[Histonet] Needle biopsies

[Joe Nocito]

Jim,
I always refer to what my 8th grade shop teacher told us. It is always
easier to shave off a little more wood, than it is trying to glue it back
on. I have taken this advice to the histo lab.
	Once, when I was a rookie many moons ago, I had to fish through paraffin
shavings to locate a renal biopsy that I cut away. Since that time, I always
cut on the conservative side and explain to the pathologists that it always
easier to go back into the block than fish through paraffin shavings. I do
get static sometimes, but after they cool down, they realize it was a good
descion.

As always, the opinions of the author do not reflect the opinions of his
employers and their lawyers.


Joe Nocito, BS, HT(ASCP) QIHC
Histology Manager
Pathology Reference Lab
San Antonio, TX

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of Jim Ball
Sent: Wednesday, December 29, 2004 3:56 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Needle biopsies


I am a tech with 25+ years of experience and have been bitten by about every
snake in the garden of eden (Histology), and I guess that is one of the main
reasons I will error on the side of caution at every turn. I really try to
be as conservative as possible with tissue when trimming into a needle
biopsy, as soon as I have a full face on properly enbedded needles(usually
not more than 20 microns or less I start taking slides). The sections are
3microns and may produce as many as 5 to 10 sections suitable for mounting.
This acounts for max 30 more micrones into the block.  It is at this point I
would like to preserve the remainder of the tissue until it is reviewed by a
pathologist. I refer to my madness as scouting (a procedure if used by
General Custer would have saved alot of lives), but as we all know  there
are some patologist that will declare we did not trim enough if what they
are looking for is 100 micrones into the block.
   While I have been reseaching a procedure that will keep everyone happy I
ran across an article that state there was a study done to determine if
histologists were trimming away microcalcifications in needle biopsies, and
according to the high lights of the article (one they wanted me to purchase
to add insult to injury) it was determined that after x-raying the histology
shavings from trimmed breast biopsies the culprit once again was the
histologist.  Go figure.
  At the present time I am on a public computer and some one needs to use
it, but before I leave please foward any ideas you may have on this subject
via this server or directly to my e-mail address listed with this posting



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