Scott Taft in Tucson, Arizona asks:

Would you be kind enough to take this B5 survey?

1. Are you currently using B5 fixative? I use it whenever I can in my locum 
tenens jobs, and perhaps half of my client - mostly small labs - use it.

2. Has your lab used B5 fixative in the past? I've been using it since it 
came into widespread use about 20 years ago.

3. If you have discontinued its use, when and why? - I don't see many labs 
that have discontinued it.

4. What alternative fixative are you using in its place? - I've tried 
alternatives, with no success. If you can't use B-5 fixative, the best 
"alternative" is to insist on overnight fixation of the specimen in neutral 
buffered formalin, rather than trying to process it the same day.

5. Do you need to use the "de-zenk" procedure for this substitute? "De-zenk" 
- "dezenkerization" - the use of iodine to remove mercury pigment - is 
required for all mercury containing fixatives.

6. If you use B5; and work in a reference lab, what percentage of cases 
require its use? - I don't work in a reference lab, at least not often. A 
very low percentage of cases. More if you fix bone marrow biopsies in it. The 
important thing is to use as little of it as possible - no more than 10 mL 
per case.

Bob Richmond
Samurai Pathologist
Knoxville TN