[Histonet] What's on that H&E?

[joelle weaver]

Just depends on the protocol at that laboratory- often at the discretion of the pathologist(s) reading or the medical director- I guess all variations  are acceptable so long as all the sections are of good quality, they may not want/need serials, but prefer levels, and if  they meet the diagnostic needs, and are representative of the tissue sample.  I think you could do things a lot of different ways dependant on the tissue type and clinical differential. I have seen and done many of the variations you mention in your post, up to 9-12 serial sections ( rows of  3 ribbons on one slide) and up to 12 levels ( specific depth into the block) on single or multiple slides., with special stains and IHC levels thrown in as well- so "sky's the limit"  to me as to what might work for your lab and pathologists. Sometimes you don't really need to provide all the extra sections, but for some specimens that might make sense. So I like it when the protocols are pretty specific- though that variability may not apply to your lab if you do only a few tissue types. Anyhow I would rather do all that is likely to be needed the first time into the block, no matter how complicated the protocol,  than have to recut it again and again. You might end up losing too much tissue that you need later for molecular or other testing too. Outside numbers are a good initial benchmark to me, but your own productivity statistics and staff are often a lot more meaningful. I have just seen different numbers for rates on these protocols versus single section slides.  Maybe do a side by side, of having them read single section slides  and then the same specimen type ( as similar as possible) with other different sectioning using complex  protocols with times to produce in sectioning time, stain throughput, all variables you can think of- maybe they may have different opinions then? Just an idea.    



Joelle Weaver MAOM, HTL (ASCP) QIHC
 > From: BGapinski <@t> pathgroup.com
> To: histonet <@t> lists.utsouthwestern.edu
> Date: Fri, 8 Feb 2013 18:00:11 +0000
> Subject: [Histonet] What's on that H&E?
> 
> Dear Histonians,
>                 How many sections do put on a slide from a block cast in a small embedding mold? Do you automatically include any levels?  Then please tell me how many slides your techs cut per hour?
>                 The problem is (may be) that we put 4 levels on a slide with two sections per level. That is:
> 
>   1.  Full face (or pretty close) 2 sections
>   2.  Level 2 sections
>   3.  Level 2 sections
>   4.  Level 2 sections
> So I have 8 sections on my H&E. This takes me some time, and I understand all histologists may not be doing things this way. But the problem is, when we discuss output and my techs appear slow I find that other labs put much less tissue on a slide. Some labs give a fatty string of serial sections in two rows, and that appears to be just like my slide. But only on the surface (pardon the pun).
> My pathologists just renegotiated the contracts for all our dermatologists after the new 88305TC pricing, and those doctors say "Oh, we can get slides cheaper than that." Maybe they can but what would they see on the H&E, and would they care?
>         So now I'm faced with doing things as we have or stop giving those levels. I understand my job as a Histologist is to demonstrate the tissue. So I'll stick to the levels, because  I:
> 
> 1.       Work for the patient
> 
> 2.       Am supervised by the Pathologists
> 
> 3.       Am reimbursed by our company
> Tell me what you do in you lab, please
> 
> Bruce Gapinsk HT (ASCP)
> Chief Histologist
> Marin Medical Laboratories
> PathGroup SF
> 
> 
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