[Histonet] RE: Nuclear "Artifact"

[Jennifer MacDonald]

Our pathologists also complained about some of the GI biopsies looking 
burnt.  We tracked all of the problem cases back to one histotech.  The 
histotech was causing the "burn" artifact with excessive use of freezing 
spray. 



From:   "Arbaugh, Roberta" <rarbaugh <@t> csdermatology.com>
To:     "'Morken, Timothy'" <Timothy.Morken <@t> ucsf.edu>, Sue 
<suetp918 <@t> comcast.net>, Lisa Roy <Royl1 <@t> LabCorp.com>
Cc:     "histonet <@t> lists.utsouthwestern.edu" 
<histonet <@t> lists.utsouthwestern.edu>
Date:   04/22/2015 11:32 AM
Subject:        RE: [Histonet] RE: Nuclear "Artifact"
Sent by:        histonet-bounces <@t> lists.utsouthwestern.edu



We have had the same problem. We come to the conclusion that it was water 
droplets. We had the problem when our humidity was high in the lab, or our 
weekend run. The changes we made where :
1. We no longer process over the weekend . We cannot count on our heating 
and cooling in our building.
2. We place a towel and a thick piece of cardboard on top of the processor 
lid.
3.We do not use the really fine mesh cassettes. We will use formalin 
soaked sponges or perm papers.
4. We do not over pack cassette basket.
We had our processor check every time we saw the artifact and they could 
never find a problem with the processor.
Hope this help, Roberta

-----Original Message-----
From: Morken, Timothy [mailto:Timothy.Morken <@t> ucsf.edu]
Sent: Wednesday, April 22, 2015 11:16 AM
To: Sue; Lisa Roy
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] RE: Nuclear "Artifact"

"One pathologist said it looks like the tissue has been cooked."  Which 
could also be drying artifact after bx, before formalin.

"The only issue is we can have two biopsies right next to one another in 
the basket one looks good and one looks bad. My director also thinks it is 
the processors."

Same processor but two results? Solving intermittent problems takes time 
to check variables - time almost no one wants to spend to check out every 
possibility. But if one variable is the same for both, and the result is 
different, then most likely it is a different variable causing the 
problem.

I think the other idea suggested of checking the handling of the tissue at 
the source of the biopsy is more likely to shed some light on this issue.


Tim Morken
Pathology Site Manager, Parnassus
Supervisor, Electron Microscopy/Neuromuscular Special Studies Department 
of Pathology UC San Francisco Medical Center





-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [
mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Sue
Sent: Tuesday, April 21, 2015 4:55 PM
To: Lisa Roy
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] Nuclear "Artifact"

OMG we are experiencing the same issue. At first it was just GI and now we 
are seeing it on prostate. One pathologist said it looks like the tissue 
has been cooked. The only issue is we can have two biopsies right next to 
one another in the basket one looks good and one looks bad. My director 
also thinks it is the processors. I had Thermo out and they could find 
nothing. We changed out all the reagents and the biopsies were fine than 
two days later we had some bad ones. I know in July Fisher had a formalin 
recall associated to the mixture of buffer, water and formalin. We thought 
that might be it but it is now almost a year later and all the bad 
formalin should be gone. The histotechs say the tissue is crunchy and they 
are right. I am running a test tonight of a small needle biopsy that I 
made from a colon. I placed it is straight formaldehyde overnight and am 
processing it on our biopsy cycle tonight. My director also wanted us to 
only put three levels on our Thermo, but he wanted the middle level to 
have empty baskets. I stopped that today because I think the other issue 
is that the poor biopsies may be on the top level and as the reagents are 
used the level changes, and also due to displacement with the middle level 
being empty the reagent levels may not reach the top. We just do not have 
the manpower to inspect every reagent every day, we have 6 processor and 
it would take a tech all day. We actually take a digital picture when they 
come out of the processor. I want to check my problems cases tomorrow. We 
do not use sponges but the only other like was the PA who was wrapping the 
blue paper very tight around the tissue. I really do not think this is the 
issue though.. Any other insight would be greatly appreciated.

Susan T. Paturzo
TJUH
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