[Histonet] micro chatter in prostate bx's

[Rene J Buesa]

Usually micro chatter in prostate biopsies (as well as in any other small biopsy, 
like gastric or colonic) are a result of a combination of factors:
1-they may start at the collection site if the biopsy is let to dry before it
is placed in the fixative;
2- NBF is good, but not other alcohol containing fixatives that will start
dehydration along with fixation. If the fixative is changed to one containing
alcohol, then the processing protocol has to be change to reduce dehydration
times;
3-If the biopsies are run along with other general tissues they may run the risk of
being overdehydrated;
4-overdehydration will be lessen if infiltration steps are adequate (we overcame 
these problems when we began infiltrating with mineral oil instead of xylene);
5- another point where the problem can be increased is while casting the blocks
if  the paraffin does not solidify quickly and completely around the biopsy.
6- cutting too fast can also produce the chatter, as well as an inadequate
blade angle.
All of the above will be invalidated if you are having problems with only one
histotech. If this is the case then the problem should be in the cutting technique.
Some "soaking" of the block after it is faced down may help.
You should compare the techniques of all your histotechs and try that the one
with problems adopts the correct cutting procedure.
Also remember that sometimes there are people that just "are not born to cut" 
(I have had at least 2 of them); this aspect of our art is very tricky (as you know).
Hope this will help (although I am sure you knew of all this)!
Rene J.

CrochiereSteve <@t> aol.com wrote:
I know this has been discussed before, but, does anyone have any suggestions 
to reduce the amount of microchatter in the glands of prostate needle bx's? I 
have been having a recurring problem with this (usually with the same tech) 
and would like to make suggestions to this tech (other than "Don't cut bx's). 
I've tried soaking the blocks and cutting slower, but this doesn't seem to be 
solving the issue. Is there a different fixative other than NBF that we could 
use in the collection kits that may help? Any and all suggestions are welcome. 
Thanx,

Steven M. Crochiere, HT(ASCP)
Histology Supervisor
LifePath Partners @ Mercy Medical Center
Springfield, MA 01104
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