Tasha R. Bourm at Olympic Medical Center in Port Angeles WA (up at the far end of the Olympic Peninsula - wotta view!) asks about Helicobacter pylori controls for staining gastric biopsy specimens, and several people replied.

The varied pathology services I've done locum tenens work for have real difficulty getting Helicobacter controls, mostly because the histotechnologists aren't communicating with the pathologists and the transcriptionists. When I see a case that would make a good Helicobacter control, I send in a special stain request form with "good Helicobacter control" scribbled on it instead of a request for a stain.

The ideal control tissue is a gastrectomy specimen crawling with bugs. Fortunately for patients, unfortunately for pathology services, such specimens have become rare. But look for these specimens; one good case can supply you with controls from now until your Social Security kicks in.

Helicobacter pylori is extremely difficult to culture - most small labs have never succeeded - so that cultures are an unlikely source of controls. I really don't like to see other bacteria used as controls.

Many services either don't do a Helicobacter control, or use some irrelevant piece of tissue - and all the commercial controls I've seen have been worthless. I don't think this is acceptable practice - though I don't think it's necessary to run a positive control with every Giemsa stain run (immune stains do of course require a positive control).

I've become convinced that it's necessary to use an oil immersion lens with Giemsa stains for Helicobacter, a view that makes me unpopular with my fellow pathologists. One of the advantages of the immune stain, in my personal experience, is that it allows you dispense with oil immersion, a time-consuming procedure.

Bob Richmond
Samurai Pathologist
Knoxville TN

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