[Histonet] RE: Tissue Processing Protocol for Small iopsies

Boyd, Debbie M DKBoyd <@t> chs.net
Mon May 14 07:10:43 CDT 2012


Ian, 
For our endoscopic biopsies a 12 hour run is too long.  We load ours in the afternoon but they stay in formalin until about 2 am.  They end at 5:30 in the morning.  The dehydration is 20 minutes x5 stations, with 30 in the 6th.  Clearant is 20 minutes x2 stations, with 30 in the 3rd.  Paraffin is 30 min. x2 and 45 in the 3rd station.  Our breast cores process with our larger tissues for the 12 hr. program without advise affects.  However we use ProSoft and ProPar from Anatech 
(on both processors) which is very gentle on the tissues.



-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Ian R Bernard
Sent: Sunday, May 13, 2012 12:15 PM
To: histonet <@t> lists.utsouthwestern.edu
Cc: BERNARD, IAN R MSgt USAF USAFA 10 MDSS/SGSH
Subject: [Histonet] Tissue Processing Protocol for Small iopsies 

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

_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet
--------------------------------------------------------------------------
Disclaimer: This electronic message may contain information that is
Proprietary, Confidential, or legally privileged or protected. It
is intended only for the use of the individual(s) and entity named
in the message. If you are not an intended recipient of this
message, please notify the sender immediately and delete the
material from your computer. Do not deliver, distribute or copy
this message and do not disclose its contents or take any action in
reliance on the information it contains.



More information about the Histonet mailing list