Re: [Histonet] Frozen Section controls

From:"Joe Nocito"

I haven't been flamed in a while. Today seems like a good day. I took the pleasure of pasting  these CAP questions to my answer. 

ANP.21250             Phase II                                                                                            N/A   YES   NO


Examine several prepared slides.  Are they of sufficient quality for diagnosis?


NOTE:  Histopathology slides must be of adequate technical quality to be diagnostically useful.  Criteria to evaluate include adequate tissue fixation, thickness of sections, absence of interfering tissue folds and tears, and good staining technique.  For hematoxylin and eosin and other routine stains, the patient slide serves as the internal control to ensure adequate staining technique.  


The sections must be cut from sufficient depth in the block to include the entire tissue plane.

ANP.21400             Phase II                                                                                            N/A   YES   NO


Are positive controls run routinely on all special stains, with reactivity results documented, and are they verified for acceptability before reporting results?


NOTE:  A positive control slide must be run at the same time as any single or group of slides stained with the same special stain.  The tissue chosen for the special stain control slide must be appropriate in type and amount.  Both the control slide and the test tissue slide must be judged technically acceptable before the results of the special stains are reported.

If your metachromatic stain is part of your routine frozen procedure, then it is a routine stain. I mean, you use routinely, don't you? If not, then I would put it in my procedure as a routine stain, make a copy and send it to CAP with your deficiency package. Problem solved.


----- Original Message ----- 
From: "Sheila Haas" 
Sent: Thursday, July 10, 2008 9:50 AM
Subject: [Histonet] Frozen Section controls

Here's a new one on me. At recent inspection I was told we should be running a frozen section control slide with our metachromatic stain daily. The inspector was at an off-site facility where we do not have capability of keeping tissue frozen from one day to next not to mention that the metachromatic stain is not permanent (he told me we had to hold slides for 2 years). I also explained that our pathologists do indicate acceptability of stain daily but he said that was not sufficient since the pathologist was looking at patient tissue instead of control tissue. When I explained issue of inability to keep tissue frozen (we have numerous off-site locations) he said to cut an initial, superficial slide of patient tissue to use as control then proceed with patient frozen section after approval of stain. Any one heard of this? Seems a bit much to me.

Sheila Haas
Laboratory Supervisor

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