re:[Histonet] Isopropyl (again)

From:"Stephen Peters M.D."

I cannot help you with the isopropal question. But let me ask you are you trying to speed 
up your turn around time on breasts or are you having trouble cutting under processed 
 If you are trying to speed up turn around time you picked a bad tissue to be in a 
rush with! Reading a miserably processed breast specimen is a frustrating and risky 
buisness frought with potential legal repercussions. I think your pathologists would
 agree with this. I suggest a little patience. If the surgeons are busting their chops it is time 
for a little histology lesson for the surgeons. I like to tell my surgeons I will be be happy to give a rush diagnosis, but if they would like the correct diagnosis that will take a bit longer!
If poorly processed tissue is the problem then it is a matter of  all the things you already know. The sections should  be cut no more than 3mm thick across the entire section
 ( not just the edge). Once cut sections should be give adequate fixation in clean 
formalin before putting it in the processor. Over night if possible. Processor solutions should 
be clean and changed at appropriate intervals. Baskets should not be overstuffed if possible especially with, cassettes filled with large samples. If you have multiple processors at your disposal you may want to sequester these cases an adjust the program and solution 
changes until you are satisfied with the result.
If your grossing staff leaves intact specimen sit overnight  in the fixative it arrived in and 
then cuts it the next day, fixation will often not be adequate because inadequate amout
 of formalin, formalin which has been weakened by dilution or inability of the formalin 
to penetrate and fix a thick piece of tissue. 
I am sure you already know this . Make sure your grossing staff do to.

Stephen Peters M.D. 
Vice Chairman of Pathology
Hackensack University Medical Center 
201 996 4836
Pathology Innovations, LLC 
410 Old Mill Lane, 
Wyckoff, NJ 07481 
201 847 7600 

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