[Histonet] Histonet Digest, Vol 140, Issue 6 Specimen loss

[Simmons, Christopher]

As one of the lead participants in the cited study....
We never "lost" specimens.
Did we have fewer than was noted on the casette from gross, yes. Could we attribute that to mucoid samples, yes and no.
We counted everything, even dust like particles, hence the 6% fewer on the slide.
Keeping in mind that a full face is needed for any diagnosis, these particles were exhausted from the block achieving this.
We also kept track of those specimens that either fragmented during processing or when they were handled by the embedding technicians.
WE DO NOT LOSE 7% OF OUR TISSUE.
The protocol is to wrap 0.2-0.3cm and below in biopsy paper. This makes more work for the grossers/embedders, but it is better than fishing samples apart from the ball in the corner they become during processing if you don't.
Now that we are clear (hopefully) can we drop this pointless thread?


Chris Simmons B.S., A.S., HTL(ASCP)

-----Original Message-----
From: Steve McClain [mailto:SteveM at mcclainlab.com] 
Sent: Thursday, July 09, 2015 7:53 AM
To: Blazek, Linda; histonet at lists.utsouthwestern.edu
Subject: Re: [Histonet] Histonet Digest, Vol 140, Issue 6 Specimen loss

Ms. Blazek,
To clarify the matter, I read the cited paper by SR Owens, and I interpret those data differently, and in my opinion, the 7% figure for "lost" specimens is incorrectly quoted.
The majority of his cases where there was a difference between the number of fragments submitted and the fragments observed on the slide involved a gain in number due to fragmentation in 5% of cases.
Where tissue was "lost" (0.6% had fewer fragments at embedding and 6% had fewer on the slide) that mainly appeared to occur during the microtomy phase, due to exhaustion of the fragment in the block.

Owens gives no indication there were any cases where all tissue was lost.
Nor does he specifically define the minimum size to be counted as a fragment, e.g., how small is a fragment.

These data do not support the daily loss of all fragments in a specimen block or the expectation that tissue will not survive processing.

In UPMC protocol They wrap all specimens, ink the tissue with eosin (erythrosine) at the grossing bench and cut two levels at 40 microns.

Steve A. McClain, MD
631 361 4000

-----Original Message-----
From: Blazek, Linda [mailto:lblazek at digestivespecialists.com]
Sent: Wednesday, July 08, 2015 2:40 PM
To: Steve McClain; histonet at lists.utsouthwestern.edu
Subject: RE: Histonet Digest, Vol 140, Issue 6 Specimen loss

Dear Mr. Cantankerous, :)

So how would you gross a colon biopsy that was <0.1 cm and probably mucus?  

-----Original Message-----
From: Steve McClain [mailto:SteveM at mcclainlab.com]
Sent: Wednesday, July 08, 2015 1:47 PM
To: histonet at lists.utsouthwestern.edu
Subject: Re: [Histonet] Histonet Digest, Vol 140, Issue 6 Specimen loss

My goodness 7% tissue loss is ridiculous.
What fool published that?

A 0.8% "loss of tissue" is beyond me.
Would any one advertise in the local paper that your center of excellence lab loses nearly 1% of your specimens?

"possibly too small to survive processing" is in my opinion, a self-fulfilling prophesy, one to be eschewed and denounced, or beaten out of the grosser who dares use that description for it is an expectation of failure.
That grosser would not last a week around me.
I would walk them to the train station and ask them not to return.

I felt less cantankerous before I read that one. 
Steve A. McClain, MD
631 361 4000
****

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