[Histonet] Tissue Processing Protocol for Small iopsies

[Ian R Bernard]

Fellow histonetters, I'm looking for evidence based or best practice/ benchmarked tissue processing protocols for the small biopsies listed below.  Please provide a reference since our facility strives for evidence based  procedures for our patients .

I am processing a number of:

-          Endoscopic or gastroenterology biopsies

-          Breast Core Biopsies


Currently, owing to one processor (Sakura, Tissue Tek- VIP-5), we put all tissues on our 12 hour processing run.  As a result, the endoscopic tissue, owing to its size, tends to be more dehydrated. To avoid the chatter artifacts associated with over dehydration, we soak these specimen blocks, a minimum of 15 minutes before sectioning with minimal or no chatter. We are hoping to improving turnaround time( to the pathologist) by  not having to soak so long. Thus, we feel that a tissue processing  protocol of less time will make a difference.

As we all know CAP and ASCO, have recommended breast core biopsies (the evidence based standard for determining breast cancer) be fixed at a minimum of 6 to 72 hrs before processing to accommodate accurate testing of immune stains ER. PR and Her2Neu for breast cancer determination.

Our processor reagents are as follows: 10% Neutral Buffered Formalin x 2 changes; 70% isopropanol x 1; 95% isopropanol x 1; 100% isopropanol- x 3 changes; clearing reagent- x 3 changes; and paraffin- 4 changes.  By the way, we are looking at purchasing another processor- my next communicated topic to accommodate processing of our small biopsies.

Question: is it ok to mix endoscopic with other small tissues such as: cervical bxs, shaves, ECC or EMB specimens on the same endoscopic processing protocol?  Again provide a reference as a matter of evidence based medicine. We do this to  try and split cases to avoid cross contamination at the grossing, embedding and cutting.  We consider this a QA mechanism for maintaining the integrity of the specimen cases.



V/r
Ian R. Bernard
Ian R. Bernard, MSgt, USAF, MSHA, HT (ASCP)
10th Medical Group- Anatomic Pathology Lab
USAF Academy, CO 80840