RE: biopsy specimens & sections

From:"Cheasty, Sandra"

I've worked in several labs over the last 18 years, and while there is always variation, generally the practice has been similar. It is something to discuss with your pathologists. How many levels or serial sections do they want and need? Are some serial sections redundant and unnecessary? Here is what I have found to work well without increasing the # of recuts, without giving the docs more than they need to look at, and without the techs taking too many unnecessary sections. 
* Routine, boring stuff (gallbladders, uteri, tonsils etc) One section per slide,  even if you can fit two. (Some histotechs have a hard time with this... they don't like to see empty space on a slide...)
* Small biopsies (G.I., skins) Two levels: The first level is one or two serial sections placed horizontally on the slide near the top of the slide and the second level, same thing, below the first level. We used to give two, multi serial section levels vertically on the slide, but the pathologists just needed one or two serial sections from each level. This saves both the docs and techs some time. (No, we have not increased the number of our recuts)
* "Special" biopsies (breast cores, cervical biopsies, cervical cones, prostate needle biopsies) 4 to 6 levels placed on the slide horizontally as in the "Small Biopsy" levels. Sometimes you can get all 4 on a slide, sometimes with a cone you can only get one level per slide. I've worked at a lab where the # of levels was determined by the size of the tissue. If you had a cervical cone biopsy done and the pieces were small, the techs would cut more levels than if they were large pieces... In this case, size shouldn't matter... You should treat each specimen by what is needed and not by size. If you have a large cone section or a cassette with lots of breast cores and your policy is 4 levels for those specimens, that's how many you should do, regardless of  how many slides it takes. (It took forever to convince the techs I worked with at the time...)

It would be interesting to hear from the rest of you, any "unusual"  policies you have come across in your career re: what and how much to put on a slide...

Sandy Cheasty
LLU Pathology - CA

 -----Original Message-----
From: 	Morrison, Michelle [] 
Sent:	Wednesday, November 06, 2002 10:54
To:	''
Subject:	biopsy specimens & sections

Good morning Histonetters;  I am curious how many labs out there may have a
limit to the number of sections placed on a slide, mainly for small biopsy
specimens.  Currently we do 3 slides (3 levels, one level per slide) per bx
block.  This is a small rural hospital, we cut anywhere from 10 to 70 blocks
a day; some days are rushed, others not (one tech on morning duty).  this is
not a question of the histotech being overworked, rather a question of --"do
we have an overworked pathologist?"  Generally, for prostate biopsies, we
usually give 3-5 sections/slide.  Our temporary locum tenens path. has asked
for 1 section/slide for biopsy cases.  Any feedback here is appreciated.
Personally, i feel a disservice is being done here to the patient, if I give
in to this.  Thank you.

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