RE: [Histonet] Number of Blocks Submitted by PA

From:"Marshall Terry Dr, Consultant Histopathologist"

Whatever the American books say - halve it, and you will sometimes be about right, but mostly, far too fussy.
Most cut up protocols now, (and the Brits are getting as bad) generate much noise and little added useful information.
Is it really useful:
to measure a tumour in 3 planes
to take n blocks of a tumour (unless a sarcoma or other rare exceptions)
to send yourself batty finding nodes 2mm in diameter
to have complicated formulae (which change from time to time) of so many blocks per 10 grammes of tissue etc
to ink margins to see where the edge is
...and so on

(Just head up from 40 odd blocks of a radical prostatectomy specimen, which followed 2 blocks (generous) from each of a pair of 1300 gramme boob tissue - excess to need)

Dr Terry L Marshall, B.A.(Law), M.B.,Ch.B.,F.R.C.Path
 Consultant Pathologist
 Rotherham General Hospital
 South Yorkshire

-----Original Message-----
From: Jackie M O'Connor [mailto:Jackie.O']
Sent: 24 May 2005 15:39
Subject: Re: [Histonet] Number of Blocks Submitted by PA

Maybe our on-line Pathologists would have a say about this - I recall 
seeing several texts or reference material on how to dissect different 
large organs, like a radical prostate, where to take blocks from, and how 
many should be submitted. I know there are "industry standards".   I'm out 
of the clinical side of pathology now - but yes, I remember it well.

Jacqueline M. O'Connor HT(ASCP) QIHC
Assistant Scientist
GPRD Cancer Research
Abbott Laboratories, Abbott Park, IL

"Karen Percival" 
Sent by:
05/24/2005 09:19 AM

        Subject:        Re: [Histonet] Number of Blocks Submitted by PA

Hi Wanda,

When I worked in clinical histology  and the PA put too many blocks
through, the pathologists were the ones who talked to her about what and
how much to submit.  If the pathologists are not complaining about
having to read all of the slides that your PA is submitting,  then they
must be getting what they want.  If you feel there are too many blocks
being submitted by the PA, then perhaps you should discuss that with
your pathologists.  See what their response is.  The pathologists that I
had worked for wanted to read as few slides as possible, so they worked
well with the PA to get block submission to a minimun. 


Karen Percival
Research Scientist I
Wyeth Research
1 Burtt Road
Andover, MA 01810
888-577-1500 x 4058

>>> "Smith Wanda"  5/24/2005 8:55:58 AM
Good Morning Histonetters,
I have a question for you this morning...Are there written standards or
"Rules of Thumb" regarding number of blocks that should be submitted on
certain tissues?  The reason I ask is, "it seems to me"  that sometimes
the PA submits an extreme number of blocks on some specimens that could
be accomplished with less.  I'm not advocating cutting corners or not
performing good medical practice, I just need to know.  An example would
be a uterus w/ fibroids, tubes and ovaries which we have gotten up to 24
blocks on.  I'm not a PA, but it's interesting to me that when the
Pathologist cut, we get alot less blocks.
Please advise.

> Wanda G. Smith,  HTL/HT(ASCP)
> Pathology Supervisor
> Trident Medical Center Laboratory Services
> *9330 Medical Plaza Drive, Charleston, SC 29406
> *843-797-4586 *fax 843-797-4296
> * 
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