GEWF colon CA lymph node fixative
A lot of us on the Pathology (PATHO-L) and Histology (HistoNet) listservers
use special fixatives to facilitate retrieval of lymph nodes from colorectal
cancer specimens. A group from the University of Western Ontario (at London)
has an interesting method I'd like to try out. What's different about this
technique from others I've seen is the use of the special fixative as a
postfixative after overnight formalin fixation, a real convenience if you
receive a lot of half-fixed specimens such as most of us do.
"GEWF solution: an inexpensive, simple, and effective aid for the retrieval
of lymph nodes from colorectal cancer specimens."
Ken J. Newell, Barry W. Sawka, Brian F. Rudrick, David K. Driman.
Arch Pathol Lab Med, May 2001;125:642-645.
GEWF solution consists of:
100 parts absolute ethanol [or reagent alcohol, I'm sure]
34 parts water
16 parts strong (37%) formalin
10 parts glacial acetic acid
mixed in the order listed [why does that matter?]
Open, pin out, and fix the specimen overnight in neutral buffered formalin
detach the pericolic fat
postfix it overnight in GEWF solution
dissect out lymph nodes
The technique increased the average number of nodes recovered from 7 to 10,
doubled the number of positive nodes found, and decreased the average size of
positive nodes from 7 m to 5 mm. The authors found no interference with
immunohistochemical stains.
Bob Richmond
Samurai Pathologist
Knoxville TN
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