Kathy Machado at Danville, Virginia, Regional Medical Center asks: >>I was wondering if other labs are "automatically" ordering special stains and/or IHC on stomach biopsies and esophageal biopsies? Or do you wait until H&E is screened?<<
A number of fairly small labs I've worked in in recent years all do whatever studies they do at all on all biopsies. What they do varies greatly - and usually the pathologist isn't allowed to ask for anything not done on every biopsy. Specifically: Every lab I've seen does either a stain or IHC for Helicobacter on all gastric biopsies. A few do Alcian blue on all esophageal biopsies. I've never seen a lab that did any stain routinely on duodenal biopsies, where the pathologist is deliriously happy just to get consistently interpretable H & E slides. I've been asking around about routine CD3 on duodenal biopsies. A fair number of labs do it, but G.I. pathologists caution you not to, because there are no published standards for interpreting this stain. As you're probably aware, the regulatory agency for the Virginias and the Carolinas is planning to put a stop to all routine G.I. biopsy special stains, and limit Helicobacter staining to 20% of gastric biopsies. I think this is acceptable practice, provided that there is a serious quality assurance program for G.I. biopsy slides, something I've yet to see. Bob Richmond Samurai Pathologist Maryville TN _______________________________________________ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet