[Histonet] Re: Prostate Needle Bx

[Bob Richmond]

Laurie Colbert asks about processing prostate needle biopsy specimens.

The subject is extensively reviewed in this month's or last month's
Archives of Pathology. Your pathologists have copies of this if they're
fellows of the College of American Pathologists. Here's the method as
presented in that article - I've been doing this for a good many years now.

The urologist should submit six containers, three for each side of the
prostate, each container containing two or more cores. No more than two
cores should be put in one cassette. Use those little blue sponges in the
cassettes to keep the cores flat. Measure each core, and record the
measurements. Don't dye the cores with eosin (fluorescent) - if you want to
dye them use safranin O.

Process with other small biopsy specimens.

Embed using a tamper to get the cores flat in the bottom of the boat.

Cut sections onto slides suitable for immunohistochemistry. Cut 5 sections
of each block, with little if any trimming. Stain slides 1, 3, and 5 with H
& E. Reserve slides 2 & 4 for possible immunohistochemistry (needed in
about a tenth of cases).

It's a lot of work, but it makes cancer diagnoses. Expect a cancer
diagnosis in about a third of cases.

Bob Richmond
Samurai Pathologist
Maryville TN