[Histonet] fatty tissue Protocol
I'd like to know how many labs use an extended protocol to process fatty breast tissue. Does an extended protocol really work. I still believe if the tissue is submitted in small, thin and adequately fixed sections prior to processing there should be no need for a 16 hour processing cycle. Any thoughts. Andrea Beharry Technical specialist William Osler Health system Brampton, Ontario Sent from my iPad ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] fatty tissue Protocol
I agree if the tissue is cut properly you should not need an extended program but when you have residents and PA's they tend to rush and their sections are thicker. We do not have an extended program still within the CAP limits and it works quite nicely. TJUH Sue ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC billing question
That's what we do as well. Martha Ward Wake Forest Baptist Health From: Weems, Joyce K. [joyce.we...@emoryhealthcare.org] Sent: Friday, May 01, 2015 9:13 AM To: 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question I do it every day - change every first to 88342. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard Sent: Thursday, April 30, 2015 5:33 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] IHC billing question Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Question
All that matters here is the final concentration of the reagent - it doesn't matter what stock you start with if you calculate the dilution. Adding 1.25 ml to 1000 ml is diluted by a factor of .00125 so 10N x .00125 = .0125 N final concentration. If using a 1 N stock solution, just add 10X the volume or 12.5 ml 1 N stock to 987.5 ml water. Hope this helps, Tresa -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bernice Frederick Sent: Thursday, April 30, 2015 1:35 PM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] Question All, I have a procedure here that call for and I quote 1.25 ml NaOH 10N in 1L of water. I know how to get 1 N, but how do I get 10. Having rarely hd the opportunity to make many Normal solutions ,my brain is not computing. Is it an error? Bernice Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility Robert. H. Lurie Cancer Center Northwestern University 710 N Fairbanks Court Olson 8-421 Chicago,IL 60611 312-503-3723 b-freder...@northwestern.edumailto:b-freder...@northwestern.edu ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Question
Huh? Take a solution more dilute than you want it and dilute it more? Geoff On 5/1/2015 10:41 AM, Goins, Tresa wrote: All that matters here is the final concentration of the reagent - it doesn't matter what stock you start with if you calculate the dilution. Adding 1.25 ml to 1000 ml is diluted by a factor of .00125 so 10N x .00125 = .0125 N final concentration. If using a 1 N stock solution, just add 10X the volume or 12.5 ml 1 N stock to 987.5 ml water. Hope this helps, Tresa -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bernice Frederick Sent: Thursday, April 30, 2015 1:35 PM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] Question All, I have a procedure here that call for and I quote 1.25 ml NaOH 10N in 1L of water. I know how to get 1 N, but how do I get 10. Having rarely hd the opportunity to make many Normal solutions ,my brain is not computing. Is it an error? Bernice Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility Robert. H. Lurie Cancer Center Northwestern University 710 N Fairbanks Court Olson 8-421 Chicago,IL 60611 312-503-3723 b-freder...@northwestern.edumailto:b-freder...@northwestern.edu ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet -- -- ** Geoff McAuliffe, Ph.D. Neuroscience and Cell Biology Robert Wood Johnson Medical School 675 Hoes Lane, Piscataway, NJ 08854 voice: (732) 235-4583; fax: -4029 mcaul...@rwjms.rutgers.edu ** ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC billing question
We have 2 billing codes for IHC. One for the first IHC and another for all additional IHC's on the same case. Hazel Horn Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital 1 Children's Way | Slot 820| Little Rock, AR 72202 501.364.4240 direct | 501.364.1241 fax hor...@archildrens.org archildrens.org -Original Message- From: Weems, Joyce K. [mailto:joyce.we...@emoryhealthcare.org] Sent: Friday, May 01, 2015 8:13 AM To: 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question I do it every day - change every first to 88342. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard Sent: Thursday, April 30, 2015 5:33 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] IHC billing question Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ** The information contained in this message may be privileged and confidential and protected from disclosure. If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by replying to the message and deleting it from your computer. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC billing question
And what LIS to you have? Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: Horn, Hazel V [mailto:hor...@archildrens.org] Sent: Friday, May 01, 2015 11:50 AM To: Weems, Joyce K.; 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: RE: IHC billing question We have 2 billing codes for IHC. One for the first IHC and another for all additional IHC's on the same case. Hazel Horn Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital 1 Children's Way | Slot 820| Little Rock, AR 72202 501.364.4240 direct | 501.364.1241 fax hor...@archildrens.org archildrens.org -Original Message- From: Weems, Joyce K. [mailto:joyce.we...@emoryhealthcare.org] Sent: Friday, May 01, 2015 8:13 AM To: 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question I do it every day - change every first to 88342. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard Sent: Thursday, April 30, 2015 5:33 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] IHC billing question Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC billing question
Meditech Hazel Horn Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital 1 Children's Way | Slot 820| Little Rock, AR 72202 501.364.4240 direct | 501.364.1241 fax hor...@archildrens.org archildrens.org -Original Message- From: Weems, Joyce K. [mailto:joyce.we...@emoryhealthcare.org] Sent: Friday, May 01, 2015 10:51 AM To: Horn, Hazel V; 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: RE: IHC billing question And what LIS to you have? Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: Horn, Hazel V [mailto:hor...@archildrens.org] Sent: Friday, May 01, 2015 11:50 AM To: Weems, Joyce K.; 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: RE: IHC billing question We have 2 billing codes for IHC. One for the first IHC and another for all additional IHC's on the same case. Hazel Horn Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital 1 Children's Way | Slot 820| Little Rock, AR 72202 501.364.4240 direct | 501.364.1241 fax hor...@archildrens.org archildrens.org -Original Message- From: Weems, Joyce K. [mailto:joyce.we...@emoryhealthcare.org] Sent: Friday, May 01, 2015 8:13 AM To: 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question I do it every day - change every first to 88342. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard Sent: Thursday, April 30, 2015 5:33 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] IHC billing question Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu
Re: [Histonet] Question
The final concentration of 1.25 ml 10N NaOH into 1000 ml water is the same as: 12.5 ml 1N NaOH into 987.5 ml water. -Original Message- From: Geoff [mailto:mcaul...@rwjms.rutgers.edu] Sent: Friday, May 01, 2015 9:16 AM To: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Question Huh? Take a solution more dilute than you want it and dilute it more? Geoff On 5/1/2015 10:41 AM, Goins, Tresa wrote: All that matters here is the final concentration of the reagent - it doesn't matter what stock you start with if you calculate the dilution. Adding 1.25 ml to 1000 ml is diluted by a factor of .00125 so 10N x .00125 = .0125 N final concentration. If using a 1 N stock solution, just add 10X the volume or 12.5 ml 1 N stock to 987.5 ml water. Hope this helps, Tresa -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bernice Frederick Sent: Thursday, April 30, 2015 1:35 PM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] Question All, I have a procedure here that call for and I quote 1.25 ml NaOH 10N in 1L of water. I know how to get 1 N, but how do I get 10. Having rarely hd the opportunity to make many Normal solutions ,my brain is not computing. Is it an error? Bernice Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility Robert. H. Lurie Cancer Center Northwestern University 710 N Fairbanks Court Olson 8-421 Chicago,IL 60611 312-503-3723 b-freder...@northwestern.edumailto:b-freder...@northwestern.edu ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet -- -- ** Geoff McAuliffe, Ph.D. Neuroscience and Cell Biology Robert Wood Johnson Medical School 675 Hoes Lane, Piscataway, NJ 08854 voice: (732) 235-4583; fax: -4029 mcaul...@rwjms.rutgers.edu ** ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] GMS Question
Hello, I think I already know the answer but I'm not sure why so if someone can help me understand the theory behind it, I would greatly appreciate it. Currently, we use the Richard Allen kit for the GMS stain and it uses Periodic Acid as the 1st step. We use a control tissue from a case we had that was positive for fungus and it's a fungus ball from the Rt Maxillary. We ran a test for fungus on a different and current case of the same tissue (different patient): Rt Maxillary sinus. The control tissue did work, but the patient's tissue did not, so the doctor ordered a PAS for fungus and this clearly showed the fungal elements nicely. My question is why would the control and patient tissue have different results when they are both fungus balls from the same specimen source? Thanks in advance, Paula Lab Manager Bio-Path Medical Group ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC billing question
Am I misunderstanding, or should it be per specimen and not per case? Michael Mihalik PathView Systems | cell: 214.733.7688 | 800.798.3540 | fax: 952.241.7369 -Original Message- From: Horn, Hazel V [mailto:hor...@archildrens.org] Sent: Friday, May 01, 2015 8:50 AM To: 'Weems, Joyce K.'; 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question We have 2 billing codes for IHC. One for the first IHC and another for all additional IHC's on the same case. Hazel Horn Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital 1 Children's Way | Slot 820| Little Rock, AR 72202 501.364.4240 direct | 501.364.1241 fax hor...@archildrens.org archildrens.org -Original Message- From: Weems, Joyce K. [mailto:joyce.we...@emoryhealthcare.org] Sent: Friday, May 01, 2015 8:13 AM To: 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question I do it every day - change every first to 88342. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard Sent: Thursday, April 30, 2015 5:33 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] IHC billing question Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ** The information contained in this message may be privileged and confidential and protected from disclosure. If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution
[Histonet] Combination bracket for Gross lab senior
Does anybody have an idea how to attach the combination bracket with a shelf for the Printmate from Thermo Fisher. No instructions and trying to conceptualize how this thing goes together. Worse than putting together a swing set or new kid's bicycle. Diagram or picture with one attached would be helpful. Manufacturer trying to find some instructions also. Jim Jim Vickroy Histology Manager Springfield Clinic, Main Campus, East Building 1025 South 6th Street Springfield, Illinois 62703 Office: 217-528-7541, Ext. 15121 Email: jvick...@springfieldclinic.commailto:jvick...@springfieldclinic.com This electronic message contains information from Springfield Clinic, LLP that may be confidential, privileged, and/or sensitive. This information is intended for the use of the individual(s) or entity(ies) named above. If you are not the intended recipient, be aware that disclosure, copying, distribution, or action taken on the contents of this information is strictly prohibited. If you have received this electronic message in error, please notify the sender immediately, by electronic mail, so that arrangements may be made for the retrieval of this electronic message. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] GMS Question
To get a positive PAS or GMS fungal stain, one must oxidize the carbohydrate in the fungal cell wall. Chromic acid is a stronger oxidizer than periodic acid, so would work better with mature fungal cell walls that are highly polymerized. Treat an immature cell wall for too long, and you may get a false negative because the carbohydrate structure no longer resembles a fungal cell wall. Tresa -Original Message- From: Paula Lucas [mailto:plu...@biopath.org] Sent: Friday, May 01, 2015 8:17 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] GMS Question Hello, I think I already know the answer but I'm not sure why so if someone can help me understand the theory behind it, I would greatly appreciate it. Currently, we use the Richard Allen kit for the GMS stain and it uses Periodic Acid as the 1st step. We use a control tissue from a case we had that was positive for fungus and it's a fungus ball from the Rt Maxillary. We ran a test for fungus on a different and current case of the same tissue (different patient): Rt Maxillary sinus. The control tissue did work, but the patient's tissue did not, so the doctor ordered a PAS for fungus and this clearly showed the fungal elements nicely. My question is why would the control and patient tissue have different results when they are both fungus balls from the same specimen source? Thanks in advance, Paula Lab Manager Bio-Path Medical Group ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC billing question
We have CoPath. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: Horn, Hazel V [mailto:hor...@archildrens.org] Sent: Friday, May 01, 2015 12:00 PM To: Weems, Joyce K.; 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: RE: IHC billing question Meditech Hazel Horn Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital 1 Children's Way | Slot 820| Little Rock, AR 72202 501.364.4240 direct | 501.364.1241 fax hor...@archildrens.org archildrens.org -Original Message- From: Weems, Joyce K. [mailto:joyce.we...@emoryhealthcare.org] Sent: Friday, May 01, 2015 10:51 AM To: Horn, Hazel V; 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: RE: IHC billing question And what LIS to you have? Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: Horn, Hazel V [mailto:hor...@archildrens.org] Sent: Friday, May 01, 2015 11:50 AM To: Weems, Joyce K.; 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: RE: IHC billing question We have 2 billing codes for IHC. One for the first IHC and another for all additional IHC's on the same case. Hazel Horn Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital 1 Children's Way | Slot 820| Little Rock, AR 72202 501.364.4240 direct | 501.364.1241 fax hor...@archildrens.org archildrens.org -Original Message- From: Weems, Joyce K. [mailto:joyce.we...@emoryhealthcare.org] Sent: Friday, May 01, 2015 8:13 AM To: 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question I do it every day - change every first to 88342. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard Sent: Thursday, April 30, 2015 5:33 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] IHC billing question Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments.
[Histonet] long answer RE: GMS Question
Hi Paula, The same site of infection for your control and patient tissues does not mean the fungus species was the same. Now for addtional commentary. The classic GMS uses chromic acid as the oxidizer, stronger than periodic acid. This is something to beware of since you had a false negative result with the kit. Periodic acid should be freshly made up from periodic acid crystals just before use (Culling insisted on fresh periodic acid reagent) then discarded after that day - something that is not going on with a kit where all components are sent to you in ready to use liquid form. I think if you had used the classic GMS with chromic acid to start with, you would have had the results seen with Periodic Acid/Schiffs. Part of the problem is the not all fungus species stain well either PAS or Periodic acid/GMS, and even classic GMS. All these factors can present a problem when trying to diagnose fungal infections.Lee Luna in AFIP manual, pointed out it has been found that the time of exposure to methenamine-silver nitrate solution for complete development may vary according to type and/or strains suspected. He advised if Nocardia asteroides is suspected, then two slides should be run: one for 60 minutes and one for 90 min in the silver solution. Histotechs should be aware these possible problems. Fungi are difficult at best even when doing fungus cultures and treat. Fortunately, there are antibodies for some fungi i.e. Aspergillus, Candida) but you would probably need the specific fungus as a control for the antibody being used. Fungus IHC experts can weigh in on the latter topic. I don't know what fungus species was in your fungus ball control block, but our clinical lab fungus ball control contained Aspergillus sp. from a post mortem human lung. With the researcher, he only had pure Aspergillus sp. infecting the tissues.It would be nice to know what species of fungus is in your control tissue block The publication by Frieda Carson along with Jerry Fredenburgh and John Maxwell Inconsistent detection of Histoplasma capsulatum with periodic acid in GMS fungus stain , J Histotechnology, 1999 is a profound statement about what you just experienced. Their tissue control i.e. Aspergillus sp. stained adequately with periodic acid/GMS but the H. capsulatum fungus in tissue did not stain. They studied several different times, temperatures, periodic acid concentrations and fungus species. They had additional controls containing fungi other than Aspergillus sp. for better sampling of PA/GMS on different fungi. Having different fungus species control blocks is a luxury many labs do not enjoy. The reason chromic acid is not in kits is due to shipping, health and safety hazards, must be handled carefully and collected for proper, safe disposal so it is easier to make up GMS kits with periodic acid.If you have to collect your silver solutions for safe chemical disposal, then chromic acid shouldn't be a big problem to do the same. Also, since Periodic acid/Schiffs is popular and commonly used for fungus staining, PAS can also present false negative results or weak staining due to the weaker periodic acid oxidation, even when the periodic acid is made in house, fresh for the day. Chromic acid/Schiffs has been recommended by people on Histonet to improve fungus staining over PAS. PAS stain always seem to work well with Candida sp. and Aspergillus sp. but classic GMS was always better in my hands. I only used classic GMS, prepared in house, and controlled the development with a microscope to avoid under and over silver staining of fungus. I will be happy to send the Carson et al publication and scan the AFIP manual pages with photos on fungus staining by Luna. I apologize for long discourse as chromic acid/GMS stain is one of my favorite special stains to perform along with a long standing interest in fungus staining. I hope this helps. Gayle M. Callis HTL/HT/MT(ASCP) -Original Message- From: Paula Lucas [mailto:plu...@biopath.org] Sent: Friday, May 01, 2015 8:17 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] GMS Question Hello, I think I already know the answer but I'm not sure why so if someone can help me understand the theory behind it, I would greatly appreciate it. Currently, we use the Richard Allen kit for the GMS stain and it uses Periodic Acid as the 1st step. We use a control tissue from a case we had that was positive for fungus and it's a fungus ball from the Rt Maxillary. We ran a test for fungus on a different and current case of the same tissue (different patient): Rt Maxillary sinus. The control tissue did work, but the patient's tissue did not, so the doctor ordered a PAS for fungus and this clearly showed the fungal elements nicely. My question is why would the control and patient tissue have different results when they are both fungus balls from the
Re: [Histonet] GMS Question
Hi Gayle - We have never had a noticeable problem detecting fungi using 5% aqueous chromic acid at room temperature for 1 hr. The presence of mature and immature wall structures may be the reason. We have never tried to determine the end point for over oxidation, but my best guess is that it is much longer than 60 minutes. More often, I think a false negative would result from inadequate oxidation of the fungal cell wall. In addition to cell wall maturity, I believe the composition adds to differences in rates of oxidation, the major contributors being the prevalence of precursors susceptible to aldehyde formation and melanin. One needs enough product to produce a visible color reaction. A complex question and any more detail and I will have to hit the books. Tresa -Original Message- From: Gayle Callis [mailto:gayle.cal...@bresnan.net] Sent: Friday, May 01, 2015 1:17 PM To: Goins, Tresa; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] GMS Question Hi Tresa, What staining parameters do you suggest for seeing mature and/or immature fungal cell walls? I don't think you will know what level of maturity is present before doing a fungus stain. But wouldn't both levels of maturity both be present if the fungus is actively growing in a tissue? What do you recommend, using both a PAS, or chromic acid/Schiffs along with chromic acid GMS method? We used 4% chromic acid at RT for 1 hour but would you recommend duplicating slides so you do pull one slide out of chromic acid at 30 minutes and one for 60 minutes to stain either mature or immature fungal and/or both cell wall structure. Gayle Callis HTL/HT/MT (ASCP) -Original Message- From: Goins, Tresa [mailto:tgo...@mt.gov] Sent: Friday, May 01, 2015 11:29 AM To: Paula Lucas; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] GMS Question To get a positive PAS or GMS fungal stain, one must oxidize the carbohydrate in the fungal cell wall. Chromic acid is a stronger oxidizer than periodic acid, so would work better with mature fungal cell walls that are highly polymerized. Treat an immature cell wall for too long, and you may get a false negative because the carbohydrate structure no longer resembles a fungal cell wall. Tresa -Original Message- From: Paula Lucas [mailto:plu...@biopath.org] Sent: Friday, May 01, 2015 8:17 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] GMS Question Hello, I think I already know the answer but I'm not sure why so if someone can help me understand the theory behind it, I would greatly appreciate it. Currently, we use the Richard Allen kit for the GMS stain and it uses Periodic Acid as the 1st step. We use a control tissue from a case we had that was positive for fungus and it's a fungus ball from the Rt Maxillary. We ran a test for fungus on a different and current case of the same tissue (different patient): Rt Maxillary sinus. The control tissue did work, but the patient's tissue did not, so the doctor ordered a PAS for fungus and this clearly showed the fungal elements nicely. My question is why would the control and patient tissue have different results when they are both fungus balls from the same specimen source? Thanks in advance, Paula Lab Manager Bio-Path Medical Group ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Tissue transfer method:
Does anyone have a procedure that they can share on tissue transfer? One stained slide to another? Thank you for your help. Sincerely, Craig Sent from my iPhone ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC and oven temperature
Hi Rene, Contradiction? Possibly but HIER is done in an aqueous environment, whereas the oven heating above 60oC was done dry (I will send you a copy of the article under a separate email). Regards, Tony (from down under, currently in London UK). From: Rene J Buesa [rjbu...@yahoo.com] Sent: Friday, 1 May 2015 5:56 AM To: Tony Henwood (SCHN); Histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC and oven temperature What about HIER at 95-98ºC? Everybody uses it to enhance epitopes detection. Is there not an intrinsic contradiction here? René J. On Thursday, April 30, 2015 3:32 PM, Tony Henwood (SCHN) tony.henw...@health.nsw.gov.au wrote: Yes, I read the Dako IPX educational guides (5th ed) and on page 32: No processes should raise tissue temperature to higher than 60oC as this will cause severe loss of antigenicity that may not be recoverable Unfortunately there is no evidence given or cited that validates this statement. Even though this could be right (and there are several papers that have looked at this), this statement is scientifically weak and we should not cite this as truth. Now I do recommend the Dako reference series to my students, and I have contributed to one of these texts myself (Microscopic control of routine HE - know your histology) but I request my students to continue to question what they read and confirm the scientific validity of the information. Regards, Tony From: Joelle Weaver [joellewea...@hotmail.commailto:joellewea...@hotmail.com] Sent: Saturday, 25 April 2015 5:51 AM To: Tony Henwood (SCHN); WILLIAM DESALVO; Preiszner, Johanna Cc: histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] IHC and oven temperature I remember reading that the preffered temperature was about 60 degrees Celsius. I think that this was in the Dako education guides if I'm not mistaken. If that is the case, the citation for the source is probably in that resource available as pdf from their website. Joelle Weaver MAOM, HTL (ASCP) QIHC From: tony.henw...@health.nsw.gov.aumailto:tony.henw...@health.nsw.gov.au To: wdesalvo@outlook.commailto:wdesalvo@outlook.com; preis...@mail.etsu.edumailto:preis...@mail.etsu.edu Date: Fri, 24 Apr 2015 09:43:59 + Subject: RE: [Histonet] IHC and oven temperature CC: histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu Hi temp drying shown to be a bad idea: Henwood, A., (2005) “Effect of Slide Drying at 80°C on Immunohistochemistry” J Histotechnol 28(1):45-46. Abstract Prolonged high temperature dry heating has been found to be deleterious to the immunohistochemical demonstration of several antigens in formalin-fixed, paraffin- embedded sections. Paraffin sections were dried at 80°C for 7 h and their immunoreactivity was compared with mirror sections dried for 1 h at 60°C. NCL-5D3, CMV, S100, HMB45, and CEA were quite labile to dry overheating whereas AElAE3, HBsAg, HBcAg, HSVII, EMA, chromogranin, and NSE were found to be quite resistant. It is recommended that coated slides (poly-L-lysine or aminopropyltriethoxysilane) and low-temperature drying (60°C) be routinely used for irnmunohistochemistry. From: histonet-boun...@lists.utsouthwestern.edumailto:histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edumailto:histonet-boun...@lists.utsouthwestern.edu] on behalf of WILLIAM DESALVO [wdesalvo@outlook.commailto:wdesalvo@outlook.com] Sent: Tuesday, 21 April 2015 1:56 AM To: Preiszner, Johanna Cc: histonet@lists.utsouthwestern.edumailto:histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC and oven temperature Dry heat compared to wet heat. Do not dry your slides at high heat. You are removing water trapped between slide and paraffin section. Antigen retrieval is an entirely different process. So not try to combine the two processes Sent from my iPhone On Apr 20, 2015, at 8:48 AM, Preiszner, Johanna preis...@mail.etsu.edumailto:preis...@mail.etsu.edu wrote: Hi Netters, is there something wrong with this logic: If the tissue needs 95C for HIER, it's ok to dry the slides in an 82C oven. Of course I'll test it before I try it on real specimens, but maybe someone else already knows the answer... Thanks! Hanna Preiszner ETSU/QCOM ___ Histonet mailing list Histonet@lists.utsouthwestern.edumailto:Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edumailto:Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC and oven temperature
Hi Charles, In this study, having previously heated the tissue to 80 degrees would improve and speed up antibody-antigen reaction by ensuring the antigen was denatured. But not all antibodies, some were not affected, others were adversely affected. The cell and cell molecules are complex and variable. I will send you a copy of the paper in a separate email Regards Tony Henwood MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Laboratory Manager Senior Scientist, the Children’s Hospital at Westmead Adjunct Fellow, School of Medicine, University of Western Sydney Tel: 612 9845 3306 Fax: 612 9845 3318 Pathology Department the children's hospital at westmead Cnr Hawkesbury Road and Hainsworth Street, Westmead Locked Bag 4001, Westmead NSW 2145, AUSTRALIA From: Scouten, Charles [charles.scou...@leicabiosystems.com] Sent: Friday, 1 May 2015 7:51 AM To: Tony Henwood (SCHN); Histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] IHC and oven temperature I have recently reviewed literature about sacrifice microwave fixation. Proteins in the living brain are denatured in as little as .3 seconds, stopping all brain chemical reactions (all catalyzed by enzymes to tightly regulate brain), freezing the chemical state of the brain. Proteins, including enzymes, in the mammalian body denature between about 40 degrees C to 80 degrees C. Depending on the specific protein, each of which would have a denature temperature. In formation, proteins fold, and then fold again. Enzyme active sites are in the tertiary structure. Proteins can be denatured, unfolded, destroying enzymes, without losing antigenicity, depending on what the antibody is attaching to. Heating up to 90 degrees or higher does not break apart the proteins amino acid chain, which has much stronger bonds than the hydrogen bonds that hold the protein folded. My guess about the statement below is that it oversimplifies. Depending on which antigen you are going for, what its own denature temperature is, and whether the antibody in question reaches across folds to bind (is this known in any case?) you may or may not lose antigenicity between 40 degrees C and 80 degrees C. Some monoclonal antibodies raised with a native protein bind preferentially to the denatured antigen Bertrand Friguet, Lisa Djavadi-Ohaniance, Michel E. Goldberg In this study, having previously heated the tissue to 80 degrees would improve and speed up antibody-antigen reaction by ensuring the antigen was denatured. Cordially, Charles W. Scouten, Ph.D. Applications Specialist Leica Biosystems charles.scou...@leicabiosystems.com http://www.myneurolab.com Ph. 630 964 0501 Cell 314 724 5920 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Tony Henwood (SCHN) Sent: Thursday, April 30, 2015 2:32 PM To: Histonet@lists.utsouthwestern.edu Subject: FW: [Histonet] IHC and oven temperature Yes, I read the Dako IPX educational guides (5th ed) and on page 32: No processes should raise tissue temperature to higher than 60oC as this will cause severe loss of antigenicity that may not be recoverable Unfortunately there is no evidence given or cited that validates this statement. Even though this could be right (and there are several papers that have looked at this), this statement is scientifically weak and we should not cite this as truth. Now I do recommend the Dako reference series to my students, and I have contributed to one of these texts myself (Microscopic control of routine HE - know your histology) but I request my students to continue to question what they read and confirm the scientific validity of the information. Regards, Tony From: Joelle Weaver [joellewea...@hotmail.com] Sent: Saturday, 25 April 2015 5:51 AM To: Tony Henwood (SCHN); WILLIAM DESALVO; Preiszner, Johanna Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] IHC and oven temperature I remember reading that the preffered temperature was about 60 degrees Celsius. I think that this was in the Dako education guides if I'm not mistaken. If that is the case, the citation for the source is probably in that resource available as pdf from their website. Joelle Weaver MAOM, HTL (ASCP) QIHC From: tony.henw...@health.nsw.gov.au To: wdesalvo@outlook.com; preis...@mail.etsu.edu Date: Fri, 24 Apr 2015 09:43:59 + Subject: RE: [Histonet] IHC and oven temperature CC: histonet@lists.utsouthwestern.edu Hi temp drying shown to be a bad idea: Henwood, A., (2005) Effect of Slide Drying at 80°C on Immunohistochemistry J Histotechnol 28(1):45-46. Abstract Prolonged high temperature dry heating has been found to be deleterious to the immunohistochemical demonstration of several antigens in formalin-fixed, paraffin- embedded sections. Paraffin sections were dried at 80°C for 7 h and
[Histonet] Bubble in MMA blocks
Hi histonetter and specifically Gayle Callis, I try to explain why we need to leave MMA embedded glass vials in water bath during embedding to a research lab. But I need experts to have a convencing explaination. The lab use vacuum desiccator (which has sealed ring to keep vacuum) to leave the vials from 4 degree overnight, remove it to room temperature for 3 hours, then move to 32 degree oven with the vials in the vacuum dessiccator. They often found there are bubbles in the vial after polymerization down. I knew they have change the way to do embedding by remove the vial from dessiccator to close the cap and leave the vial in water bath and space out to vent the heat generated during polymerization. But how can I say the vacuum dessiccator. Thanks everyone to explain. Dorothy Hu ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] FW: IHC and oven temperature
I assume that the dako manual is referring to dry heating above 60oC, not HIER which is done in an aqueous environment. The paper I quoted (which I will send you) found that it depended on the Ag-Ab combination that was being used, some antigens were irretrievable after dry heating where as others were un-affected. Also, my caveat on this, is the importance that formalin cross-linking has in protecting some antigens from the denaturation of high temperature drying, which may not have been investigated as yet. Regards Tony Henwood MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Laboratory Manager Senior Scientist, the Children’s Hospital at Westmead Adjunct Fellow, School of Medicine, University of Western Sydney Tel: 612 9845 3306 Fax: 612 9845 3318 Pathology Department the children's hospital at westmead Cnr Hawkesbury Road and Hainsworth Street, Westmead Locked Bag 4001, Westmead NSW 2145, AUSTRALIA From: John Kiernan [jkier...@uwo.ca] Sent: Friday, 1 May 2015 9:24 AM To: Histonet@lists.utsouthwestern.edu; Tony Henwood (SCHN) Subject: Re: FW: [Histonet] IHC and oven temperature The statement quoted by Tony from the Dako manual cannot be true because many antigens have to be exposed to water at 100C in order to be immunostained - antigen retrieval. Denaturation of a macromolecule by heat increases the number of exposed epitopes, which typically are short amino acid sequences that bind specifically to the Fab segments of antibody molecules. On the other hand, it is easy to believe that 60C would denature antibody molecules enough to damage their binding sites and impair or prevent immunostaining. According to AWP Vermeer and W Norde (2000), the Fab segments of IgG were denatured when the temperature of a solution slightly exceeded 60C. (The Thermal Stability of Immunoglobulin: Unfolding and Aggregation of a Multi-Domain Protein Biophysical Journal 78: 394–404.) They found that further heating denatured the Fc segment, but the changed molecules became entangled and aggregated before denaturation was complete. Microwave heating is sometimes used to accelerate immunostaining, but control of the temperature is critical. For example: ME Boon E Marani (1991) The major importance of temperature data in publications concerning microwave techniques European Journal of Morphology 29: 181–183. John Kiernan London, Canada = = = On 30/04/15, Tony Henwood (SCHN) tony.henw...@health.nsw.gov.au wrote: Yes, I read the Dako IPX educational guides (5th ed) and on page 32: No processes should raise tissue temperature to higher than 60oC as this will cause severe loss of antigenicity that may not be recoverable Unfortunately there is no evidence given or cited that validates this statement. Even though this could be right (and there are several papers that have looked at this), this statement is scientifically weak and we should not cite this as truth. Now I do recommend the Dako reference series to my students, and I have contributed to one of these texts myself (Microscopic control of routine HE - know your histology) but I request my students to continue to question what they read and confirm the scientific validity of the information. Regards, Tony From: Joelle Weaver [joellewea...@hotmail.com] Sent: Saturday, 25 April 2015 5:51 AM To: Tony Henwood (SCHN); WILLIAM DESALVO; Preiszner, Johanna Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] IHC and oven temperature I remember reading that the preferred temperature was about 60 degrees Celsius. I think that this was in the Dako education guides if I'm not mistaken. If that is the case, the citation for the source is probably in that resource available as pdf from their website. Joelle Weaver MAOM, HTL (ASCP) QIHC From: tony.henw...@health.nsw.gov.au To: wdesalvo@outlook.com; preis...@mail.etsu.edu Date: Fri, 24 Apr 2015 09:43:59 + Subject: RE: [Histonet] IHC and oven temperature CC: histonet@lists.utsouthwestern.edu Hi temp drying shown to be a bad idea: Henwood, A., (2005) “Effect of Slide Drying at 80°C on Immunohistochemistry” J Histotechnol 28(1):45-46. Abstract Prolonged high temperature dry heating has been found to be deleterious to the immunohistochemical demonstration of several antigens in formalin-fixed, paraffin- embedded sections. Paraffin sections were dried at 80°C for 7 h and their immunoreactivity was compared with mirror sections dried for 1 h at 60°C. NCL-5D3, CMV, S100, HMB45, and CEA were quite labile to dry overheating whereas AElAE3, HBsAg, HBcAg, HSVII, EMA, chromogranin, and NSE were found to be quite resistant. It is recommended that coated slides (poly-L-lysine or aminopropyltriethoxysilane) and low-temperature drying (60°C) be routinely used for irnmunohistochemistry. From: histonet-boun...@lists.utsouthwestern.edu
Re: [Histonet] Tissue transfer method:
Slide Repair 1. Soak coverslip off of slide in xylene. 2. Piece slide back together. 3. Apply Mount-Quick to slide, covering tissue. Allow to dry overnight. 4. Place slide in cold water in refrigerator overnight. 5. Carefully peal the Mount-Quick off the slide. The tissue should come up with the Mount-Quick, if it does not stop pealing up the Mount-Quick and place back into the water overnight again. 6. Carefully trim excess Mount-Quick from areas where tissue is not present. Leave at least ¼ inch of Mount-Quick around the tissue 7. On a new slide that is wet with water, place the removed Mount-Quick and tissue in the center of the slide (make sure the tissue is next to the slide), removing as many air bubbles from under the Mount-Quick as possible. 8. Cover the slide with a wet piece of filter paper then place a blank slide on top. If you have multiple slides to repair then they can be stacked. Apply weight to the top of this and let stand overnight. 9. Soak the dry slide in Xylene until the Mount-Quick is removed and coverslip as usual. James Watson HT ASCP GNF Genomics Institute of the Novartis Research Foundation Scientific Technical Leader II, Histology Tel 858-332-4647 Fax 858-812-1915 jwat...@gnf.org -Original Message- From: Jb [mailto:craiga...@gmail.com] Sent: Friday, May 01, 2015 1:10 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Tissue transfer method: Does anyone have a procedure that they can share on tissue transfer? One stained slide to another? Thank you for your help. Sincerely, Craig Sent from my iPhone ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Tissue transfer method:
With Mount Quick you can also decolorize the section and do a different stain on them. I have even performed IHC on these transferred sections when needed. Shirley Powell -Original Message- From: James Watson [mailto:jwat...@gnf.org] Sent: Friday, May 01, 2015 4:21 PM To: 'Jb'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Tissue transfer method: Slide Repair 1. Soak coverslip off of slide in xylene. 2. Piece slide back together. 3. Apply Mount-Quick to slide, covering tissue. Allow to dry overnight. 4. Place slide in cold water in refrigerator overnight. 5. Carefully peal the Mount-Quick off the slide. The tissue should come up with the Mount-Quick, if it does not stop pealing up the Mount-Quick and place back into the water overnight again. 6. Carefully trim excess Mount-Quick from areas where tissue is not present. Leave at least ¼ inch of Mount-Quick around the tissue 7. On a new slide that is wet with water, place the removed Mount-Quick and tissue in the center of the slide (make sure the tissue is next to the slide), removing as many air bubbles from under the Mount-Quick as possible. 8. Cover the slide with a wet piece of filter paper then place a blank slide on top. If you have multiple slides to repair then they can be stacked. Apply weight to the top of this and let stand overnight. 9. Soak the dry slide in Xylene until the Mount-Quick is removed and coverslip as usual. James Watson HT ASCP GNF Genomics Institute of the Novartis Research Foundation Scientific Technical Leader II, Histology Tel 858-332-4647 Fax 858-812-1915 jwat...@gnf.org -Original Message- From: Jb [mailto:craiga...@gmail.com] Sent: Friday, May 01, 2015 1:10 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Tissue transfer method: Does anyone have a procedure that they can share on tissue transfer? One stained slide to another? Thank you for your help. Sincerely, Craig Sent from my iPhone ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Tissue transfer method:
I have used this for IHC, as well. It's great stuff! You can also use other, very viscous mounting medias, but the time it takes to dry/soak are longer than with Mount-Quick! Thanks, Bonnie -Original Message- From: Shirley A. Powell [mailto:powell...@mercer.edu] Sent: Friday, May 01, 2015 4:27 PM To: James Watson; 'Jb'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Tissue transfer method: With Mount Quick you can also decolorize the section and do a different stain on them. I have even performed IHC on these transferred sections when needed. Shirley Powell -Original Message- From: James Watson [mailto:jwat...@gnf.org] Sent: Friday, May 01, 2015 4:21 PM To: 'Jb'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Tissue transfer method: Slide Repair 1. Soak coverslip off of slide in xylene. 2. Piece slide back together. 3. Apply Mount-Quick to slide, covering tissue. Allow to dry overnight. 4. Place slide in cold water in refrigerator overnight. 5. Carefully peal the Mount-Quick off the slide. The tissue should come up with the Mount-Quick, if it does not stop pealing up the Mount-Quick and place back into the water overnight again. 6. Carefully trim excess Mount-Quick from areas where tissue is not present. Leave at least ¼ inch of Mount-Quick around the tissue 7. On a new slide that is wet with water, place the removed Mount-Quick and tissue in the center of the slide (make sure the tissue is next to the slide), removing as many air bubbles from under the Mount-Quick as possible. 8. Cover the slide with a wet piece of filter paper then place a blank slide on top. If you have multiple slides to repair then they can be stacked. Apply weight to the top of this and let stand overnight. 9. Soak the dry slide in Xylene until the Mount-Quick is removed and coverslip as usual. James Watson HT ASCP GNF Genomics Institute of the Novartis Research Foundation Scientific Technical Leader II, Histology Tel 858-332-4647 Fax 858-812-1915 jwat...@gnf.org -Original Message- From: Jb [mailto:craiga...@gmail.com] Sent: Friday, May 01, 2015 1:10 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Tissue transfer method: Does anyone have a procedure that they can share on tissue transfer? One stained slide to another? Thank you for your help. Sincerely, Craig Sent from my iPhone ___ Histonet mailing list Histonet@lists.utsouthwestern.edu https://urldefense.proofpoint.com/v2/url?u=http-3A__lists.utsouthwestern.edu_mailman_listinfo_histonetd=AwIFAwc=k9MF1d71ITtkuJx-PdWme51dKbmfPEvxwt8SFEkBfs4r=BgjUe6oLZB0OAcW6Y6Rn-n0Q03Ac4dWC2x8Sg24AeiYm=VtchPmYfwzJbDOUXGIQ85Zgy9x3jvjqfbP0HekAs5UQs=kIfbRG7j3tUkCk3OVTZFiiD1QZ8UAahPIuyyIToZwOoe= ___ Histonet mailing list Histonet@lists.utsouthwestern.edu https://urldefense.proofpoint.com/v2/url?u=http-3A__lists.utsouthwestern.edu_mailman_listinfo_histonetd=AwIFAwc=k9MF1d71ITtkuJx-PdWme51dKbmfPEvxwt8SFEkBfs4r=BgjUe6oLZB0OAcW6Y6Rn-n0Q03Ac4dWC2x8Sg24AeiYm=VtchPmYfwzJbDOUXGIQ85Zgy9x3jvjqfbP0HekAs5UQs=kIfbRG7j3tUkCk3OVTZFiiD1QZ8UAahPIuyyIToZwOoe= ___ Histonet mailing list Histonet@lists.utsouthwestern.edu https://urldefense.proofpoint.com/v2/url?u=http-3A__lists.utsouthwestern.edu_mailman_listinfo_histonetd=AwIFAwc=k9MF1d71ITtkuJx-PdWme51dKbmfPEvxwt8SFEkBfs4r=BgjUe6oLZB0OAcW6Y6Rn-n0Q03Ac4dWC2x8Sg24AeiYm=VtchPmYfwzJbDOUXGIQ85Zgy9x3jvjqfbP0HekAs5UQs=kIfbRG7j3tUkCk3OVTZFiiD1QZ8UAahPIuyyIToZwOoe= ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC billing question
It's per specimen - 88342 for the first ab on a specimen, 88341 for ea additional on same specimen. (Not multiple blocks on same specimen). Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: Michael Mihalik [mailto:m...@pathview.com] Sent: Friday, May 01, 2015 1:06 PM To: 'Horn, Hazel V'; Weems, Joyce K.; 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] IHC billing question Am I misunderstanding, or should it be per specimen and not per case? Michael Mihalik PathView Systems | cell: 214.733.7688 | 800.798.3540 | fax: 952.241.7369 -Original Message- From: Horn, Hazel V [mailto:hor...@archildrens.org] Sent: Friday, May 01, 2015 8:50 AM To: 'Weems, Joyce K.'; 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question We have 2 billing codes for IHC. One for the first IHC and another for all additional IHC's on the same case. Hazel Horn Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital 1 Children's Way | Slot 820| Little Rock, AR 72202 501.364.4240 direct | 501.364.1241 fax hor...@archildrens.org archildrens.org -Original Message- From: Weems, Joyce K. [mailto:joyce.we...@emoryhealthcare.org] Sent: Friday, May 01, 2015 8:13 AM To: 'Cartun, Richard'; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question I do it every day - change every first to 88342. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard Sent: Thursday, April 30, 2015 5:33 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] IHC billing question Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu
Re: [Histonet] IHC billing CoPath workaround
Interesting! Thanks! Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: Terri Braud [mailto:tbr...@holyredeemer.com] Sent: Friday, May 01, 2015 2:34 PM To: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing CoPath workaround We have a great workaround in built in CoPath. Every antibody in our IHC dictionary, is built in triplicate. One is called [Ab name]-Primary with a 88342 CPT code, the second is called [Ab name]-Add with an 88341 CPT code. The third is [Ab name]-NC for no charge or N/A in the CoPath dictionary. This is for when the pathologists wants the same antibody on multiple blocks for the same specimen (which can't be charged) Then we just educated everyone on how to order correctly and provided a cheat sheet. For panels, the stain groups were built correctly so that the first Ab ordered is always 88342, and the remaining charge as 88341. It has worked very well for us with few mistakes at implementation. It bills correctly, counts stained slides correctly, and orders across the interface to the stainer correctly, so that we get the right bar code labels for our IHC stainer. A win-win situation. From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard Sent: Thursday, April 30, 2015 5:33 PM Subject: [Histonet] IHC billing question Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax ** ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC billing question
Histologists enter all TC IHC billing codes manually as performed before they leave the lab. Joelle Weaver MAOM, HTL (ASCP) QIHC From: garr...@gmail.com Date: Thu, 30 Apr 2015 17:52:25 -0400 To: mpe...@grhs.net Subject: Re: [Histonet] IHC billing question CC: histonet@lists.utsouthwestern.edu; richard.car...@hhchealth.org Your Lis should not have done that. If you are using Copath/Cerner, I think they have automated it now according to their most recent newsletter. Currently, I have to manually change the 88342's to 1's It's somewhat of a pain. But, your Lis should have consulted someone before deleting all codes. Your pathologists should have been on top of it as well imho. Unfortunately, someone has to change. It may be too late to bill too for some. Garrey Sent from my iPhone On Apr 30, 2015, at 5:44 PM, Mike Pence mpe...@grhs.net wrote: We do all of our IHC billing manually. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of WILLIAM DESALVO Sent: Thursday, April 30, 2015 4:43 PM To: Cartun, Richard Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question We have to manually review the IHC billing also and continue to audit. It took billing and IT three months to create the logic to automate billing for a specimen and account for combination of there being the possibility of 88341, 88342 88344 and the proper combinations. Sent from my iPhone On Apr 30, 2015, at 2:34 PM, Cartun, Richard richard.car...@hhchealth.org wrote: Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] GMS Question
Hi Tresa, What staining parameters do you suggest for seeing mature and/or immature fungal cell walls? I don't think you will know what level of maturity is present before doing a fungus stain. But wouldn't both levels of maturity both be present if the fungus is actively growing in a tissue? What do you recommend, using both a PAS, or chromic acid/Schiffs along with chromic acid GMS method? We used 4% chromic acid at RT for 1 hour but would you recommend duplicating slides so you do pull one slide out of chromic acid at 30 minutes and one for 60 minutes to stain either mature or immature fungal and/or both cell wall structure. Gayle Callis HTL/HT/MT (ASCP) -Original Message- From: Goins, Tresa [mailto:tgo...@mt.gov] Sent: Friday, May 01, 2015 11:29 AM To: Paula Lucas; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] GMS Question To get a positive PAS or GMS fungal stain, one must oxidize the carbohydrate in the fungal cell wall. Chromic acid is a stronger oxidizer than periodic acid, so would work better with mature fungal cell walls that are highly polymerized. Treat an immature cell wall for too long, and you may get a false negative because the carbohydrate structure no longer resembles a fungal cell wall. Tresa -Original Message- From: Paula Lucas [mailto:plu...@biopath.org] Sent: Friday, May 01, 2015 8:17 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] GMS Question Hello, I think I already know the answer but I'm not sure why so if someone can help me understand the theory behind it, I would greatly appreciate it. Currently, we use the Richard Allen kit for the GMS stain and it uses Periodic Acid as the 1st step. We use a control tissue from a case we had that was positive for fungus and it's a fungus ball from the Rt Maxillary. We ran a test for fungus on a different and current case of the same tissue (different patient): Rt Maxillary sinus. The control tissue did work, but the patient's tissue did not, so the doctor ordered a PAS for fungus and this clearly showed the fungal elements nicely. My question is why would the control and patient tissue have different results when they are both fungus balls from the same specimen source? Thanks in advance, Paula Lab Manager Bio-Path Medical Group ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC billing CoPath workaround
We have a great workaround in built in CoPath. Every antibody in our IHC dictionary, is built in triplicate. One is called [Ab name]-Primary with a 88342 CPT code, the second is called [Ab name]-Add with an 88341 CPT code. The third is [Ab name]-NC for no charge or N/A in the CoPath dictionary. This is for when the pathologists wants the same antibody on multiple blocks for the same specimen (which can't be charged) Then we just educated everyone on how to order correctly and provided a cheat sheet. For panels, the stain groups were built correctly so that the first Ab ordered is always 88342, and the remaining charge as 88341. It has worked very well for us with few mistakes at implementation. It bills correctly, counts stained slides correctly, and orders across the interface to the stainer correctly, so that we get the right bar code labels for our IHC stainer. A win-win situation. From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard Sent: Thursday, April 30, 2015 5:33 PM Subject: [Histonet] IHC billing question Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax ** ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] long answer RE: GMS Question
I totally agree and if I might add: Pneumocystis jiroveci are difficult to see after PAS staining because of the strong mucin background staining. GMS is also more advantageous because it stains old and non-viable fungal elements more efficiently than PAS (Henwood, A. F., Prasad, L., Bourke, V. M. (2013). The application of heated detergent dewaxing and rehydration to techniques for the demonstration of fungi: a comparison to routine xylene-alcohol dewaxing. Journal of Histotechnology, 36(2), 45-50). Also be aware of pseudo-fungi (eg Russell bodies), things that look like fungi are PAS positive but GMS negative. Pseudo-fungi will give a positive reaction with a GMS stain using periodic acid instead of chromic acid Regards Tony Henwood MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Laboratory Manager Senior Scientist, the Children’s Hospital at Westmead Adjunct Fellow, School of Medicine, University of Western Sydney Tel: 612 9845 3306 Fax: 612 9845 3318 Pathology Department the children's hospital at westmead Cnr Hawkesbury Road and Hainsworth Street, Westmead Locked Bag 4001, Westmead NSW 2145, AUSTRALIA From: Gayle Callis [gayle.cal...@bresnan.net] Sent: Saturday, 2 May 2015 2:50 AM To: 'Paula Lucas'; histonet@lists.utsouthwestern.edu Subject: [Histonet] long answer RE: GMS Question Hi Paula, The same site of infection for your control and patient tissues does not mean the fungus species was the same. Now for addtional commentary. The classic GMS uses chromic acid as the oxidizer, stronger than periodic acid. This is something to beware of since you had a false negative result with the kit. Periodic acid should be freshly made up from periodic acid crystals just before use (Culling insisted on fresh periodic acid reagent) then discarded after that day - something that is not going on with a kit where all components are sent to you in ready to use liquid form. I think if you had used the classic GMS with chromic acid to start with, you would have had the results seen with Periodic Acid/Schiffs. Part of the problem is the not all fungus species stain well either PAS or Periodic acid/GMS, and even classic GMS. All these factors can present a problem when trying to diagnose fungal infections.Lee Luna in AFIP manual, pointed out it has been found that the time of exposure to methenamine-silver nitrate solution for complete development may vary according to type and/or strains suspected. He advised if Nocardia asteroides is suspected, then two slides should be run: one for 60 minutes and one for 90 min in the silver solution. Histotechs should be aware these possible problems. Fungi are difficult at best even when doing fungus cultures and treat. Fortunately, there are antibodies for some fungi i.e. Aspergillus, Candida) but you would probably need the specific fungus as a control for the antibody being used. Fungus IHC experts can weigh in on the latter topic. I don't know what fungus species was in your fungus ball control block, but our clinical lab fungus ball control contained Aspergillus sp. from a post mortem human lung. With the researcher, he only had pure Aspergillus sp. infecting the tissues.It would be nice to know what species of fungus is in your control tissue block The publication by Frieda Carson along with Jerry Fredenburgh and John Maxwell Inconsistent detection of Histoplasma capsulatum with periodic acid in GMS fungus stain , J Histotechnology, 1999 is a profound statement about what you just experienced. Their tissue control i.e. Aspergillus sp. stained adequately with periodic acid/GMS but the H. capsulatum fungus in tissue did not stain. They studied several different times, temperatures, periodic acid concentrations and fungus species. They had additional controls containing fungi other than Aspergillus sp. for better sampling of PA/GMS on different fungi. Having different fungus species control blocks is a luxury many labs do not enjoy. The reason chromic acid is not in kits is due to shipping, health and safety hazards, must be handled carefully and collected for proper, safe disposal so it is easier to make up GMS kits with periodic acid.If you have to collect your silver solutions for safe chemical disposal, then chromic acid shouldn't be a big problem to do the same. Also, since Periodic acid/Schiffs is popular and commonly used for fungus staining, PAS can also present false negative results or weak staining due to the weaker periodic acid oxidation, even when the periodic acid is made in house, fresh for the day. Chromic acid/Schiffs has been recommended by people on Histonet to improve fungus staining over PAS. PAS stain always seem to work well with Candida sp. and Aspergillus sp. but classic GMS was always better in my hands. I only used classic GMS, prepared in house, and controlled the development with a microscope to avoid under and over silver
Re: [Histonet] GMS Question
Hi Teresa, Very interesting. Do you have any references on mature and immature fungal cell walls and how they react histochemically? Regards Tony Henwood MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Laboratory Manager Senior Scientist, the Children’s Hospital at Westmead Adjunct Fellow, School of Medicine, University of Western Sydney Tel: 612 9845 3306 Fax: 612 9845 3318 Pathology Department the children's hospital at westmead Cnr Hawkesbury Road and Hainsworth Street, Westmead Locked Bag 4001, Westmead NSW 2145, AUSTRALIA From: Goins, Tresa [tgo...@mt.gov] Sent: Saturday, 2 May 2015 3:28 AM To: Paula Lucas; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] GMS Question To get a positive PAS or GMS fungal stain, one must oxidize the carbohydrate in the fungal cell wall. Chromic acid is a stronger oxidizer than periodic acid, so would work better with mature fungal cell walls that are highly polymerized. Treat an immature cell wall for too long, and you may get a false negative because the carbohydrate structure no longer resembles a fungal cell wall. Tresa -Original Message- From: Paula Lucas [mailto:plu...@biopath.org] Sent: Friday, May 01, 2015 8:17 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] GMS Question Hello, I think I already know the answer but I'm not sure why so if someone can help me understand the theory behind it, I would greatly appreciate it. Currently, we use the Richard Allen kit for the GMS stain and it uses Periodic Acid as the 1st step. We use a control tissue from a case we had that was positive for fungus and it's a fungus ball from the Rt Maxillary. We ran a test for fungus on a different and current case of the same tissue (different patient): Rt Maxillary sinus. The control tissue did work, but the patient's tissue did not, so the doctor ordered a PAS for fungus and this clearly showed the fungal elements nicely. My question is why would the control and patient tissue have different results when they are both fungus balls from the same specimen source? Thanks in advance, Paula Lab Manager Bio-Path Medical Group ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet * This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient, please delete it and notify the sender. Views expressed in this message and any attachments are those of the individual sender, and are not necessarily the views of The Sydney Children's Hospitals Network. This note also confirms that this email message has been virus scanned and although no computer viruses were detected, The Sydney Childrens Hospital's Network accepts no liability for any consequential damage resulting from email containing computer viruses. * ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Tissue transfer method:
Hi, I have used a product called Mount Quick. It is designed as a liquid coverslip, but once applied, it can be removed lifting the sections along with it. Here is a link with a good description of the process. http://www.newcomersupply.com/product/mount-quick Happy Friday, Amos Brooks On Fri, May 1, 2015 at 4:27 PM, histonet-requ...@lists.utsouthwestern.edu wrote: Message: 10 Date: Fri, 1 May 2015 13:10:19 -0700 From: Jb craiga...@gmail.com To: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Subject: [Histonet] Tissue transfer method: Message-ID: f42622a7-4434-4bd9-a50b-6756a83d8...@gmail.com Content-Type: text/plain; charset=us-ascii Does anyone have a procedure that they can share on tissue transfer? One stained slide to another? Thank you for your help. Sincerely, Craig ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] GMS Question
I would strongly suggest that you not use Periodic acid for the GMS, its alright for the PAS but for the GMS. Use chromic acid as described the standard texts. Regards Tony Henwood MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Laboratory Manager Senior Scientist, the Children’s Hospital at Westmead Adjunct Fellow, School of Medicine, University of Western Sydney Tel: 612 9845 3306 Fax: 612 9845 3318 Pathology Department the children's hospital at westmead Cnr Hawkesbury Road and Hainsworth Street, Westmead Locked Bag 4001, Westmead NSW 2145, AUSTRALIA From: Paula Lucas [plu...@biopath.org] Sent: Saturday, 2 May 2015 12:16 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] GMS Question Hello, I think I already know the answer but I'm not sure why so if someone can help me understand the theory behind it, I would greatly appreciate it. Currently, we use the Richard Allen kit for the GMS stain and it uses Periodic Acid as the 1st step. We use a control tissue from a case we had that was positive for fungus and it's a fungus ball from the Rt Maxillary. We ran a test for fungus on a different and current case of the same tissue (different patient): Rt Maxillary sinus. The control tissue did work, but the patient's tissue did not, so the doctor ordered a PAS for fungus and this clearly showed the fungal elements nicely. My question is why would the control and patient tissue have different results when they are both fungus balls from the same specimen source? Thanks in advance, Paula Lab Manager Bio-Path Medical Group ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet * This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient, please delete it and notify the sender. Views expressed in this message and any attachments are those of the individual sender, and are not necessarily the views of The Sydney Children's Hospitals Network. This note also confirms that this email message has been virus scanned and although no computer viruses were detected, The Sydney Childrens Hospital's Network accepts no liability for any consequential damage resulting from email containing computer viruses. * ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC billing question
I do it every day - change every first to 88342. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cartun, Richard Sent: Thursday, April 30, 2015 5:33 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] IHC billing question Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
