[Histonet] bone marrow biopsies

[Della Speranza, Vinnie]

You are being placed in a difficult position that will only translate into physician unhappiness, so even though they are in a hurry (and usually for valid clinical reasons) the fact is that compromises will affect something else.

I'm assuming you are a one shift operation. My lab is 24 hours, which allows us sufficient time for fixation and decalcification while enabling slides to be out the next morning.

While Dr. Richmond is correct that there are faster decalcifiers, I'm guessing they want immunohistochemistry in at least some cases and the mineral acids will destroy your hopes of good immuno staining. We use 10% formic acid and still have to decalcify for about six hours in order to have blocks that section well.

If you had an evening shift I'd suggest shortening your processing time. Shortening fixation time is counter productive to good morphology and good IHC.

Lastly, you don't indicate if your bone marrows arrive at all times of the day. If you are trying to complete fixation and decalcification on specimens arriving in the afternoon, all to be on the processor at the end of your shift,  you end up in the position you find yourself currently, with blocks poorly decalcified that section poorly.

The only way to make this work to everyone's satisfaction is to have a longer work day, if it is possible to stagger work shifts. This also presumes that you have multiple tissue processors and can place your bone marrows on a shorter cycle, perhaps along with other biopsies.

Others here may be able to advise you regarding using microwave technology for fixation and decalcification which may ultimately save the day for you.



Vinnie Della Speranza
Manager for Anatomic Pathology Services
Medical University of South Carolina
165 Ashley Avenue  Suite 309
Charleston, South Carolina 29425
Tel: (843) 792-6353
Fax: (843) 792-8974
 

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Cynthia Robinson
Sent: Thursday, October 30, 2008 11:44 AM
To: histonet
Subject: [Histonet] bone marrow biopsies

We are currently using 10% formalin fixation on our bone marrow cores.  We fix for 2 hours minimum prior to decal.  We are using Immunocal from Decal Corp. for 2-4 hrs followed with processing overnight in VIP.  Cores are still crunchy upon sectioning and we are doing surface decal for up to 30 min. Our paths want cores turned out within 24 hrs following procedure. Any suggestions? 
 
Thanks.
Cindi 
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