The signalment and historical narrative given at the time of sample submission provide the framework in which the pathologist views a case. A complete, concise history is a tremendous aid to the pathologist and, in some cases, is critical for arriving at an accurate diagnosis. A gross description and diagram of the anatomic location and shape of the mass help provide a mental image of the lesion. A short description of any previous treatments and the response to treatment should also be included. A comment regarding the etiologic agent or pathologic process suspected is a valuable addition to the history, since it summarizes the clinical impression of the practitioner. Comments regarding any additional tests being performed, such as bacterial or fungal culture, or adjunctive therapies, such as post-surgical cryotherapy, are also useful to the pathologist. Providing case numbers or a copy of the report of previous submissions helps the pathologist follow the disease progression. Finally, if any legal actions are being considered related to the case, it is helpful to alert the pathologist to this fact.

From the pathologist’s perspective, the larger the sample size, the better the chance of examining an area that will yield an accurate diagnosis. Submission of the entire lesion is preferable. Surgical excisions with wide normal tissue margins will provide more tissue for histologic examination, will allow margins to be examined for presence of tumor cells, and may be curative. If an incisional or core biopsy is to be performed, selection of the biopsy site is crucial. It is critical to avoid areas of necrosis, often found within the center of the mass and characterized by soft, friable, or ulcerated tissue. Instead, multiple samples from the edges of the lesion are preferred and will provide tissue that is more likely to contain viable, proliferating cells with diagnostic architectural features. An exception is when a mass within bone is to be sampled. In these cases, the tissue most useful for biopsy is usually situated near the center of the mass.

Handling biopsy samples gently helps to preserve normal tissue architecture. Samples that have had excessive pulling or crushing forces applied will have distorted tissue architecture that may prevent accurate diagnosis or margin evaluation. The use of electrocautery or laser energy causes coagulation of tissues, which results in loss of the fine features of cells.