Re: Entering the mercury disposal fray and what you may encounter
Gayle Callis notes:
<< True, B5 is excellent, but pathologists CAN learn to read tissues fixed
with a mercury fixative substitute, since some complain about cells not
looking good. >>
It's not the pathologist that loses, it's the patient. If the tissue is
inadequately prepared, then the diagnosis of lymphoma is compromised, and the
patient has to undergo another biopsy.
Actually, the B-5 "substitute" we need is overnight fixation. The major
reason we use B-5 is that it's fast, and permits same-day processing of
tissue for lymphoma diagnosis. Fix overnight, and neutral buffered formalin
usually does the job quite adequately. Since the full diagnosis of a lymphoma
takes several days and treatment is rarely urgent, I don't think that this
one day delay compromises either patient care or Managed Care.
About thioacetamide: it's now considered to be a bad enough carcinogen that I
don't think we're allowed to use it as a mercury precipitant any longer. Will
someone respond to my previous comment about sodium sulfide?
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