[Histonet] Cautery-Like Artefact

[Rene J Buesa]

Roger:
Any artifact that is hematoxylin (+) and resembles a cautery i.e. without cellular details at all is either caused by an actual cautery procedure, by incomplete fixation or by drying out.
Your dermatologists attest they are not using cautery, so that can be eliminated.
You wrote they are fixed overnight so it is very likely that fixation is close to appropriate, so fixation can be eliminated also. Additionally had this artifact appear in all your Bx. fixation would be the culprit.
You wrote that the artifact appears both in "conventional" and in MW tissue processing so processing with MW oven can be eliminated.
Then the only cause not "eliminated" is drying out and it has to occur before fixation.
The issue is now determining when the Bx. dries out and if you receive all your Bx. in fixative, the drying out has to occur at the dermatologist's office. Sometime between the moment the Bx. is taken and is placed in the fixative the margins of the Bx. driy out.
Answers to some questions will allow you to "narrow down" the problem:
1- is this artifact more frequent during the periods when the air in your area is drier, i.e., are there variations in the frequency during different months?
2- is this artifact more frequent in Bx. from some dermatologists than from others?
3- does the artifact present variations in the "intensity" of the drying, meaning that it can be concluded that the drying times can be identified?
I think that you should tally this artifact frequency and intensity against months of the year and referring dermatologists. You may even end with enough information to write something about this artifact after all.
René J.    


________________________________
From: Roger Heyna <rheyna <@t> lumc.edu>
To: histonet <@t> lists.utsouthwestern.edu 
Sent: Monday, August 19, 2013 4:55 PM
Subject: [Histonet] Cautery-Like Artefact


We are experiencing a staining artefact on our H&E's, most commonly seen on skin specimens, but also observed on other specimen types as well. 

Within the dermis and subcutaneous regions of the skin specimens, there are portions of what should be collagen that appear homogenized and stained with hematoxylin, instead of the 
usual eosin staining. It's often on the edge of the section and varies in size between different specimens. The pathologist is normally able to read around it, but there have been cases that were made more difficult to diagnosis by this artefact.

Our pathologists believe this artefact resembles cautery artefact, but the dermatologists insist they are not using cautery during collection. 

We have a large derm service, and most of our derm specimens fix overnight. We have both microwave and conventional processing, and the "artefact" specimens have been processed on both. All of these specimens have grossing ink on them.

Any thoughts on what could be causing this? If it's not cautery, does it seem like a fixation issue? Has anyone seen grossing ink affect processing?

Thanks ahead of time for your help.
Roger
_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet