[Histonet] Re: GI biopsies

[Barbara Tibbs]

Dr. Richmond,

A large portion of our business is GI biopsies.  We cut three levels per slide.  We achieve this by cutting three ribbons at different levels and picking up two sections from each ribbon.  If an H.pylori or AB/PAS is ordered we choose two sections from the middle ribbon.  I check the quality of the slides before handing them out to the pathologists.  I encourage the pathologists to share any unhappiness they have with our microtoming and work to improve the problem ASAP.

It seems to me that skilled, caring histotechnologists plus good communication with the pathologists is the magic equation for excellent quality slides.

Barbara S. Tibbs
Histology Supervisor
Accurate Diagnostic Labs
South Plainfield, NJ
barbara.tibbs <@t> accuratediagnosticlabs.com
732-839-3374
Cell: 610-809-6508


________________________________________
From: histonet-bounces <@t> lists.utsouthwestern.edu <histonet-bounces <@t> lists.utsouthwestern.edu> on behalf of Bob Richmond <rsrichmond <@t> gmail.com>
Sent: Friday, March 14, 2014 10:37 AM
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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