[Histonet] HELP!!!!! H. Pylori Immunos

[McMahon, Loralee A]

We also cut our controls in sequence.  Stain the first of the sequence and the last.  To make sure that you have not cut through the area.

Loralee McMahon, HTL (ASCP)
Immunohistochemistry Supervisor
Strong Memorial Hospital
Department of Surgical Pathology
(585) 275-7210

________________________________
From: Jay Lundgren [jaylundgren <@t> gmail.com]
Sent: Tuesday, March 01, 2011 3:10 PM
To: McMahon, Loralee A
Cc: Heather Cooper; histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] HELP!!!!! H. Pylori Immunos






Our problem, in my opinion is a control issue and not a staining one..our pathologist wants to see the bugs in certain areas-glands(spelling appologies!) its called, the circular groups of cells, in the middle of these areas and not just occasional bugs in other areas....Everywhere else I've worked the pathologist would use a Diff-Quick, Cresyl Violet or Geimsa in addition to the H&E,   I'm aware of other newer special stains for H.Pylori that are out there, but this pathologist is firm on the IHC method of choice.
I use NovaCastra polyclonal, incubation @23 min. HIER with low PH for 30 minutes.with  recommended detection kit..


     Heather,

      I hope you don't mind that I copied your email so that everyone on this forum can learn from your question.  I always use the "Reply to All" button so everyone can see my response.

     I was willing to bet before I read your query that we were dealing with a control problem, not a staining problem.  I have seen some miserable commercial H. pylori controls lately.  Some areas of the country are awash in HP, some labs can't get a good positive control block of their own.  You must first obtain a KNOWN POSITIVE CONTROL block. Stain slides from that block with whichever chemical special stain is acceptable to your Pathologist, I like a modified Warthin-Starry.  Sit down with your Pathologist and evaluate the control slides.  Is it acceptable to the Pathologist? If so, stain more slides from the positive control block, this time immuno stain and chemical special stain in parallel.  Evaluate the slides with the Pathologist.  Is there correlation between the chemical and special stain?  If so, proceed, running your first 20 cases in parallel (immuno and chemical special stains) and documenting (with the Pathologist's signature) the correlation of your first 20 cases.

     If you are able to demonstrate HP with a chemical special stain, but not with your immuno procedure, call your immuno vendor.

     If you are unable to demonstrate HP with a chemical special stain, it's your control.  Or it could be your stain, but a Giemsa is pretty hard to mess up.
                                                                          Good Luck,


                                                                                 Jay A. Lundgren M.S., HTL (ASCP)