Daniel,
You wrote;
That said, is there a reason why we couldn't or shouldn't
process breast core Bx's on the Xpress provided they've been sitting
overnight in formalin?
See following article.
Concensus Recomendations on ER testing in breast cancer by IHC(Appl
Immunohistochem Mol Morphol 2008;16:513-520)
Bryan
---- Original Message -----
From: "Daniel Schneider" <dlschnei...@gmail.com>
To: "Jean Warren" <jwarre...@cinci.rr.com>
Cc: "histonet" <histonet@lists.utsouthwestern.edu>
Sent: Tuesday, July 28, 2009 10:01 AM
Subject: Re: [Histonet] Sakura Rapid Tissue Processor
Actually, that was perfect, wordy replies are what I had hoped for.
How is the automated embedding working out for you? The way I see things,
automated embedding is the true killer feature of the Xpress -- that is,
if
it works.
Why don't skins process well on the Xpress? (When I first appreciated the
automated embedding feature, my first thought was "Great, no more
misembedded pigmented skin lesions!" But if we can't do skins, well...)
Breasts cancers require at least 8 hours formalin fixation for reliable
Her2Neu FISH; presumably that's why you've been told not to do breasts on
the Xpress. That said, is there a reason why we couldn't or shouldn't
process breast core Bx's on the Xpress provided they've been sitting
overnight in formalin?
Thanks!!!
Daniel Schneider
On Tue, Jul 28, 2009 at 7:20 AM, Jean Warren <jwarre...@cinci.rr.com>
wrote:
We have the Sakura rapid tissue processor at my hospital lab, which is a
large private hospital. We have had it three years and it has been
somewhat
of a disappointment::
We have been told that you should not process breasts in it, because you
will not get reliable
results for FISH.
Its implementation has created schedule changes that have caused some
good
techs to leave.
The scenario to get a case out the same day is rare.
If a patient has surgery at 7 am and we receive it by 8 am, it is
accessioned
and grossed in.
Except for biopsies, the specimen still will need 2 hours fixation in
formalin. When
we receive it in Histology at 1030 am, it must go in pre-processing
solution
for 30 minutes. At 1100, we process it for approx 1 hour.
Then embed, cut and stain. Our docs would get it well after lunch and, if
all is
OK, they can get the report out.
And, there are not many cases that meet that time criterion.
One other drawback is that it is more labor intensive to handle 10 blocks
ten times a day than to handle 100 at one time. Our lab processes from
400-750 blocks a day and less than 100 a day are processed on that
processor. All we are handling on the instrument are bxs, bone marrows
and
cytology blocks. If too large a specimen is placed on it, we usually
have a
problem. Endometrial bxs, skins and cones have not had favorable results.
On the other hand, biopsies, especially livers, look and cut better. Our
hematology expert wants all bone marrows done that way. We also rapid
process most cytology that way, but bloody cases still need formalin
fixation.
It is much simpler to change the processor ( and more expensive ).
We tried to do most specimens on it with terrible failure. If anyone gets
it, I
would recommend starting slowly with a few specimen types and gradually
adding.
Our hope is that it will be more useful in the future.
I know, rather wordy answer!
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