Re: small biopsies

From:RSRICHMOND@aol.com

The grumpy old pathologist has been meaning to respond to this very 
interesting thread.

Pathologists - myself included - know scandalously little about embedding - 
which tends to occur at times of day when pathologists' plasma caffeine 
levels are at panic-value low levels. I've always thought that 
histotechnologists do surprising well in getting things oriented in the wax, 
particularly when they work without a tissue log that tells them what the 
specimens are as they go.

I've used agar embedding in a number of laboratories. For the pathologist 
grossing, it's impractically time-consuming. In some histotechnology labs, it 
seems to cut without difficulty, while others have trouble with it, and I 
don't know why. Usually used trypticase soy agar from the microbiology lab, 
but haven't seen agar embedding for more than 15 years now.

Empty tea bags used to be available from the Salada tea people. They're made 
of paper made from a very long-staple fiber, abaca fiber. I wonder if there's 
another source of abaca-fiber paper, perhaps as an art supply item. Jenny 
Oblander, tell us more about >>I switched to permanent paper, it can be 
purchased from beauty supply stores.<<

Biopsy specimens are indeed getting smaller, and this trend will continue. It 
continues to amaze me that enormous amounts of effort are devoted to 
obtaining these ever smaller specimens, and yet there is no pressure on us to 
change our methods so as to optimize recovery of them. Once again, nobody 
else in health care has the slightest idea what it is we do.

Both pathologists grossing and histotechnologists embedding badly need stereo 
dissecting microscopes. I have never seen one available for either purpose, 
in perhaps fifty laboratories in my "career". The need for such optical 
assistance increases as we all get older. Some pathologists I work with can 
barely see to gross at all, but they have no optical assistance. (At the age 
of 62, I can still gross with reading glasses, because I am so nearsighted 
that I can examine small specimens with my unaided eyes.) In contrast, 
surgeons - particularly otolaryngologists, ophthalmologists, and plastic 
surgeons - routinely do surgery using quite powerful microsc

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