Re: GI biopsy blues

From:Bryan Hewlett

We process and cut large numbers of GI biopsies daily in three group laboratories. Only one lab has a processor dedicated to GI biopsies, the other labs process along with the routine surgicals. All three sites sporadically have some days with microchatter(venetian blinding). All sites use NBF for fixation, all use the same processing reagents, all cool the blocks on ice trays, no ammonia water.
This cuttting artifact is independent of processing times, it is seen more readily after short(less than 4 hours) fixation times in NBF. After all, the shorter the time in NBF the greater the fixation in processing alcohols!  But the cause is still operator and workload dependant.
The effect is mainly seen on very busy days with technologists who are under pressure, either real or imagined, to 'get the work out'. In every case, when the block has been re-cut and the same operator instructed to cut SLOWLY, the microchatters have been absent!!
I would recommend that when any tech in your lab has a microchatter episode with a case, carefull, SLOW, re-cuts of the block will solve the problem.
Bryan R. Hewlett
Technical Specialist
Department of Anatomical Pathology
Hamilton Regional Laboratory Medicine Program.
Ontario, Canada
----- Original Message -----
Sent: Wednesday, April 24, 2002 5:53 PM
Subject: GI biopsy blues

Hi Everyone,
I am faced with some GI microchatter that has occurred recently.  This is a sporadic matter but as of this afternoon, I am currently ensued in a battle with my lab manager over the soaking of blocks in ammonia water. She thinks everything needs to be soaked, I say it is not necessary but she is insistent and I want to change her mind. I see no need to expose myself to ammonia fumes unecessarily.

I have one tech that soaks everything in ammonia water and there is no difference between her slides and the ones I cut that are faced and placed onto wet ice. I am literally at wits end regarding this subject and do not want to submit to "ingesting" ammonia water if at all possible. Are there any articles written on ways to prevent microchatter? One last thing I should mention is that we process our GI biopsies along with our other larger samples (breast, colon, thyroid, etc) and everything else comes out looking great.  I am not at work at the moment and can't remember our processing schedule right of the top of my head but the solutions we are using is as follows: formalin x2, 80% ETOH, 95% ETOH x2, ABS x3, xylene and of course infiltrating with paraffin. I will post the exact scheduling and temps later as I can't recall those now. 

Any suggestions would be appreciated! Thanks in advance,

Donna Barlow
Section Head, Raleigh Community Hospital

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