RE: [Histonet] cross contamination

From:"Marshall Terry Dr, Consultant Histopathologist"

This is my practise. It is not held out to be perfect, but is honest.

If it's very obvious, as in a case yesterday with a colonic gland sticking onto the surface of a piece of skin, I ignore it in all respects.

If less than an expert might misconceive it, I mention it. E.g. "a fragment of endometrium, which is clearly a cross-over from another patient is noted."

The crunch comes when you suspect it might be from another patient but you can't know it. There is no easy way out of this one - you have to tell it as it is.  Then wait for the "can't you do a test?" - "would immunochemistry help?" - "can you do DNA testing" - "what do I tell the patient" and dozens more possible witless comments or questions.

As to the language, cross-over or cross contaminant seems to cover any of cutting board, processing and water bath contamination. 
If you can see it in the block you can be more specific, but there is little point to being so.

Luckily, the bad scenario happens infrequently.
The worst scenario, where the cross-over is not recognised or suspected seems even less frequent, and of course, can only be suspected in retrospect.

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

-----Original Message-----
From: Scholz, Stephen J. []
Sent: 14 January 2005 15:41
Subject: [Histonet] cross contamination

Hello all;

I have a question for the masses regarding cross contamination in surgical specimens.  I would like know how others are handling situations when a small fragment from one specimen gets embedded with a different case. (probably stuck on  forceps)  When it is obvious upon reading the slide that the fragment doesn't belong does the Histologist remove it?  Does the Pathologist comment in the Path Report and what is the common language used (debris, cross-contaminate, ect)?  What is done from the Pathologist perspective when the contaminate tissue is similar but logic dictates that it doesn't belong with that case. Again, is it mentioned in the report and what language is used to state the Pathologist believes there is incorrect tissue fragments with the case?

I eagerly await your replies,

Stephen J. Scholz HT(ASCP)
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