[Histonet] Underfixation of breast tissue may lead to
Troyer, Dean A.
TroyerDA <@t> EVMS.EDU
Wed Mar 23 13:12:21 CDT 2011
Just wanted to qualify somewhat the observation that alcohol is a poor fixative. Alcohol can be very effective as a primary fixative.
I agree formalin isn't likely to be displaced in this country soon, but aqueous ethanol or methanol is a viable alternative that has merits worth considering.
Eastern Virginia Medical School
From: histonet-bounces <@t> lists.utsouthwestern.edu on behalf of Bryan Llewellyn
Sent: Wed 3/23/2011 1:28 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] Underfixation of breast tissue may lead to falseresults?
This has been commented on several times by old fogey histotechs in the
Any formalin variant takes some time to actually chemically alter (fix)
the tissue. Usually this is a minimum of 24 hours for a 3-4 mm thick
piece. In modern labs there is a focus on 24 hour or less turnaround
time, so formalin fixation is usually minimalist and may be inadequate,
as in this case. After all, the universe will not change itself for our
benefit just because we want fast results.
This means that underfixed tissues with just a few hours in formalin are
processed. The unfixed components are exposed to ethanol during this
process. Remember that ethanol is also a (very poor) fixing agent, so
the inadequatly fixed tissue is fixed by it, with all the
characteristics ethanol fixation gives, shattering, hardening,
distortion, etc. This is frequently referred to as "overprocessing", but
it is just poor fixation from ethanol. For most tissues, wetting the
block surface allows reasonable sections to be cut, but that is only a
Procedures which require tissues to be properly fixed may not be
successful as a consequence.
Goodwin, Diana wrote:
> Dear Histonetters:
> I recently read the following in an article on Medscape:
> "Underfixation of breast tissue may lead to false negative ER results and false-positive HER2 results. In these situations, the tissue is actually fixed in 100% ethanol, which is used to dehydrate the specimens after fixation."
> Can anyone explain?
> Diana Goodwin
> Supervisor, Histology Laboratory
> xt. 6996
> Histonet mailing list
> Histonet <@t> lists.utsouthwestern.edu
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