[Histonet] Prostate Needle Biopsies

[Garrison, Becky]

Just this week, our Urology Center, in reviewing its QA measures,
wanted to know if its Ok for them to ink the specimen by color 
to reduce specimen ID mix ups.  
My first reaction was no because  of concerns that unknown inks
might interfere with fixation and ultimately IHC and the possibility of
crush atefact introduced by "non-pathology" hands.    In reading messages 
to this list, apparently there are additional measures taken to prevent
specimen ID mix ups.  Any other Pathology labs receiving prostate biopsies
already inked (or perhaps the formalin tinted) by the Urologist??
Any other measures taken (in addition to the standard precautions of
inspecting each container for correct patient/specimen ID before submission
to
Pathology?
All input is appreciated.

Becky Garrison
Pathology Supervisor 
Jacksonville, FL


 

-----Original Message-----
From: RSRICHMOND <@t> aol.com [mailto:RSRICHMOND <@t> aol.com]
Sent: Sunday, February 29, 2004 1:00 AM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Prostate Needle Biopsies


Cindy DuBois, HT ASCP at Delta Pathology Associates in Stockton, California,

asks about embedding of prostate needle biopsy specimens. A few words from
the 
pathologist who has to read them:

I want to see the entire length of every specimen submitted, since prostate 
cancer is often focal and present in very small quantities. When you gross
the 
specimen, you need to record the length of each specimen (the big prostate 
mills are very careful about this). I'll be measuring the length of
specimens on 
the slide, and the length of the tumor present within them. 

Tamping the individual specimens flat in the embedding mold is essential.
I'd 
prefer you use as few cassettes as possible, but it's more important that I 
see the entire length of each specimen than that you conserve cassettes and 
slides. Some labs specify no more than two cores per block.

I'm going to want a high molecular weight cytokeratin (34BE12) immunostain
on 
about one case in ten. I need to see the section that's right next to the H
& 
E section I'm looking at, so you need to cut extra unstained slides on every

case.

All prostate biopsy specimens look alike in the gross, and you need to take 
extraordinary care not to mix up patients, particularly if you're
accessioning 
nothing else but prostate biopsy specimens. Cassettes of different colors, 
indexed to slides of the same colors, cost nothing extra and help prevent
mixups. 
So does the use of colored marking inks.

Bob Richmond
Samurai Pathologist
Gastonia NC
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