Recognition and discrimination of tissue-marking dye color by surgical pathologists: recommendations to avoid errors in margin assessment.
OBJECTIVES
A variety of tissue-marking dye (TMD) colors can be used to indicate surgical pathology specimen margins; however, the ability of pathologists to differentiate between specific microscopic margin colors has not been assessed systematically. This study aimed to evaluate pathologists' accuracy in identifying TMD color and determine the least ambiguous combinations of colors for use in surgical pathology.


METHODS
Seven colors of TMD were obtained from three manufacturers and applied to excess formalin-fixed uterine tissue. Study blocks contained multiple tissue pieces, each marked with a different color from the same manufacturer. Slides were assessed by eight participants for color and color distinctness of each piece of tissue.


RESULTS
Black, green, red, and blue TMDs were accurately identified by most participants, but participants had difficulty identifying violet, orange, and yellow TMDs. Black, green, and blue TMDs were most commonly rated as "confidently discernable."


CONCLUSIONS
Pathologists have difficulty identifying and distinguishing certain colors of TMDs. The combined use of certain colors of TMDs (yellow/orange/red, blue/violet, and red/violet) within the same specimen should be avoided to decrease the risk of inaccurately reporting specimen margins.
['Williams|Andrew S|AS|', 'Hache|Kelly Dakin|KD|']
D004396:Coloring Agents D006801:Humans D010340:Pathology, Surgical
Surgical pathology Gross examination Margin inking Specimen handling Staining and labeling