[Histonet] Re: Formalin Fixation issues

[Bob Richmond]

At this point I'm not sure I understand what Jill Cox's problem is.
Forgive me if I keep blaming the pathologist - since I am one! - but
in my experience most of these breast problems originate at the gross
desk.

Is your pathologist cutting the fatty breast tissue thin enough? This
is always a challenge, even after you've done it as long as I have. If
your pathologist is cramming the cassettes full of fat, then that's
where the problem lies.

Do you prepare your own neutral buffered formalin, or buy it? I
prepared a lot of it years ago, and supervised others who did, and I
learned the hard way that mistakes are easy to make when you brew your
own. If you buy your NBF ready made, as most people do nowadays, then
read the label carefully. Have you changed brands recently?

Bob Richmond
Samurai Pathologist
Knoxville TN
***************************************************
On Mon, Jul 9, 2012 at 1:38 PM, Jill Cox <jcox90 <@t> yahoo.com> wrote:
> I think you misunderstood what I meant. I know it's not supposed to be fixed
> before grossing, it's also not getting fixed after processing. But thanks
> for your two cents..
>
> From: Bob Richmond <rsrichmond <@t> gmail.com>
> To: histonet <@t> lists.utsouthwestern.edu
> Sent: Monday, July 9, 2012 10:25 AM
> Subject: [Histonet] Re: Formalin Fixation issues
>
> Jill Cox asks: >>Is anyone having problems with breast fixation prior
> to processing in formalin? For a couple of months now our breast
> specimens aren't fixing very well before gross. Our pathologist thinks
> they have changed something in the formalin itself. We utilize 15/1
> ratio and in some cases let fix over the weekend. This has only been
> happening over the last couple of months and can't seem to figure this
> out. Any advice or similar problems, would love to hear from you.<<
>
> Breast specimens shouldn't be expected to fix before they're grossed,
> or at least before they've been cut into thin slices. Delaying
> fixation compromises immunostaining, to say nothing of H & E. They
> should be grossed as promptly as possible after they're received, and
> should never sit over the weekend without dissection.
>
> I seriously doubt that anything in the formalin has changed. It's your
> technique that needs to change. Unfortunately, this is a difficult
> task to delegate.
>
> Bob Richmond
> Samurai Pathologist
> Knoxville TN