[Histonet] Sections

[Boyd, Debbie M]

It all depends on your definition of "levels" .   Levels is going deeper into the block between each pick up.  Serial sections are just cutting a ribbon and taking that ribbon.  I don't feel you are deeper in the block when you take "sections" at 12 and 13.  Sections 19 and 20 may be deep enough to be considered "level 2".    You are only advancing 3um with  each section.  It doesn't do the patient any good to leave the tissue undiagnosed in the block.  There have been times when the cancer didn't show up until level 3.  I treat every biopsy as my own.  Of course, you must defer to the pathologist .   Our job is not to make it easier on us, ours is to serve the patient.  Just my 2 cents. 


-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of joelle weaver
Sent: Tuesday, July 23, 2013 7:16 PM
To: Jay Lundgren; Tony Auge
Cc: histonet <@t> lists.utsouthwestern.edu; Martin, Gary
Subject: RE: [Histonet] Sections

Agreed.  




Joelle Weaver MAOM, HTL (ASCP) QIHC
 
> Date: Tue, 23 Jul 2013 14:56:15 -0500
> From: jaylundgren <@t> gmail.com
> To: tony.auge <@t> gmail.com
> Subject: Re: [Histonet] Sections
> CC: histonet <@t> lists.utsouthwestern.edu; gmartin <@t> marshallmedical.org
> 
>     I've worked places where they've used all kinds of leveling 
> methods, specifying number of microns between levels, etc.  I cut 
> exactly whatever the pathologist wants me to cut.  I've traveled for 
> 16 years now.  Think about some of the wacky crap I've seen.
>     A GOOD histotech, in my humble opinion, ( assuming a new, state of 
> the art mirotome, new disposable blade, cold, rough cut, hydrated 
> blocks) should be able to lay out a 21 section 3um ribbon of a GI bx 
> longways on the water bath in one go.
>     Said histotech  would always  ignore the first and last sections 
> of said 21 section ribbon (one is touching the waterbath, and the 
> terminal one touched the forceps/stick/finger/etc) and pick up the 
> 2nd/3rd, 12th/13th, and 19th/20th sections. This is 3 levels.
>      A BAD histotech will lay out a six section ribbon, take six 
> sections (and a floater),  and call it 3 levels.
>      Make absolutely sure that you are rough cutting into the block 
> adequately to provide a full face section.  Most of your recuts will come
> from under-faced blocks.   But try to cut and float nice LOOOOOOONG ribbons
> to pick up your sections from and you will get nicer sections and less 
> recuts.  What takes time cutting (traditional) levels is the refacing 
> and recooling/rehydration of the block.
>  If you can get true levels off of one long ribbon (not 6 adjacent 
> sections), and not increase recuts as a result, you win twice. So does 
> the patient. :)
> 
>                                      Sincerely,
> 
>                                            Jay A. Lundgren, M.S., HTL 
> (ASCP)
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> On Tue, Jul 23, 2013 at 2:04 PM, Tony Auge <tony.auge <@t> gmail.com> wrote:
> 
> > We cut the way your Pathologist is requesting at my lab, it's 
> > simpler and faster then the way you are currently cutting. I was 
> > used to cutting the way you described but this way is much easier. 
> > Check with your other Pathologists that they will be ok with the 
> > switch. I have certain Pathologist that will order more deepers 
> > because they want to see more of the block. It will speed up cutting 
> > in the first place but may take more time to cut deepers later in the day.
> > --
> >
> > Tony Auge HTL (ASCP) QIHC
> > Cell: (651) 373-4768
> > Email: tony.auge <@t> gmail.com
> > _______________________________________________
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> > Histonet <@t> lists.utsouthwestern.edu
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> >
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