[Histonet] Use of 1% AgNO3 in gross room

[Jackie M O'Connor]

'Twas always my impression that the reason for marking the surgical margin 
of a specimen was to determine microscopically that all the tumor had been 
excised.  Lots of surgeons like to cut it really close.



"Marshall Terry Dr,     Consultant Histopathologist" 
<Terry.Marshall <@t> rothgen.nhs.uk> 
Sent by: histonet-bounces <@t> lists.utsouthwestern.edu
04/26/2007 09:57 AM

To
"Kemlo Rogerson" <Kemlo.Rogerson <@t> waht.swest.nhs.uk>, "Greg Dobbin" 
<gvdobbin <@t> ihis.org>, <Histonet <@t> lists.utsouthwestern.edu>
cc

Subject
RE: [Histonet] Use of 1% AgNO3 in gross room






Wimp:-)

Seriously though, I am perpetually perplexed for this modern mania for
marking the margins.
I think it's a response to blunt knives. Alternatively, and going back
to a thread of a couple of weeks ago, a response to cutting tissue
before it is fixed and firm, AKA quick turnaround time, AKA keeping
ahead of the competition. 
If you cut with a sharp knife when the tissue is fixed and firm, there
will be a flat embedding surface. The real edge of the tissue will be
the bit where tissue becomes empty space. Is this so difficult? 

The suggestion of having buckets of silver nitrate around the place is a
species of insanity to my thoughts.

Terry

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Kemlo
Rogerson
Sent: 26 April 2007 15:35
To: Greg Dobbin; Histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Use of 1% AgNO3 in gross room

Silver Nitrate
Poisonous. Causes burns. Long-term exposure can cause permanent
blue-grey staining of eyes, mouth, throat and skin, (argyria) and may
cause eye damage. Short contact can lead to deposition of black silver
stains on the skin. Very destructive of mucous membranes. Skin and eye
irritant. Experimental equivocal tumorigenic agent. 

Toxicity data 

ORL-MUS LD50 50 mg kg-1
UNR-MAN LDLO 29 mg kg-1
ORL-RBT LDLO 800 mg kg-1
SCU-GPG LDLO 62 mg kg-1
IVN-RBT LDLO 9 mg kg-1 

Would you really want a bucket of the stuff lying around for people to
dunk things into and increase the surface area for exposure?

I would suggest you carry out the procedure in a fume cupboard with
small quantities, wearing gloves and lab coat. Mind you blue-grey eyes,
mouth, throat and skin might be rather attractive.



Kemlo Rogerson
Pathology Manager
DD   01934 647057 or extension 3311
Mob 07749 754194; Pager 07659 597107;
 
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