Re: [Histonet] Re: breast processing
In my recent past, I worked with an excellent pathologist who would thinly
(5-10 cm) "breadloaf" mastectomy and other large breast specimens, placing
paper towels between each slice to wick in the formalin. These specimens
would fix at least overnight in large closed 'tupperware' vats before
additional grossing early in the a.m. We would then fix the cassettes in
alcoholic formalin for the rest of the day (6-7 hours) before routine
processing. (No need to go back into 10% NBF - started off in 70% on the
processor. Specimens like this were processed for 1 hour each station
(under vacuum), and I don't recall having any underprocessed/underfixed
tissues. Don't tell the kiddies, but in my more distant past, when I
did come across a block that was underprocessed, I'd take a good whiff to
see what solution (alcohol, xylene, formalin) I smelled in the block, and
back it up to that point only. If I smelled xylene, it needed more time
in paraffin - plopping it back into a couple of fresh changes of paraffin
for a couple of hours seemed to do the trick. If it smelled like
alcohol, it was backed up to fresh xylene for a couple of hours, then
brought forward again. Ahh, the good old days. Thanks Flonase.
Sent by: firstname.lastname@example.org
05/12/2004 11:03 AM
Subject: [Histonet] Re: breast processing
although I recall seeing this published in the Journal of
Histotechnology, I also don't agree with teh idea of squeezing the fat
out of fatty breast tissue. Other labs have also just soaked them in
molten paraffin overnight, sometimes resulting in burned looking tissue.
If they are not adequately fixed and processed well in the first place,
any of this type of trauma can't be good for the specimen. I do like
the idea of adding a xylene step in the processing schedule between the
alcohols, never thought of that. Brilliant!
I do suggest that some labs that have particular difficulty with their
pathologists routinely not grossing in these specimens well, use this as
a Quality Improvement marker. I would talk with the Lab Director and
Head Pathologist about doing this first because you will need their
support, but that might help supply the pressure (from somewhere besides
the techs) to improve their technique.
Bottom line is, we do what is best for the patient.
Managing Director Histology Facility
Stowers Institute for Medical Research
1000 E. 50th St.
Kansas City, Missouri 64110
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