[Histonet] Re: Processing Whole prostate

[Robert Richmond]

I don't have any experience with whole-mount sections of radical
prostatectomy specimens, which obviously require slides larger than
the standard 3 by 1 inch slide.

I'm not entirely current here, but a few years ago major prostate
pathologists such as Jonathan Epstein (at Johns Hopkins) were telling
us that while whole-mount sections were necessary for in research
settings such as his own, that they were distinctly not required as
standard of care in community hospitals.

I prefer to let a whole radical prostatectomy specimen sit overnight
in neutral buffered formalin (without removing the urethral catheter
if there is one), then cut it, then further fix the sections
overnight. Fixation isn't wonderful, but remember that most of what I
want to see is near the exterior surfaces of the specimen. I flick out
any of those little black prostatic calculi I may see.

The right and left halves of the prostate should be marked with
contrasting colors of ink, either before or after fixation, but before
cutting. Learning to orient the specimen is a non-trivial task.

I wouldn't invest much money in setting up whole-mount sections. I
expect the numbers of these specimens to decrease, as the futility of
treating early prostate cancer is more widely appreciated.

Bob Richmond
Samurai Pathologist
Knoxville TN