[Histonet] prostate trimming protocol
wdesalvo.cac <@t> outlook.com
Tue Oct 9 11:11:37 CDT 2012
Talk w/ the pathologists or residents, have a conversation about what and why. The multiple samples could be due to teaching or cancer protocols. The number, size and selection area of samples is always the responsibility of the pathologists. I find it best to not wonder why, just ask. Typically the pathologist will be more than happy to discuss and explain their dissection and sampling protocol.
The variation in thickness and sample size by residents can be corrected by the trainer, typically a PA or pathologist. There may be a need to rewrite or create an good standardized procedure that the trainner can use. Again, have a discussion about how consistency in sample size, crisp edges and consistent thickness, < 3 mm, can improve quality. I suggest you start w/ a visual, a good old nickel. Consider super gluing one to every gross dissection board. Precision at the grossing board leads to increased quality in processing, microtomy and staining.
I am firm believer that if you concentrate on quality, both in action and conversation, you will get more bang for your buck! Always remember, when you start asking the questions, be prepared to get involved w/ training and correcting the process.
William DeSalvo, B.S., HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Control Committee
Owner/Consultant, Collaborative Advantage Consulting
> From: contact <@t> histocare.com
> Date: Tue, 9 Oct 2012 10:53:37 -0500
> To: histonet <@t> lists.utsouthwestern.edu
> Subject: [Histonet] prostate trimming protocol
> Good morning all,
> Could someone with more knowledge in this matter than I have help shed a little light?
> While at a nationally-renowned medical facility, I've come across something rather interesting (to me) for which no one in the immediate lab has a definitive answer for.
> I see varying trimming(or grossing) techniques by the residents. I'm told that it's very common to have poorly grossed tissue submitted regularly whenever a new group comes through, but nothing is done to correct it.
> It runs the gamut from non-decalcified bone, or humongous chunks of tissue that barely fits in the cassette but has to be nearly shoved into the mold, and tissue that's >5mm, seriously.
> This time, it's prostate tissue. I've been places where maybe 3 or 4 sections were submitted from the area of interest and maybe a sample of normal tissue just for differentiation. But here, it's common to receive anywhere from 30 to 50 cassettes from the same site. I'm guessing they don't want to discard ANY tissue.
> What's interesting is some of this is submitted as a bunch of very tiny slivers in some cassettes and then nickel and quarter-sized chunks from the same site in others.
> Has anyone else seen prostate submitted this way? Is there a rhyme or reason that I'm not aware of?
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