The original problem as described, is almost certainly a fixation issue.
I can appreciate the desire to provide a diagnosis as rapidly as
possible, established practices still have to be followed. Treating any
tissue, regardless of its size for 15 minutes in formalin, cannot and
will not fix it. It is just not possible. It has been proven, many, many
times by numerous workers, that adequate formalin fixation requires
several hours even with tiny biopsies. Tissues that are "immersed" in
formalin for 15 minutes and then transferred to alcohols are fixed by
the alcohols, not by the formalin.
Again, it has been shown repeatedly, that alcohol is not a good fixative
for solid tissues. It is great for smears, blood films, aspirates, etc,
but is a very poor choice for solid tissues, even tiny biopsies. I would
hope that the clinical significance of the biopsy would encourage the
technologists to employ procedures that would ensure an end-product of
the highest quality. Speed and a rapid turn-around-time are admirable
goals, but not at the expense of quality!
I would strongly suggest that the current processing schedule be
re-designed and that a much longer time be assigned to the fixation
step. A second suggestion would be to use slightly warm formalin to
increase the speed of fixation. Raising the temperature of the formalin
to 37 degrees, will increase the speed of fixation noticeably. I would
not suggest raising the temperature further without running some trial
As an after thought, I have read all the responses to this question, and
I have not interpreted any of them as "snide or condescending". Several
of them have been given with a "tongue in cheek" attitude, but that does
not make them snide or condescending. I fully agree with Terry's comment
that a very professional and helpful suggestion can be made with humor
and without the need for formality. Anybody who subscribes to Histonet
on a regular basis should know by now that some of the most valued
contributors use a dry, English, sense of humor to present their
> 15 mins will not fix anything!!! That's your major issue
> Take care
> From: firstname.lastname@example.org [mailto:email@example.com]
> Sent: 20 March 2008 12:10
> To: kemlo; firstname.lastname@example.org; Histonet@pathology.swmed.edu
> Subject: RE: [Histonet] Train to catch?Yes!
> I guess I am surprised at all the comments about this being such a rush
> processing schedule. These are very small needle core bxs, and the
> processing takes about 3 hours to complete. Is anyone else using hand
> processing willing to share their protocol please?
> -------------- Original message --------------
> From: "kemlo"
>> Oh so renal biopsy stat!!!
>> Is life really that hectic? Maybe a little more time spent gets the
>> result rather than rushing and ruining.
>> Tortoise and the hare?
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