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?

Bob Richmond
Samurai Pathologist
Knoxville TN

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