[Histonet] Tissue Fixation

Fri Mar 31 12:10:55 CDT 2017

I second the opinion of Joyce. We see such effects in portio-conisations, that are done with a thermo-electrical knife. The surface and the underlying area show a very pink colour in HE. It can also be seen in prostata-chips. IHC on such biopsies shows the effect of an non-stainable edge with a clear cut between positive and negative. 
https://www.uni-marburg.de/fb20/zahnerhaltk/lehre/Download/Bilder/35_plattenepithelmetaplasie_portio_02212427.jpg
I've found this picture, that shows a typical conisation-section.
regards
Gudrun 

-----Ursprüngliche Nachricht-----
Von: Weems, Joyce K. via Histonet [mailto:histonet at lists.utsouthwestern.edu] 
Gesendet: Freitag, 31. März 2017 17:26
An: Morken, Timothy; Rene J Buesa; T H; Histonet at lists.utsouthwestern.edu
Betreff: Re: [Histonet] Tissue Fixation

Aren't LEEPS done with some sort of electric method that will damage the tissue before it even reaches formalin. I'm not positive but Google it - I believe that might be the problem. j

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
770-380-8099 Cell
joyce.weems at emoryhealthcare.org

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Atlanta, GA 30342

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-----Original Message-----
From: Morken, Timothy via Histonet [mailto:histonet at lists.utsouthwestern.edu]
Sent: Friday, March 31, 2017 11:07 AM
To: Rene J Buesa <rjbuesa at yahoo.com>; T H <thigginsht at msn.com>
Cc: Histonet <histonet at lists.utsouthwestern.edu>
Subject: Re: [Histonet] Tissue Fixation

Tim, I have to agree with Rene that the formalin or time in formalin is obviously not the problem - it has plenty of time in formalin (and who would dilute it anyway?). Handling before formalin must always be determined when problems arise. If the sample sits on a paper towel, gauze etc it does not really degrade faster, rather the tissue may dry out and so fixes by dehydration rather than by formalin. It may be the formalin cannot get into the tissue in those dried out portions of the tissue. However that is just speculation. Since these all seem to be from one particular client, the client is the place to start. The only way to determine the problem is to follow the specimen from start to finish. Can you or someone you trust physically observe the way samples are handled from the time they are taken to the time put in formalin? One issue I always run up against is people  saying they do one thing but actually doing another. And they may realize during questioning that they are not doing it right but don't want to admit it. It wastes a lot of time. I've had physicians tell me to ignore the part of the process they are responsible for because they do it right. I just tell them that to be complete we need to follow the process from start to finish, nothing personal, just business. Leaving any part out may lead to not resolving the problem. Probably 99% of the process is just fine, but that 1% is damaging the sample and needs to be illuminated.

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

-----Original Message-----
From: Rene J Buesa via Histonet [mailto:histonet at lists.utsouthwestern.edu]
Sent: Friday, March 31, 2017 6:33 AM
To: T H; histonet at lists.utsouthwestern.edu
Subject: Re: [Histonet] Tissue Fixation

What you describe as a possible scenario is absolutely possible.If your PT does not "want to hear" about it, suggest she gets a "hearing aid" or to study something about histotechnology or even better yet, pay attention to what a professional on the subject (you) has to say about it. You would never dare to question her diagnosis, why would she question yours on this subject?René

    On Friday, March 31, 2017 9:11 AM, T H via Histonet <histonet at lists.utsouthwestern.edu> wrote:

 Good Morning,

I have a pathologist that is not happy with the fixation on some of our LEEP specimens.  She swears its histology doing something to the specimen to cause the tissue to look unfixed on only "part" of the LEEP specimens (all the same client specimens).  She claims we must be diluting our formalin to cause this issue or "something".  We mentioned maybe it was on the clients end not placing them in 10% formalin right away, she wouldn't hear of it.

Let me give you some back ground on how our process works.  Our clients send us all our specimens to us via Overnight FedEx or UPS in 10% formalin they will then they sit in 10% formalin in-house until the processors are started around 3pm and sits an additional 5 hours in 10% formalin on the processor before the processor actually starts.  That being said the fixation process has had a pretty good start before we ever even touch it.

My question is, and I thought I had read this in the past is, when a specimen is left out prior to fixation and lying on a absorbent surface such as a paper towel, won't the area of the tissue touching the absorbent surface begin the disintegration processes faster in that exact area then the rest of the specimen?  Or if you have any other suggestion on what might be happening to only "certain" specimens would be great as well.

Thanks for your help!

Tim

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