Re: fixation of frozen sections for Mohs surgery

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Gayle Callis asks:

>>What fixatives, nonformalin, are being used for frozen sections in MOHS
procedures?? - Also, what is your favorite Toluidine blue stain proceudre for 
MOHS procedure?<<

Uh-oh, there Gayle goes again, using the worst four letter word in surgical 
pathology. - Mohs is the name of the doctor who invented the technique, not 
an acronym "MOHS". Anybody who's up against a Mohs surgeon should look at Dr. 
Mohs's book, just to see what you're dealing with. (In my opinion, the only 
theatre Dr. Mohs should ever have cut in was Palo Mayombe.) - Actually, in my 
personal experience most procedures billed as Mohs procedures are nothing of 
the sort, just the surgeon trying to bill a higher code.

Anyway, if I have to work with a Mohs surgeon and suicide isn't an option, 
the blue Diff-Quik II solution works adequately to identify basal cell 
carcinoma or the lack thereof. (A buffered toluidine blue solution would do 
as well.) The main thing is speed - accuracy is extremely secondary. - I'd 
just pass the sections through alcohol by way of fixation.

On second thought, I think I'll go read some more of that Netherlands suicide 
Web site that's been all over the's slow going, Dutch is hard to 

Bob Richmond
Samurai Pathologist
Knoxville TN

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