient outcomes.