[Histonet] Histonet Digest, Vol 158, Issue 22 Breast Specimen

[Rathborne, Toni]

There is also a CAP checklist standard that might help you to document these cases, without it seeming like you're complaining. Once the offenders have it brought to their attention, and know that it is being documented, they may start to give more consideration to the sections they're putting through.

**NEW** 07/28/2015
ANP.10038 Tissue Sample Quality Phase II There is a procedure that describes the process by which histotechnologists provide feedback to submitting pathologists and pathology assistants on the quality of the gross tissue sections received for tissue processing.
NOTE: Inadequate fixation, overly thick tissue sections, non-decalcified bone, the presence of staples, etc., can lead to poor quality histologic sections and/or poor quality special stains/special studies.
This requirement applies to both laboratories that gross tissue and perform all processing onsite, as well as laboratories that gross tissue and send it to another laboratory for processing, embedding, and sectioning (regardless of the outside laboratory's accrediting organization).
Records of such feedback and corrective action taken when problems are identified may be incorporated into the laboratory's quality management program.
Evidence of Compliance:
✓ Records of feedback and corrective action for problems identified with tissue quality


Toni


-----Original Message-----
From: Steve McClain via Histonet [mailto:histonet at lists.utsouthwestern.edu]
Sent: Monday, January 30, 2017 3:14 PM
To: histonet at lists.utsouthwestern.edu
Subject: Re: [Histonet] Histonet Digest, Vol 158, Issue 22 Breast Specimen


*** This is an External Email ***

In my experience, rushing to process fatty or inadequately fixed specimens is a fool's game.
In my opinion, this problem cannot be solved by the histotechs- it begins with the grossers and is one for the pathologists to solve at the grossing bench.

Suggestion #1 Do nothing and let the medical director pathologist/ sign it out/deal w this individual case.

Suggestion #2  Sometimes a decent section can be obtained after changing paraffin.
[place the blocks in molds and melt the blocks and change to new paraffin- let them sit in the embedding center in the new paraffin for 60 minutes. Re-embed in new paraffin (2 changes) and then re-embed.]

Suggestion #3 Reprocess these blocks if permitted, recognizing that breast markers (if cancerous) may be erroneous.

Suggestion #4 Seek to prevent future occurrences by adjusting behavior at the grossing bench.
a) first ensuring adequate fixation and b) second ensuring adequate length/time of processing.


Steve A. McClain, MD
631 361 4000

What is the best way to handle Breast specimens that were grossed too thick and did not process well?  Our medical director does not want us to reprocess the tissue but it is almost impossible to get even a remotely decent section. If anyone has any other tips please let me know as soon as possible

--

Charles Riley HT(ASCP)CM

Histopathology Coordinator/ Mohs**********************

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