RE: [Histonet] Revealing lymph nodes

From:"Weems, Joyce"

We use Clark's - alcohol and acetic acid - Carnoy's without the
chloroform. It does fairly well.. j

-----Original Message-----
[] On Behalf Of Luck,
Greg D.
Sent: Wednesday, March 01, 2006 4:56 PM
Subject: FW: [Histonet] Revealing lymph nodes


-----Original Message-----
From: Luck, Greg D. 
Sent: Wednesday, March 01, 2006 1:42 PM
To: 'Marshall Terry Dr, Consultant Histopathologist'
Subject: RE: [Histonet] Revealing lymph nodes

Oh it's always something,
We use PenFix from R.A. with marginal improvement in helping distinguish
lymph nodes from surrounding tissues (obviously "fat" in particular).
you're willing to tolerate a bit more obnoxious dissection experience
add a
little Trichloroacetic Acid to your Davidson's or try some Tri-Fix which
have custom made for us by American Mastertech.  It's nearly as
effective as
"Disect-Aid" but less unpleasant to work with.  I know how impressed
many of
our surgeons are when we're able to consistently identify and
lymph nodes from those problematic (from a node shuckin' perspective)
anterior and abdominal perineal resections.  Good luck, Greg Greg Luck,
HT(ASCP) Anatomic Pathology Supervisor Deaconess Medical Center 800 W.
Ave Spokane, WA 99204 Phone 509.473.7077 Fax 509.473.7133

-----Original Message-----
From: Marshall Terry Dr, Consultant Histopathologist
Sent: Wednesday, March 01, 2006 5:10 AM
Subject: RE: [Histonet] Revealing lymph nodes

This is an opportune discussion, because I have tried Davidson's in the
and could see no difference whatsoever between before and after.
In the last few days we have made up a new batch, modified slightly to
into consideration JK's view that there should be a greater proportion
Same result, no difference whatsoever. No clearing, no lymph nodes going
white - nothing.

Is this the Emperor's new cloths?

PS I only tried it in the first place because of the regard I have for
anything uttered by Bob Richmond.

Dr Terry L Marshall, B.A.(Law), M.B.,Ch.B.,F.R.C.Path  Consultant
Pathologist  Rotherham General Hospital  South Yorkshire  England

-----Original Message-----
From: []
Sent: 28 February 2006 18:58
Subject: [Histonet] Revealing lymph nodes

I think that a clearing fixative (such as the examples already given;
are also commercial products) is essential for finding the small lymph
that are often positive for colon cancer in colon resection specimens.
Remember that just one tiny positive lymph node upstages the tumor, and
makes chemotherapy mandatory - so there's a real patient care decision
involved here.
In my travels as a locum tenens pathologist I noted that about half of
pathologists were using clearing fixatives, and about half were not. As
as I know there have been no official pronouncements on the subject.
Clearing fixatives are less necessary in axillary dissection material
breast cancer - the specimensare smaller and the lymph nodes - and
metastases - are usually much bigger. The mesenteries from a colon
resection are voluminous and hard to search through.
Bob Richmond
Gastonia NC
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