[Histonet] Needle biopsies

[Bauer, Karen]

Hi Jim,

This is the way we treat all of our needle biopsies:

As soon as we face into the block and see some exposed tissue, we start
taking our sections.  We cut 8 slides (charged slides), two levels on
each slide.  For example; face in a little, take the first section, face
in a little more, take the next section, and so on until 8 slides have
two levels on each of them.  The rule of thumb here is to start with a
little tissue and end up with a little tissue so the pathologists know
that all of the biopsy has been sampled.  We then stain slides 1, 3, 5,
and 7 with H&E and save 2, 4, 6, and 8.  These saved slides are for
possible specials or IP's.  One pathologist just has us stain the rest
with H&E if he doesn't need any further stains.  This seems to keep the
pathologists happy, we have had no complaints.  All of the saved slides
are kept for a month or so, just in case, otherwise they are thrown
away.

Hope this helps you out a bit and good luck,

Karen Bauer HT(ASCP)
Histology Supervisor
Luther Hospital
Eau Claire, WI

-----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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