[Histonet] Contamination..processor?

Wed Mar 24 12:46:13 CDT 2010

Response to Tjapser:

1 - The cells are in the same location on all levels.

2 - We have a forceps warmer, but we burn the tip in the bunsen flame in between each case, and we hold the forceps in our hand when imbedding in succession.  We do pause to trim and then go back to embedding (we are a small lab) so it is a possibility.  We will be sure to clean inside the forceps warmer.    

3 - We only have one processor.

4 - We do running the clean cycle every day.  And all solutions were changed on Monday.

We had a frozen section earlier in the day - merkel cell carcinoma skin mass - three different specimens from the same patient.  However, the pathologists take the GI biopsies straight from the little formalin containers and put them directly into the microcassettes, so they don't touch the grossing table.    
Thanks so much for your comments/suggestions.

Brandi

-----Original Message-----
From: Thomas Jasper <tjasper <@t> copc.net>
To: tigger13b <@t> aol.com
Cc: histonet <@t> lists.utsouthwestern.edu
Sent: Wed, Mar 24, 2010 1:31 pm
Subject: RE: [Histonet] Contamination..processor?

Hi Brandi,
Don't know if I can solve your problem...but here's a few questions.
1)You've determined that the floater (tonsil cells in this case) are in
he block.  Did you determine this because you consistently see the same
loater in the same spot, level after level, slide after slide?
2)Do you use a forceps warmer at your embedding station?  If so, have
he wells of that warmer been cleaned out lately?  It can be a source of
loaters.
3)Do you have 2 processors?  If so, are you running separate programs
on separate machines of course) for large and small specimens?  If you
an do this and you are not, you might want to consider it.
4)While it's possible you could be picking something up from your
rocessor, I would not be initially suspect of it.  Are you running
lean runs after processing runs?  If you are this should basically take
are of any residual tissue floaters that may have gotten out of a
tonsil) block, or any other block for that matter. 
You embedded the GI biopsies first, so I would not suspect the embedding
enter work surfaces to be a source of your tonsil floater.  Some
achines have little grooves to allow waste paraffin to drain off,
ometimes things can be trapped there.  Also, you say that the
athologist grossed the tonsils after the GI's.  I believe you and
im/her, but was anything else grossed before the GI's?  Some type of
ymphatic tissue?  I tend to look to the grossing bench 1st for the
ource of floaters because once it's done there, it shows up everywhere
lse.  Also, when techs cut and embed, they have no choice but to cut
nd embed whatever they're given.  There is no way to determine if what
ou might be looking at is a floater.  And more often than not, when
utting and embedding you've inherited a floater as opposed to
ntroducing one.

ood luck, hope this helps.
Tom Jasper
Thomas Jasper HT (ASCP) BAS
istology Supervisor
entral Oregon Regional Pathology Services
end, Oregon 97701
41/693-2677
jasper <@t> copc.net
-----Original Message-----
rom: histonet-bounces <@t> lists.utsouthwestern.edu
mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of
igger13b <@t> aol.com
ent: Wednesday, March 24, 2010 9:41 AM
o: histonet <@t> lists.utsouthwestern.edu
ubject: [Histonet] Contamination..processor?

Hello everyone.
     Today we have a problem with contamination.  The pathologist notes
ells from tonsil specimens here and there on our GI biopsy slides.  The
ells are in the block.  I'm trying to ascertain the source of the
ontamination.  
    The grossing pathologist grossed the tonsils AFTER all GI specimens
esterday (not source of contaminant).  We (the techs) embedded all GI
pecimens first, trimmed, cut, floated and stained ALL GI specimens
EFORE the tonsils (not source of contaminant).  The only other source
f the contamination I can think of is from the tissue processor.  We
ave a Tissue Tek VIP closed processor.  Has anyone ever experienced any
roblems like this?  We had a similar issue a few weeks ago.  I thought
he contaminant cells may be from a bladder tumor, which had multiple
ections submitted.  In this instance the cells showed up days work of
he bladder tumor, and in the following days work also (though the
athologists could not say for sure the cells were from the bladder
ase).  We changed our formalin solutions in the processor and the
roblem did not present the next day.  We also started putting all
ladder tumor specimens in the microcassettes, to prevent tissue from
scaping.  Has anyone had any problem like this, or does anyone have any
deas on how to prevent this in the future?  We had not seen this
roblem until these past two incidences, and this tonsil problem is
articularly strange to me because we process tonsils and GI specimens
n the same workload on a regular basis and have never had this issue
efore.  Any help is appreciated!  
Thanks!
randi

______________________________________________
istonet mailing list
istonet <@t> lists.utsouthwestern.edu
ttp://lists.utsouthwestern.edu/mailman/listinfo/histonet

-----Original Message-----
From: Thomas Jasper <tjasper <@t> copc.net>
To: tigger13b <@t> aol.com
Cc: histonet <@t> lists.utsouthwestern.edu
Sent: Wed, Mar 24, 2010 1:31 pm
Subject: RE: [Histonet] Contamination..processor?

Hi Brandi,
Don't know if I can solve your problem...but here's a few questions.
1)You've determined that the floater (tonsil cells in this case) are in
he block.  Did you determine this because you consistently see the same
loater in the same spot, level after level, slide after slide?
2)Do you use a forceps warmer at your embedding station?  If so, have
he wells of that warmer been cleaned out lately?  It can be a source of
loaters.
3)Do you have 2 processors?  If so, are you running separate programs
on separate machines of course) for large and small specimens?  If you
an do this and you are not, you might want to consider it.
4)While it's possible you could be picking something up from your
rocessor, I would not be initially suspect of it.  Are you running
lean runs after processing runs?  If you are this should basically take
are of any residual tissue floaters that may have gotten out of a
tonsil) block, or any other block for that matter. 
You embedded the GI biopsies first, so I would not suspect the embedding
enter work surfaces to be a source of your tonsil floater.  Some
achines have little grooves to allow waste paraffin to drain off,
ometimes things can be trapped there.  Also, you say that the
athologist grossed the tonsils after the GI's.  I believe you and
im/her, but was anything else grossed before the GI's?  Some type of
ymphatic tissue?  I tend to look to the grossing bench 1st for the
ource of floaters because once it's done there, it shows up everywhere
lse.  Also, when techs cut and embed, they have no choice but to cut
nd embed whatever they're given.  There is no way to determine if what
ou might be looking at is a floater.  And more often than not, when
utting and embedding you've inherited a floater as opposed to
ntroducing one.

ood luck, hope this helps.
Tom Jasper
Thomas Jasper HT (ASCP) BAS
istology Supervisor
entral Oregon Regional Pathology Services
end, Oregon 97701
41/693-2677
jasper <@t> copc.net
-----Original Message-----
rom: histonet-bounces <@t> lists.utsouthwestern.edu
mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of
igger13b <@t> aol.com
ent: Wednesday, March 24, 2010 9:41 AM
o: histonet <@t> lists.utsouthwestern.edu
ubject: [Histonet] Contamination..processor?

Hello everyone.
     Today we have a problem with contamination.  The pathologist notes
ells from tonsil specimens here and there on our GI biopsy slides.  The
ells are in the block.  I'm trying to ascertain the source of the
ontamination.  
    The grossing pathologist grossed the tonsils AFTER all GI specimens
esterday (not source of contaminant).  We (the techs) embedded all GI
pecimens first, trimmed, cut, floated and stained ALL GI specimens
EFORE the tonsils (not source of contaminant).  The only other source
f the contamination I can think of is from the tissue processor.  We
ave a Tissue Tek VIP closed processor.  Has anyone ever experienced any
roblems like this?  We had a similar issue a few weeks ago.  I thought
he contaminant cells may be from a bladder tumor, which had multiple
ections submitted.  In this instance the cells showed up days work of
he bladder tumor, and in the following days work also (though the
athologists could not say for sure the cells were from the bladder
ase).  We changed our formalin solutions in the processor and the
roblem did not present the next day.  We also started putting all
ladder tumor specimens in the microcassettes, to prevent tissue from
scaping.  Has anyone had any problem like this, or does anyone have any
deas on how to prevent this in the future?  We had not seen this
roblem until these past two incidences, and this tonsil problem is
articularly strange to me because we process tonsils and GI specimens
n the same workload on a regular basis and have never had this issue
efore.  Any help is appreciated!  
Thanks!
randi

______________________________________________
istonet mailing list
istonet <@t> lists.utsouthwestern.edu
ttp://lists.utsouthwestern.edu/mailman/listinfo/histonet