Re: [Histonet] recording Bx pieces

From:"Joe Nocito"

what I do at grossing is write in pencil, on the side of the cassette, the 
number of pieces in the cassette, especially for G.I bxs. What I was putting 
in, wasn't coming out. A thorough investigation was done finding out that 
the embedder wasn't looking at the lids and sure enough, a piece was stuck 
there. I did correct the problem.

----- Original Message ----- 
From: "Marshall Terry Dr, Consultant Histopathologist" 

To: "Charles.Embrey" ; "Tarango, Mark" 
; ; 

Sent: Wednesday, December 05, 2007 10:54 AM
Subject: RE: [Histonet] recording Bx pieces


I think that although your points are well taken (and partly addressed
by me in a previous post), you are over-dramatising, It is not written
in stone that what goes in has to come out. Since it is well known that
bits disappear because they  are mucus, fibrin, faeces or whatever, or
that parts break off, then what is really the problem?  In the scenario
you outline, there is no reason for a lawyer to get involved, and if he
did, no reason to pursue the line you talk about, and even less reason
to jump to the conclusion that one (the extra) piece is from elsewhere.

If you worry about such things, you should get yourself a calliper with
a Vernier and measure the fragments carefully; then a little arithmetic
will see things right:-)

Certainly, these worries do not override the necessity for all bits to
be looked at, and you need to know how many there were to miss one.


-----Original Message-----
[] On Behalf Of
Sent: 05 December 2007 16:28
To: Tarango, Mark; Marshall Terry Dr, Consultant Histopathologist;;
Subject: RE: [Histonet] recording Bx pieces

I have been reading this with great interest.  I think the issue of
documenting number of biopsy pieces is more complex than it appears on
the surface and the practice could actually become a liability as well
as a help.  Let's just say, for example, you document 6 prostate core
biopsies and during processing one of those little blighters breaks in
two.  Now the block and slide have what looks like 7 prostate biopsies.
If one of those cores show cancer and a lawyer looks at the records he
could argue that the seventh core on the slide is actually from a
different case and you have just caused his client to suffer great
emotional stress.  How many times has that little fleck of gi biopsy
turned out to be mucus only to dissolve and vanish in the processor.
Suddenly the 8 gi biopsy fragments become 7.  My thoughts and feelings
are that if I document a specific number at gross I have now obligated
myself to that specific number even though things, beyond anyone's
control, can occur during processing to change that number and come back
to haunt me.  Once something is documented and on the report you will be
held accountable for that documentation and any variation will have to
be explained and documented also.

Charles Embrey, PA(ASCP)

-----Original Message-----
[] On Behalf Of Tarango,
Sent: Tuesday, December 04, 2007 1:22 PM
To: Marshall Terry Dr, Consultant Histopathologist;;
Subject: RE: [Histonet] recording Bx pieces

Sounds to me like she's working with some lazy Pathologists whom do not
want to record the number of pieces during grossing.

Mark Adam Tarango HT(ASCP)
Histology & IHC Supervisor
Nevada Cancer Institute
One Breakthrough Way
Las Vegas, NV  89135
Direct Line (702) 822-5112
Treo (702) 759-9229
Fax (702) 939-7663

-----Original Message-----
[] On Behalf Of Marshall
Terry Dr, Consultant Histopathologist
Sent: Tuesday, December 04, 2007 7:17 AM
Subject: RE: [Histonet] recording Bx pieces

The question would have been better in plain English, but even then, is
missing essential detail without which the question is unanswerable.
Submitted to whom, by whom, in what time interval, and what is being
regarded as a biopsy in this particular context?


-----Original Message-----
[] On Behalf Of
Sent: 04 December 2007 15:02
Subject: [Histonet] recording Bx pieces

Could someone please give me a "really" good reason to relay to a
pathologists as to why it is beneficial to record the # of bx's
submitted??  ASAP! :)

Karen Adams
Pathology Laboratories West
9303 Park West Blvd
Knoxville, TN 37923
(865) 690-2111 FAX (865) 691-1623
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