[Histonet] Re: Formalin Fixation issues

[Weems, Joyce K.]

I would also call the company to see if they have had others with problems. Has it all been the same lot number?

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.weems <@t> emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

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-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jill Cox
Sent: Monday, July 09, 2012 2:01 PM
To: Bob Richmond; Histonet <@t> Lists. Edu
Subject: Re: [Histonet] Re: Formalin Fixation issues

Yes Bob, the sections are good and thin. We use Scientific Products, 10% NBF. Just seems like the Formalin is watered down. Going to try a different brand. I have worked for Pathologist's that cram cassettes but this is not the case here.


From: Bob Richmond <rsrichmond <@t> gmail.com>
To: histonet <@t> lists.utsouthwestern.edu
Sent: Monday, July 9, 2012 10:51 AM
Subject: [Histonet] Re: Formalin Fixation issues

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

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