[Histonet] bone fixation and decal question

[Rene J Buesa]

You answered most of your own questions.
The bone should be fixed before decalcifying it.
After that it could be cut in the cryostat, but why to do that?
It will be quite difficult. The best solution is to fix → decalcify → process routine by embedding in paraffin → cut "conventional" sections.
The whole idea behind the FS is the speed of the "intraoperative" diagnosis..
Once that is lost (by fixing → decalcifying) I don't think it matter much waiting a little bit more.
Hydrochloric acid does not fix (answering to one of your questions).
René J.

--- On Sun, 11/29/09, napoli <@t> siscom.net <napoli <@t> siscom.net> wrote:


From: napoli <@t> siscom.net <napoli <@t> siscom.net>
Subject: [Histonet] bone fixation and decal question
To: histonet <@t> lists.utsouthwestern.edu
Date: Sunday, November 29, 2009, 1:53 PM


Question regarding fresh tissue, in this case bone.
Scenario:

Mohs surgeon removes layers of skin on a patient's scalp,
eventually discovering the basal cell carcinoma extends to
the periosteum and so a bit of bone is taken and tested to
ensure the margins are free of cancer. The only problem is
that since it is bone, in order to cut it is needs to be
decalcified. 

In order to decalcify this tissue in order to cut it either
in cryostat or on regular microtome, it of course must be
fixed, correct? Reason being is I have heard of Mohs
dermatologic surgeons taking bones frags, letting their
histotech put the fresh bone in hydrochloric acid solution
for decal overnight and then cutting it in the morning on
the cryostat. This seems flawed to me as the acid would seem
to destroy architecture and critical proteins? Isnt this
practice flawed as it doesnt allow fixation? Does the
hydrochloric solution have fixative properties? Does decal
halt autolysis? Also, is there any real reason why formalin
fixed tissues cannot be mounted in OCT and cut frozen? Would
it hurt the frozen section for the specimen to be placed
into one of the decals i have seen that are both fixative
and decal? (Like Surgipath Decal I)It is said to work
reasonably quickly and the bone would be thin. Seems like
this would be the thourough way of getting quick
intraoperative results with a bit of bone on cryo.

Any comments? thanks in advance

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