It is impossible to say how deep to cut into a block. First the PA must be sure
s/he was sure the tumor/lesion was in the piece submitted to process. If that
is the case, the one who casted the block must be sure the lesion is as near
the block surface as possible in a way that when the block is trimmed, the
lesion is macroscopically visible.The rest depends on the pathologist is s/he
can make the diagnosis with the slides first submitted or if deeper sections
are required.Usually deeper sections are requested when the tumor or abnormal
tissue is visible and more information is required. It is very rare that a
pathologist requests deeper to find the lesion, unless trimming has been so
superficial that the slide barely reveals the processed tissue.Usually lesion
will be near the center of the tissue processed because the PA leaves tissue
around the lesion. If this practice is followed, the histotechs should trim
until the sections closely has the same size (area) as the processed tissue.If
the pathologist asks for deepers several times, and s/he is sure there should
be a lesion in the section, keep presenting sections until the lesion is
found.As an advise, do not discard sections and keep at least 1 every 5
sections to prevent a very small lesion is lost for ever and the diagnosis
cannot be made.Consult always with your pathologist, especially asking if there
should be a lesion, because the whole problem may reside in the fact that the
PA did not include what the pathologist is looking for in the tissue submitter
for processing.René
On Wednesday, July 19, 2017 9:30 AM, Charles Riley via Histonet
<histonet@lists.utsouthwestern.edu> wrote:
We currently are having issues with our pathologists asking for deeper
levels. They complain that they are not finding tumors that should be there
and need us to go deeper.
Does anyone have any suggestions on how far into a block I should explain
to my techs to go in order to help them get over the fear of going too deep
into a block?
--
Charles Riley BS HT, HTL(ASCP)CM
Histopathology Coordinator/ Mohs
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