But that is not what is behind last week's discussion, which dealt with PAP smears using FFPE tissue sectoins used as (+) controls.
What Dr. Miller says is similar to what Dr. Rosai also says: the H&E should be the "gold standard" and the IHC is a way of either trying to figure out some obscure origin or differentiating between several possibilities.
Also if dealing with a cell block the discussion is unnecessary, since cell blocks are FFPE also.
"Lott, Robert" wrote:
I just had to weigh in on this...
Most of you are familiar with Dr. Rodney Miller. He is the Director of Immunohistochemistry at ProPath Labs in Dallas.
He is world renown for his expertise. He is also a board certified cytopathologist and a true friend to NSH having spoken at many local, state, and national meetings.
Dr. Miller wrote a book :-) called Practical Cytopathology.
The COMPLETE contents of this textbook are as follows:
Get a good cell block and do immunostains if you can't figure it out on the H&E.
For more information follow this link:
Robert L. Lott, HTL(ASCP)
Manager, Anatomic Pathology
Trinity Medical Center / LabFirst
800 Montclair Road
Birmingham, AL 35213
205-592-5646 - fax
Date: Sun, 30 Sep 2007 11:03:18 -0700 (PDT)
From: Rene J Buesa
Subject: Re: [Histonet] IHC Forum
To: patsy ruegg
Content-Type: text/plain; charset=iso-8859-1
This week there was a discussion in Histonet about IHC on PAP smears and cytospins and using tissue sections as positive controls or not.
Roughly the positions were the following:
1- some accepted using FFPE tissue sections as (+) controls, after HIER
2- some suggested fixing the smears with NBF and cause the "crossslinkage" to do HIER afterwards
3- some advocated using ONLY known (+) smears or frozen sections as (+) controls, i.e. non-fixed tissues. The rational being a CAP instruction in which they direct to use controls treated the same as the case.
I think this is an important topic but I also think the "discussion" should be beyond an intelectual argument of each, because that will just expand what has been said this last week.
I think that with some time ahead some "hard evidence" ought to be presented for discussion, i.e. results obtained using the 3 "approaches" summarized above.
The panel then should view the slides, grade them and get to a determination. The slides should be reviewed/graded "blind", i.e. no one shoudl know the procedure s/he is evaluating.
Give consideration to this proposal.
This is a call for IHC questions to be discussed at the NSH S/C in Denver in OCT.
If you have any burning questions you would like our panel of 9 to address please email them to me ahead of time.
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