The Stock Jar

Authors: Alex K Williamson MD & Meagan Chambers MD

The following pieces of tissue should be retained in a case’s stock jar for each organ or tissue examined in the autopsy. Grossly abnormal tissue can be included in these samples; if there is no gross pathology then normal-appearing tissue should be sampled.

Any unused cassettes can be kept in the stock jar, as well, for easy reference and retrieval should you have to return to the stock jar for further sampling.

Guidelines

• Ensure compliance with any autopsy restrictions noted on the consent form.
• For fetal autopsies, the entire organ block should be retained.
• Retain samples of any gross lesions; for anatomically relevant relationships, an entire organ or block may be saved, as appropriate.
• “Pieces” of tissue should be up to 1 cm³ (e.g., thyroid), OR up to 2 x 2 cm in area (e.g., diaphragm).
• Take “neat” and well-trimmed pieces; occasionally autopsies are performed “again” by medical examiners or consultant pathologists, and their review of the sampled organs can form an initial impression of your abilities as either a sloppy or neat pathologist.

The following recommended stock jar contents represents the minimum sampling that should be conducted in adult autopsies performed in hospitals.

ADULT AUTOPSY STOCK JAR CONTENTS

1. Heart
   • Base, opened along lines of flow
   • One transverse section to include each ventricle
   • Samples of each coronary artery, to include site(s) of worst remaining stenosis
2. Aorta – one piece trimmed from edge (about 5 cm long)
3. Diaphragm – one piece
4. Larynx and proximal trachea
5. Lungs
   • Shaved hilum of each
   • One complete (sagittal) section of each lobe
6. Liver – one complete (coronal) section
7. Gallbladder – one piece and representative stones, if present
8. Spleen – one complete (coronal) section
9. Pancreas – one piece of head and tail
10. Kidneys – one half of one sagittal section of each
11. GI tract
    • GEJ, to include distal esophagus and cardia
    • One piece of body and antrum
    • Segment (5 cm) of proximal small bowel
    • Segment including terminal ileum and cecum (5 cm each) to include appendix
    • Segment (5 cm) of distal colon
    • One piece of rectum
12. Thyroid – one (transverse) section of each lobe
13. Adrenals – one (transverse) section of each
14. Urinary bladder – one piece
15. Prostate – one piece including central and peripheral zones
16. Uterus – one piece including endometrium, myometrium, and serosa
17. Testes/ovaries & fallopian tubes – one piece of each
18. Bone – remnant after trimming histology section
19. Skin – remnant after trimming histology section
20. Muscle – remnant after trimming histology section
21. Breasts – remnant of each after trimming histology section
22. Lymph nodes
    • If no lymphadenopathy, then any one node
    • If adenopathy, then one cervical, mediastinal, abdominal, and pelvic node