[Histonet] HER2 and the 48 hour rule

Tue Jan 23 14:26:54 CST 2007

We do a delay start and leave the specimens in formalin.  We do not
leave in 70%, xylene or paraffin for any length of time.  Pat

Pat Karlisch
Supervisor, Histology, Pathology and Laboratory Medicine
Penn State Milton S. Hershey Medical Center
Mail Code H179
Hershey, PA 17033
Phone (717) 531-6072
Fax: (717) 531- 7741
email: pkarlisch <@t> psu.edu

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>>> "sheila adey" <sheila_adey <@t> hotmail.com> 1/23/2007 2:36 PM >>>

This prompts a new question.
I'm curious as to whether other labs that don't work weekends leave
their 
tissues in formalin with a delayed start or do you start the processor
right 
away and leave the tissues in Xylene as stated below?

Sheila Adey HT MLT
Port Huron Hospital
Michigan

>From: Patti Loykasek <ploykasek <@t> phenopath.com>
>To: "Peterson, Dan" <1dpeterson <@t> meriter.com>,histonet 
><histonet <@t> pathology.swmed.edu>
>Subject: Re: [Histonet] HER2 and the 48 hour rule
>Date: Tue, 23 Jan 2007 10:06:08 -0800
>
>Dear Dan,
>Welcome to the new world of Her2 testing! There will definitely be
changes
>in the lab as a result of the ASCO/CAP Her2 testing guidelines. I urge
all
>techs to get a copy of the guidelines and read them.
>That being said, the time in fixation is important for Her2 testing.
With
>heat retrieval I think that too little fixation is worse than >48
hours, 
>but
>for now we must comply with 6-48 hours. I was taught (a long time ago)
that
>it is best practice for the weekend schedule fixation to reflect the
rest 
>of
>the week, and that  it is preferable to leave the tissue longer in
xylene.
>That xylene would have less bad effects than longer time in formalin. 
A
>longer time in alcohol would be deleterious to many IHC stains, and
not
>recommended for Her2.
>Whatever schedule changes you decide to implement, hopefully you can
test
>your new schedule on some tissue before full implementation of a new
>processing schedule.
>
>
>Patti Loykasek BS, HTL, QIHC
>PhenoPath Laboratories
>Seattle, WA
>
>
>
>
>
>
> > Hello Histonetters!
> > Maybe this has been discussed before, and if it has, I apologize
in
> > advance, but I need a little input. Now that the CAP has mandated a
6
> > -48 hour window of fixation time for specimens that may have Her-2
neu
> > performed, what are you doing about weekend specimens? We JUST
(after
> > 25+ years) got rid of the need for techs to come in on Saturdays,
and
> > would like to be able to continue this trend. However if a breast
bx is
> > done at an outside account on a Thursday afternoon, and does not
get
> > grossed by our staff until Friday, right now a our processors are
set to
> > start up Sunday afternoon for Monday morning (Kind of over 48 hrs).
So
> > here are my questions:
> > Do you set up the processor to sit in 70% OH after the formalin
fix? Do
> > you let it sit in the paraffin from Saturday until Monday? (Is heat
too
> > prolonged?)
> > Or do I have to break the news to staff that if their name is up,
and a
> > breast bx comes in, they're coming in Saturday am?
> > We do not have a microwave processor (yet), but soon.
> > Any and all responses will be greatly appreciated!
> >
> > Daniel R Peterson HT(ASCP)
> > Histopathology Section Head
> > Meriter Laboratories
> > (608)-267-6557
> > 1dpeterson <@t> meriter.com
> >
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