[Histonet] Re: Orienting GI biopsies during embedding

[Robert Richmond]

Sabina Sylvest at Cincinnati Children's Hospital asks:

>>We are having a heck of a time orienting GI biopsies but esophageal biopsies in particular, during embedding. If anyone could share their secret for getting these tiny specks of semi-transparent tissue oriented, we would greatly appreciate it.<<

At the very least, I'd use an OptiVISOR magnifier with 3 diopter or 4
diopter lenses - I've mentioned this item on Histonet before. See
www.doneganoptical.com/optivisor.php - Donegan doesn't retail, but you
can get the item from Amazon.

If I had one, I'd want to use a stereo dissecting microscope with 10
and 20 power magnification, but not many pathology services have them.

Orienting GI biopsies is more important than most people realize. As
public awareness of celiac disease increases, we're going to have to
improve our handling of upper small bowel biopsy specimens. I'm
thinking of

     examining the fixed gross specimen with a dissecting microscope,
as part of the gross description
     embedding with magnification
     doing special stains routinely - PAS (for Whipple cells) and CD3
(for infiltrating T lymphocytes in the surface epithelium)

Is anyone on Histonet doing any of these things?

Bob Richmond
Samurai Pathologist
Knoxville TN