[Histonet] Tissue fixation

[Bob Richmond]

Tim describes a problem "I have a pathologist that is not happy with the
fixation on some of our LEEP specimens."

LEEP specimens are inherently crappy, because of the cautery used to obtain
them, and the resulting cautery artifact in the specimens. In the last few
years they've turned the voltage down, and that's helped some - and perhaps
this particular clinic hasn't turned the voltage down.

I wonder how familiar your pathologist is with the whole process - the sort
of homely detail not taught in pathology residency, and the sort of detail
I often go out and research on my own. It's helpful to all to know that the
clinical stakes here are not high - we do report margins on cervical LEEP
specimens (when we can figure them out), but clinical outcomes apparently
don't have much to do with whether margins are positive for dysplasia or
not.

It's impossible to get india ink to stick to the cauterized gross margins,
but the cautery artifact is painfully obvious under the microscope anyway.

Bob Richmond
Samurai Pathologist
Maryville TN