[Histonet] Re: GI biopsies

[joelle weaver]

Yes Dr. Richmond
GI biopsies are prone to processing issues and shatter/chatter artifact. I like to put three true levels on one slide with unstained for later SS & IHC , OR put two parallel ribbons on one slide, ( 2 slides of 2 ribbons, for 4 actual levels). I put three ribbons for Hirshsprungs on each slide to provide the section numbers without making multitudes of slides. I have a hard time getting this accepted- The pathologist almost always wants three ribbons on 2-3 slides, and I think that is because only some of the sections are truly "readable"- the section quality is too variable for these specimens for them to feel comfortable. I like to reveiw these under the microscope since when they are tiny, it is hard to see the shatter, folds and fragmentation on the water bath. I agree it is definately a quality problem to be addressed.




Joelle Weaver MAOM, HTL (ASCP) QIHC
 
> Date: Fri, 14 Mar 2014 08:37:46 -0400
> From: rsrichmond <@t> gmail.com
> To: histonet <@t> lists.utsouthwestern.edu
> Subject: [Histonet] Re: GI biopsies
> 
> An anonymous query: >>I was just curious about how your institutions handle
> GI biopsies, specifically how many slides you cut off the bat. We presently
> cut 2 levels on each GI biopsy block, but I'm hearing that more and more
> places only cut 1 slide per GI biopsy block. Please share what you are
> doing at your establishment.<<
> 
> Well, I take what I can get. Many histotechs lack the skill, or are
> unwilling to lay more than one ribbon on a slide. I do like more than one
> level.
> 
> A more serious problem is maintaining the quality of GI biopsy sections,
> one of the most difficult quality assurance issues in histopathology. (It
> was reviewed in J HIstotechnol last year - I can find the reference.) The
> problem is at its worst with duodenal biopsies, where some services never
> prepare an adequate slide. As the "celiac disease" fad spreads and bread is
> the Evil Food of the Year, I am really concerned about signing out duodenal
> biopsies where I can't even distinguish the lymphocytes.
> 
> Edwards Deming lives!
> 
> Bob Richmond
> Samurai Pathologist
> Maryville TN
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