Re: [Histonet] delivery time of last tray of H&E -FIXATION

From:"Katri Tuomala"

The constant argument from pathologists is the all important TAT (turn 
around time). Fortunately the message is slowly getting through due to 
problems arising with immunohistocemistry and inadequate fixation. Fixation 
recommendations for Her2 testing is a step in the right direction and 
lymphoma protocols (fix one piece in NBF minimum overnight) in our lab has 
been in place for some years now.
So, there's hope, but you are right, histotechs have to keep getting the 
message through to people, who make policy changes. It seems that current=20
TAT is not there to serve the patient, but some other entity unknown to me. 
Just think, if it were your specimen, surely you could wait an extra day for 
a proper diagnosis.
Just my opinion.

Katri Tuomala
Hamilton, Ontario, Canada

----- Original Message ----- 
From: "Tarango, Mark" 
To: "Katri Tuomala" ; ; 

Sent: Wednesday, March 28, 2007 7:56 PM
Subject: RE: [Histonet] delivery time of last tray of H&E -FIXATION

Can't histonetters stick together and enforce proper fixation?  We could 
start a campaign with a clever slogan, "Force Fix!" maybe.  Get NSH to 
sponsor us and make buttons or something.  It can be the histo theme for 
2008.  We could have informational flyers explaining to 
pathologists/dermatologists/whomever that getting the specimen wet with 
formalin doesn't quite ensure proper fixation.

I mean, seriously though, it is a BIG problem.  In each lab I've worked, 
I've seen tons of problems that could have been prevented by simply fixing 
the tissue adequately.

Who is going to do anything about it but us?

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

-----Original Message-----
[] On Behalf Of Katri 
Sent: Friday, March 23, 2007 4:16 PM
Subject: Re: [Histonet] delivery time of last tray of H&E

I totally agree with you Gudrun, I think too many samples get inadequate
fixation and processing compromising the patients' samples. There has been
an improvement in our lab in regards to larger specimens. Most of them are
now opened up, fixed overnight and processed in an "extended program" in
VIP. What a joy to cut them, no more fatty holes to hand in! However many
biopsies still don't get adequate fixation, particularly if IHC is


Katri Tuomala, Hamilton, Ontario

----- Original Message ----- 
From: "Gudrun Lang" 
Sent: Friday, March 23, 2007 11:43 AM
Subject: AW: [Histonet] delivery time of last tray of H&E

And then ... the patient has to get an appointment for the talk about the
report with his/her doctor or has to get a date for the necessary surgery.
In most cases there is no reason for such short TATs.
Why all this hurry? The specimen aren't properly fixed, people have to work
in nightshifts; There is no tumor, that grows in such a speed ...

My point of view.

Gudrun Lang

Biomed. Analytikerin
Akh Linz
Krankenhausstr. 9
4020 Linz
-----Ursprüngliche Nachricht-----

[] Im Auftrag von Cheri
Gesendet: Freitag, 23. März 2007 14:44
An: 'Marshall Terry Dr,Consultant Histopathologist'; 'Akemi Allison-Tacha';
'Rene J Buesa'; 'Galiotto, Laura';
Betreff: RE: [Histonet] delivery time of last tray of H&E

Turn around time Terry. For us it's about getting the slides to the
Pathologist early so they may order whatever additional testing needed and
still get a hard copy report to the Clinician by the end of the day. We have
24 hour turnaround for most cases. Cheri

Cheri MIller HT ASCP Histology Supervisor, Phys Laboratory. Omaha Ne

-----Original Message-----
[] On Behalf Of Marshall
Terry Dr,Consultant Histopathologist
Sent: Thursday, March 22, 2007 12:28 PM
To: Akemi Allison-Tacha; Rene J Buesa; Galiotto, Laura;
Subject: RE: [Histonet] delivery time of last tray of H&E

This is all bloody unbelievable.  Don't any of you sleep?
What is the point of working at night?


-----Original Message-----
[] On Behalf Of Akemi
Sent: 22 March 2007 17:25
To: Rene J Buesa; Galiotto, Laura;
Subject: Re: [Histonet] delivery time of last tray of H&E

René--That was similar to the protocol I followed in the old days before
24/6 .  We provided rush's 1st, followed by bx's by 8AM, we did however,
provide special stains and recuts and IHC's by 2-3 PM, depending if it
wasn't a lengthy procedure.

If you have off site facilities to provide for, that is a different
situation.  You have to work around courier sheduals for delivering to off
site facilities.  Everyone needs their slides and time is money!!

With the new microwave processing technology that is now in use, there has
been a shift to having the majority of staff starting at 10 PM at night.

The day shift is minimum.  IHC is done during the day shift, after the
pathologist has determined to do so.
In most situations, a battery of IHC's tests are pre-set, as well as with
special stains.

Akemi Allison-Tacha BS, HT (ASCP) HTL
Phoenix Lab Consulting & Staffing
Specializing in Histology, SS, IHC, & Microarray Madison, WI
Tele: (925) 788-0900

--- Rene J Buesa  wrote:

> Laura:
>   For a laboratory I used to manage with quite similar annual workload
> we had the following
> schedule:
>   1- last tissue accepted at 7:00 PM;
>   2- two VIPs atarting with delay to be finished at 4:00 AM next day;
>   3- Rushes ready for the pathologists at 8:00 AM next day;
>   4-All slides ready, the latest, at 1:00 PM.
>   5- All IHC ready by 2 PM
>   6- all HC ready by noon.
>   René J.
> "Galiotto, Laura"  wrote:
>   Hello Fellow Histo Tech's,
> Will anyone be willing to share the delivery time of the last tray of
> H&E for the days workload to the pathologist reading them?
> What is your cutoff time for specimen acceptance?
> What is your annual case workload?
> I am trying to improve the TAT from specimen gross to the H&E
> delivered to the pathologist. Unless we change the cutoff time I can
> not see how I can do this? Any suggestions?
> We process 22,000 cases a year an average of 280 blks a day consisting
> of types of tissue.
> Please Help
> Laura
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