[Histonet] Re: Lymph node fixative/enhance solutions

[Robert Richmond]

Cindi Robinson, HT (ASCP) in South Dakota asks:

>>Our pathologists would like us to start using a solution to help
with the dissection and identification of lymph nodes at gross. - We
do use Pen-Fix but it doesn't dissolve the fat like the paths would
like.<<

And Dana Dittus at Polysciences notes:
>>Polysciences,Inc manufactures Hartmanns Fixative which turns lymph
nodes white. For more info see www.polysciences.com   <<

It's easy and cheap to prepare Davidson's fixative (same as Hartmann's
fixative) - mix 3 parts water, 3 parts reagent alcohol, 2 parts strong
(37%) formalin, not the buffered kind, and 1 part glacial acetic acid.
Color it with eosin if you want to.

When Dr. William Hartmann (later the chair of the American Board of
Pathology) was at Johns Hopkins in the early 1960's, Dr. Victor
McCusick (the medical geneticist, later chair of medicine at Hopkins)
asked him to introduce the fixative for Barr bodies (sex chromatin
bodies) that Moore and Barr had specified in their original articles
on Barr bodies around 1954. Moore and Barr specified "modified
Davidson's fixative", which Bill Hartmann introduced. It came into
rather widespread use at Hopkins, and Hartmann's name stuck to it. I
think the name should not be used, because of possible disastrous
confusion with Hartmann's solution, lactated Ringer's solution,
introduced into pediatric practice in the 1930's by Dr. Alexis
Hartmann Sr. at Washington University in St.Louis. Dr. Alexis Hartmann
was one of my clinical teachers, right before he retired around 1964
(sorry about all this name dropping).

John Kiernan and I discussed Davidson's fixative in this forum several
years ago. He noted that it is not really a rational formula. He hoped
to have the time to research the fixative in Davidson's papers, since
it seems never to have been published.

Getting back to the actual subject, I've used Dissect Aid (Decal
Corporation) with good results - got a bottle of it on the shelf right
now, in fact. In my brief experience with Penn-Fix, it did not
disclose lymph nodes well.

Let me support your pathologists very strongly in this endeavor. Just
one positive lymph node upstages a colon cancer and makes chemotherapy
mandatory. And in colon cancer, those postive lymph nodes can be the
size of pinheads.

Bob Richmond
Samurai Pathologist
Knoxville TN