[Histonet] Re: DiffQuik Question again

[RSRICHMOND <@t> aol.com]

Several people comment on the appropriateness of doing a stain (such as Diff-Quik) for Helicobacter pylori before the pathologist has seen the H & E slides.

In quite a number of pathology services I've worked on in the last few years, it's been customary (assuming the service has any special stain for H. pylori - not all do) to do the stain along with the H & E, on every gastric biopsy specimen submitted. For one thing, manygastroenterologists want the stain done on all their gastric biopsy specimens. And every once in a while, one sees definite Helicobacter in a specimen where no chronic active gastritis (inflammation that includes neutrophils) is to be found.

As for liver biopsy specimens (in benign disease), one always needs a trichrome stain to assess fibrosis. I can often do without an iron stain, but once again the clinicians often want it done, for very good reasons - there is more and more concern about hemochromatosis in our patient populations.

For billing purposes, it's absolutely necessary that the pathologist's report makes clear that the stain was done and what the results were. Some regulatory agencies also want the control slide results reported. A pathologist can use a canned "boilerplate" text for much of this stain reporting.

Bob Richmond
Samurai Pathologist