Re: [Histonet] Tissue falling off slides

[richard cartun via Histonet]

 Hi Annette!
Do you put anything else in your water bath besides deionized water?
Richard CartunMorphologic Proteomics, LLC(860) 490-7633

On Tuesday, January 30, 2024 at 03:14:50 PM EST, Foshey, Annette via 
Histonet  wrote:  
 
 
I work with whole mount prostate blocks that I cut and stain for IHC manually. 
I use superfrost plus slides that I purchase from the Brain Research 
Laboratories. I airdry the slides after sectioning and then they are placed in 
a rack and dried in a 60 degree oven overnight.  On some of the slides the 
tissue still lifts off the slides usually it is where there is tumor.  Any 
suggestions would be greatly appreciated.

Kindest Regards,
Annette Foshey, HT
Histology Technologist, Precision Medicine Laboratory (PML)
Phone: (414) 955-7537 | E-mail: afos...@mcw.edu
Medical College of Wisconsin | 8701 W Watertown Plank Road, Milwaukee, WI 53226

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Re: [Histonet] polyomavirus antigen immunostain in urine cytology specimens

[Richard Cartun]

Yes, what would you like to know?
 
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) 545-1596 Office
(860) 545-2204 Fax


 pathr...@comcast.net 7/31/2013 11:01 AM 



Fellow techs, 



Does any one have any experience with a immunostain for a polyomavirus antigen 
in urine cytology specimens? 



Thanks, 

Ron 
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Re: [Histonet] Shipping Slides

[Richard Cartun]

We put our send-out slides in the 5 slide plastic holders then place them in 
Jiffylite Sealed Air cushioned mailers (there are different sizes available). 
 If we are sending out a large quantity of slides we will use FedEx's Padded 
Pak, but it will cost more than a FedEx envelope.
 
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) 545-1596 Office
(860) 545-2204 Fax


 Debbie Granato debgran...@yahoo.com 7/31/2013 11:04 AM 
Good Morning!

Can anyone tell me the best way that you have found to ship slides by Fed Ex?
I need to send several cases out and want the safest way possible to eliminate 
broken slides.
We have tried plastic slide boxes with gauze for cushioning and then taped shut 
and a few other ways. Are there special transport slide containers, other than 
the 5 slide holders.
Any suggestions would be greatly appreciated!

Thank you,
Debbie Granato HT(ASCP)
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[Histonet] Question - OR specimens to Pathology

[Richard Cartun]

How are other hospitals transporting fresh tissue specimens from operating 
rooms to the Pathology Frozen Section room for an intraoperative consultation?  
Occasionally, we get specimens delivered on towels and I don't think this is 
appropriate.  I think they should be in a container that can be sealed along 
with the appropriate patient identification.  Thank you.
 
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) 545-1596 Office
(860) 545-2204 Fax
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Re: [Histonet] 88363 cpt code

[Richard Cartun]

Is there a Technical charge (TC) for 88369 or is it only a Professional 
charge that the pathologist bills?
 
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) 545-1596 Office
(860) 545-2204 Fax


 pathr...@comcast.net 7/12/2013 2:11 PM 



I was wondering if anyone bills insurance companies for a 88363 cpt code? This 
is for retrieving archived blocks and slides, packaging them and sending them 
out to outside facilities for molecular testing (PTEN, KRAS,etc). If you do 
bill, what is the charge? 

  

Thanks, 

Ron
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Re: [Histonet] DAB enhancer

[Richard Cartun]

I don't know why anyone would want to use a DAB enhancer for slides prepared on 
Leica-Microsystems' Bond Max platforms.  The resulting immunoreactivity is 
exceptionally Robust in my experience when using their Bond Polymer Refine 
Detection kit.  Could this request be for a protein target expressed at low 
levels?  Is your hematoxylin too dark obscuring the immunoreactivity?
 
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) 545-1596 Office
(860) 545-2204 Fax


 Martha Ward-Pathology mw...@wakehealth.edu 7/11/2013 2:48 PM 
I have been asked by a new pathologist to look into a DAB enhancer for use on 
our Bond III instruments.   Are many of you using this on the Bond, or any 
other staining platform and what are the pros and cons of its use?

Thanks!


Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  





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[Histonet] HHV-8

[Richard Cartun]

Is anyone doing PCR for HHV-8 on formalin-fixed, paraffin-embedded tissue?  We 
have a very interesting autopsy case where we would like to test brain tissue.  
Thank you!
 
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) 545-1596 Office
(860) 545-2204 Fax
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Re: [Histonet] Adenovirus Tissue Controls Needed

[Richard Cartun]

I do IHC for Adenovirus in my laboratory.
 
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) 545-1596 Office
(860) 545-2204 Fax


 Roger Heyna rhe...@lumc.edu 6/25/2013 12:53 PM 
We have been using tissues from an old autopsy case as our adenovirus IHC 
controls, and we are nearly out. I am not able to find another adenovirus case 
within our institution that we can use for controls.

Does anyone know a vendor that supplies these controls? Also, is there a 
reference lab that performs this test via IHC? Our usual three reference labs 
do not offer this stain. And lastly, if anyone has extra adenovirus-infected 
tissues, would you be willing to send us some? We would be willing to pay for 
it.

Thank you in advance for your help.

Roger
Maywood, IL
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Re: [Histonet] p16 on the Bond

[Richard Cartun]

We dilute the CINtec p16 RTU antibody (Ventana/Roche) 1:10 (15' primary 
antibody incubation) and use high pH retrieval (H2) for 10' on the Bond Max.
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) 545-1596 Office
(860) 545-2204 Fax
 Martha Ward-Pathology mw...@wakehealth.edu 6/21/2013 12:07 PM 


I am having trouble posting to the histonet for some reason.  I am looking for 
condition and incubation times for p16 on the Bond.  Our new pathologist says 
our p16 looks overstained to him and not at all what he is accustomed to seeing 
and I am trying to get the staining more to his liking, without much success.

Thanks in advance for the help.



Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  







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[Histonet] Re: [IHCRG] p40 staining for breast myoepithelial cells

[Richard Cartun]

We have not validated it for this purpose, but it does label myoepithelial 
cells in breast tissue very nicely.  FYI - We are using BioCare's RTU p40 on 
Leica's Bond Max.
 
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) 545-1596 Office
(860) 545-2204 Fax


 Taylor, Jean jtay...@meriter.com 6/14/2013 1:07 PM 

Hi everyone,
 
Are any labs using the monoclonal p40 antibody for myoepithelial cell staining 
in breast tissue? The pathologist that I work with has me testing this antibody 
to be used to differentiate between lung squamous and adenocarcinoma, but is 
also wondering if labs are using it on breast tissue as well.
 
Thanks,
 
Jean Taylor, HT(ASCP)QIHC
IHC Tech
Meriter Health Services
Madison, WI

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[Histonet] Question - MDM

[Richard Cartun]

Is anyone using a commercially available antibody (not RUO) for the 
immunohistochemical detection of MDM in liposarcoma?  Thank you.
 
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) 545-1596 Office
(860) 545-2204 Fax
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[Histonet] Re: [IHCRG] p40

[Richard Cartun]

I have been very impressed with BioCare's p40 monoclonal predilute. 
We are able to use it a 1:5 dilution on our Bond Max platform. 
Excellent immunoreactivity so far!
 
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) 545-1596 Office
(860) 545-2204 Fax


 Taylor, Jean jtay...@meriter.com 5/10/2013 1:53 PM 

Hi everyone,
 
I’m looking into ordering the p40 antibody for one of our pathologists.
He wants to use it to help distinguish between adenocarcinoma and
squamous cell ca in lung. I’m wondering what labs are using, the
monoclonal or polyclonal antibody, and where you purchase it from. I
haven’t found that a lot of companies that carry it. Any info would be
helpful.
 
Thanks,
 
Jean Taylor, HT(ASCP)QIHC
IHC Tech
Meriter Health Services
Madison, WI

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To post to this group, send email to ih...@googlegroups.com
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Re: [Histonet] IHC (DAB) after HE?

[Richard Cartun]

No.  Re-hydrating the tissue will remove most (if not all) of the eosin and the 
hematoxylin will serve as your counterstain (although you may need to 
counterstain again at the end of you protocol).  If you use antigen retrieval 
for an unstained slide, you will have to use it on the HE-stained slide to 
uncover your target.

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) 545-1596
(860) 545-2204 Fax


 Margaryan, Naira nmargar...@luriechildrens.org 4/4/2013 5:23 PM 
Dear Histonetters,

I would like to perform IHC (DAB) after HE. Do I need to remove HE? If answer 
is YES, my question HOW? Can I ask the protocol for that?

Thanks in advance,
Naira

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Re: [Histonet] FW: Primera Printer

[Richard Cartun]

Can this printer be interfaced with CoPath?

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) 545-1596
(860) 545-2204 Fax


 Bernice Frederick b-freder...@northwestern.edu 4/2/2013 10:52 AM 
From my manager

Bernice Frederick HTL (ASCP)
Senior Research Tech
Pathology Core Facility
ECOGPCO-RL
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

From: Herbert Skip Brown
Sent: Tuesday, April 02, 2013 8:27 AM
To: histonet-boun...@lists.utsouthwestern.edu 
Subject: Primera Printer

Linda/Jennifer:
We have just finished doing a thorough evaluation of the Primera Printer.  I 
agree with Linda that it is a smart new system that prints very well in black  
white and/or color.  We do large clinical trial projects that often require 
100+ slide sectioning.  The Primera Printer allows you to very easily go in and 
edit single slides out of a run in case data changes for  one slide or there 
was a typo error by the user.  Also and more importantly, the color feature is 
a tremendous asset to our Q.A. by being able to color code priority cases, 
individual hospitals or departments, and/or individual microtomists.  From the 
use of color we can now reduce our slide cost by not having to buy various 
colored slides, and only buying the Epic white slides and print in color.  The 
training was very hands-on via interactive on-line training through their 
technical support.  We are just initiating the unit into our system.

Herbert Skip Brown, M.Div., HT(ASCP)
Lab Manager - Pathology Core Facility
Robert H. Lurie Comprehensive Cancer Center
Northwestern University
710 N. Fairbanks
Olson 8424
Chicago, Il  60611
(312) 503-3976

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Re: [Histonet] Glutamine Synthetase and HSP 70 IHC test availability

[Richard Cartun]

We are doing these markers, but, to be perfectly honest, I am not very 
impressed with their results.

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) 545-1596
(860) 545-2204 Fax


 Sebree Linda A lseb...@uwhealth.org 3/20/2013 5:07 PM 
Hello Histonetters,

One of our pathologists is requesting Glutamine Synthetase and Heat Shock 
Protein (HSP) 70 immunostains on a liver specimen.  Our usual go to reference 
labs do not perform these.  Are there labs out there that have these tests 
available?  Even non-reference labs???

Linda A. Sebree

University of Wisconsin Hospital  Clinics
IHC/ISH Laboratory
600 Highland Ave.
Madison, WI 53792

(608)265-6596
FAX: (608)262-7174


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Re: [Histonet] Antibody IDH1

[Richard Cartun]

We run it on Leica's Bond Max with good results.  We use the mouse mAb (Clone 
H09) from dianova at a dilution of 1:50 (15' incubation) following low-pH 
retrieval.

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) 545-1596
(860) 545-2204 Fax


 Zimmerman, Billie bzimm...@gru.edu 2/22/2013 4:20 PM 
Does anyone perform this antibody?? We can't get it to work on the Ventana 
Ultra.  PhenoPath in Seattle performs it on the Dako autostainer using a small 
size polymer detection kit.  I would appreciate any input.

Thanks,

Billie Zimmerman


Augusta State University and Georgia Health Sciences University have 
consolidated to become Georgia Regents University. Effective January 9, 2013, 
my email address has changed to bzimm...@gru.edu. Please update your address 
book to reflect this change.
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[Histonet] Help!

[Richard Cartun]

I need to speak with someone who has experience with doing (and interpretating) 
in situ hybridization for EBER.  Please contact me directly.  Thank you.

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) 545-1596
(860) 545-2204 Fax




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Re: [Histonet] Process and hold?

[Richard Cartun]

I'm surprised that laboratories are not validating extended fixation times for 
their breast specimens rather than jumping through all these hoops.  There 
are now several published articles demonstrating no reduction in 
immunoreactivity for ER, PR, and HER2 in breast specimens kept in formalin for 
72 hours or longer (one of which is listed below).  Please remember that the 
total time in formalin is only one of the pre-analytic variables that can 
affect immunoreactivity.  Minimizing the cold ischemic time, making sure that 
the fresh tissue does not dry-out, and submitting THIN (2-3 mm) tissue 
sections for fixation and processing are equally, if not more important, than 
the total time that a specimen sits in formalin.

Tong LC, Nelson N, Tsourigiannis J, et al.:  The effect of prolonged fixation 
on the IHC evaluation of ER, PR, and HER2 expression in invasive breast cancer: 
A prospective study.  Am J Surg Pathol 2011;35:545-552.

A summation of their study; ... fixation for limited periods beyond 72 hours 
does not result in a reduction in assay sensitivity in the determination of ER, 
PR, or HER2 IHC status..

Obviously, each laboratory must do their own testing and validation, but it can 
be accomplished with team work (Pathologists, PAs, and Histotechnologists 
working together).

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) 545-1596
(860) 545-2204 Fax


 Tom McNemar tmcne...@lmhealth.org 2/12/2013 1:56 PM 
Hello all,

I was wondering about processing breast specimens (needle cores) on Fridays.

We have asked our radiology department to try to avoid scheduling these breast 
biopsies on Fridays since we do not work weekends and are concerned about the 
extended time in formalin.

I am thinking that we can run these specimens on a second processor over Friday 
night and have someone from the clinical lab come up  and drain the paraffin.  
The tissues would then sit in a warm moist retort until Monday morning when 
they would be embedded and cut.  I think the specimens would be fine.  
Processing would be complete at that point and they would hold in the unopened 
retort chamber.

Our alternative is to have someone come in every Saturday morning just to 
remove and embed these specimens.



Tom McNemar, HT(ASCP)
Histology Co-ordinator
Licking Memorial Health Systems
(740) 348-4163
(740) 348-4166
tmcne...@lmhealth.orgmailto:tmcne...@lmhealth.org
www.LMHealth.orgfile:///C:\Documents%20and%20Settings\TMCNEMAR\Application%20Data\Microsoft\Signatures\www.LMHealth.org


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Re: [Histonet] P16 on Leica Bond

[Richard Cartun]

When we obtained the p16 antibody from mtm Laboratories we used it a dilution 
of 1:10 on the Bond Max. I hope that the concentration will not change now that 
Ventana is selling it.

Richard

Richard W. Cartun, MS, PhD
Director, Histology  Immunopathology
Assistant Director, Anatomic Pathology
Director, Biospecimen Collection Programs
Hartford Hospital
80 Seymour Street
Hartford, CT 06012
(860) 545-1596
(860) 545-2204 Fax

 Kathryn Maddox 02/06/13 12:13 PM  
If anyone out there is performing p16 on the Leica Bond immunostainer, could 
you please tell me where you purchase your antibody and what protocol you are 
using? 
Thanks so much! 
Kathy Maddox HT{ASCP} 
Lake Charles, Louisiana 
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RE: [Histonet] Help with CPT code 88363 for archived tissue retrieval

[Richard Cartun]

I'm not 100% sure, but I don't think this CPT code has a Technical component.

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) 545-1596
(860) 545-2204 Fax


 Mike Pence mpe...@grhs.net 1/10/2013 2:27 PM 
So are you putting the charge thru twice or is the charge for the 88363
divided out into tech and prof.?

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Weems,
Joyce K.
Sent: Thursday, January 10, 2013 1:06 PM
To: 'Mark Tarango'; Natalie Nagy
Cc: histonet@lists.utsouthwestern.edu 
Subject: RE: [Histonet] Help with CPT code 88363 for archived tissue
retrieval


And I should explain the reason I most know this.. our pathologists were
denied because the tech charge hadn't been entered yet. So now I make
sure the tech charge is entered before sending to the pathologists
billing folks.

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org 



www.saintjosephsatlanta.org 
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Atlanta, GA 30342

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-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mark
Tarango
Sent: Thursday, January 10, 2013 2:01 PM
To: Natalie Nagy
Cc: histonet@lists.utsouthwestern.edu 
Subject: Re: [Histonet] Help with CPT code 88363 for archived tissue
retrieval

It can't be used to just pull blocks.  The slides have to be reviewed
and the best block chosen by a pathologist.  If there is only one block
then the pathologist needs to look at the slides and determine if there
is enough tissue for molecular testing.  It's a professional charge.

Use it on re-accessioned cases for which molecular testing is requested
and the best block needs to be chosen.

Yes we use it when sending out for Oncotype DX if the case was signed
out over 30 days before.

Mark

On Thu, Jan 10, 2013 at 7:36 AM, Natalie Nagy 
nagy_nata...@holyokehealth.com wrote:

 Hi everyone,
I just have a question about CPT code 88363, first 
 can it be used for pulling blocks for Oncotype DX testing, also is 
 there a time limit on when this code can be used? Does it have to be 
 within a year, a month, etc...of when the patient account went active?

 Thanks for all the help,

 Natalie J. Nagy (HT)ASCP
 Histology Supervisor
 Holyoke Medical Center


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Re: [Histonet] Helicobater Pylori QC block and/or slides

[Richard Cartun]

I use gastric resection tissue that is H. pylori positive.  You can use biopsy 
tissue as well, but I would be careful to not cut-through the tissue in case 
retrospective testing is ordered.  You should always try to use tissue that is 
fixed and processed in your own laboratory.

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) 545-1596
(860) 545-2204 Fax


 Tasha Fraser tfra...@olympicmedical.org 1/4/2013 12:37 PM 
Does anyone have a good suggestion for a good HP control block or
slides?

 

Tasha Fraser, HT (ASCP)

Olympic Medical Center

Port Angeles, WA 


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[Histonet] Argene Inc.

[Richard Cartun]

Does anyone know if Argene/Biosoft (France) still exists and, if so, do they 
still sell products here in the USA?  They had a number of interesting 
infectious disease monoclonal antibodies.  Thank you!

Best wishes to everyone for 2013!

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) 545-1596
(860) 545-2204 Fax




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Re: [Histonet] CAP and negative IHC controls

[Richard Cartun]

That decision needs to be made by your Medical Director.  In my laboratory we 
use polymer detection for almost all of our IHCs and, therefore, I don't 
require a Negative Reagent Control for those cases.  We have one antibody 
that requires avidin-biotin detection and we run a negative reagent control in 
parallel whenever we run that antibody.  In my experience, if you are using 
polymer detection and your antibodies are properly optimized and validated, the 
negative reagent control slide serves no useful purpose and, therefore, is not 
needed.

Best wishes to everyone on Histonet for the coming New Year!

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) 545-1596
(860) 545-2204 Fax


 jsjurc...@comcast.net 12/28/2012 3:18 PM 
How is everyone interpreting the CAP rule about using negative controls? Do we 
still need a negative with each patient slide? 
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[Histonet] PAI-1

[Richard Cartun]

Does anyone do IHC for PAI-1?  Thank you.

Happy Holidays to all and best wishes for 2013.

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) 545-1596
(860) 545-2204 Fax




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Re: [Histonet] Renal biopsies and muscle biopsies

[Richard Cartun]

I have been involved in the immediate adequacy assessment and triage of renal 
biopsies for a very long time here at Hartford Hospital.  We now have a team of 
two pathologists and myself that are called to interventional radiology and our 
children's hospital for renal biopsy procedures.  I also take a resident or 
fellow with me when they are rotating with me.  We provide on-site adequacy 
assessment and we tell the interventional radiologist or nephrologist when to 
stop based on the examination of the gross tissue provided under the microscope 
at 4x and 10x (I keep a microscope in both locations).  We report and bill an 
intra-operative consultation for this service.  I would say that over 90% of 
our procedures consistent of 2, 18-gauge needle cores.  I think in the last 10 
years we've had to call a patient back for a repeat biopsy once.

I think that it is imperative that a pathologist or someone with extensive 
training in kidney anatomy be involved in the triaging of the specimen so that 
the correct tissue can be submitted for light microscopy, immunofluorescence, 
and electron microscopy depending on the clinical diagnosis, and the amount of 
tissue provided.

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) 545-1596
(860) 545-2204 Fax


 Vickroy, Jim vickroy@mhsil.com 10/22/2012 8:58 AM 
I have been at the same hospital for over 34 years.   I have seen pathologists 
come and go, and have seen changes in services like everyone has, some good and 
some bad.  Since workflow changes demands that we do more with less, we are 
evaluating some of the extra things we do to see if  some of these duties need 
to be done by other staff and not histotechs.

In our hospital whenever a renal biopsy procedure is done in ultrasound they 
call the histology department and one of the staff go to the ultrasound and 
receive the tissue from the radiologist.  The tech then brings the tissue to 
the gross room and the grossing staff separates and processes the specimen.   
In the old days ultrasound would page the renal pathologist and the renal 
pathologist would go get the specimens and then bring them to the gross lab, 
but it seems like many things this has now been relegated to the technical 
staff.   We also pick up renal biopsies and muscle biopsies specimens from 
another hospital in the same town that sends us renal biopsies since we have 
the local renal pathologist.

We do not routinely pick up any other specimens because we have a courier 
system, but the renal and sometimes muscle biopsy service still remains in the 
hands of the histology department.  I would like to know how other hospitals 
handle transportation of specialized specimens such as renal biopsies and 
muscle biopsies.  In the old days there was a purpose for a pathologist to be 
present since often the radiologist asked the pathologist to evaluate if he or 
she had enough adequate tissue, but today with better ultrasound methods rarely 
do the radiologists ask the techs to evaluate whether enough adequate tissue 
has been taken.

I need some background information from others before I approach the powers to 
be to come up with an alternate plan so that the histotechs can spend more time 
in the lab and less time being a courier service for these biopsies.  Of course 
an alternate way will have to include a method that is reliable and not 
threaten the patient results.

Your thoughts?


James Vickroy BS, HT(ASCP)

Surgical  and Autopsy Pathology Technical Supervisor
Memorial Medical Center
217-788-4046



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RE: [Histonet] Stain for HP

[Richard Cartun]

For labs that are staining ALL gastric biopsies, Are you charging patients 
for this when there is no inflammation present?.

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) 545-1596
(860) 545-2204 Fax


 hymclab hymclab.hymc...@ministryhealth.org 10/17/2012 2:38 PM 
We do the same here!!


Dawn D. Schneider
Lead HT
Howard Young Medical Center
240 Maple Ave.
Woodruff, WI 54568
715-356-8174


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of SimmsColon, 
Janine
Sent: Wednesday, October 17, 2012 10:46 AM
To: Histonet
Subject: RE: [Histonet] Stain for HP

Routinely, manual Diff-Quik on all gastric biopsies as well as by request.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Diana McCaig
Sent: Wednesday, October 17, 2012 11:04 AM
To: Histonet
Subject: [Histonet] Stain for HP

What stain are you using for HP?--Giemsa. Warthin Starry or IHC.
Do you do them routinely or only when requested?
Are they done on an autostainer or with a kit?

Diana


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[Histonet] Fwd: Announcing the 7th international retreat of applied IHC and molecular pathology (AIMP)

[Richard Cartun]

FYI

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) 545-1596
(860) 545-2204 Fax

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Re: [Histonet] Breast processing

[Richard Cartun]

My personal experience is that formalin fixation for 72 hours (and longer) does 
not affect immunoreactivity for ER, PR, and HER2 protein overexpression as long 
as the tissue does not dry-out before being placed in formalin and thin 
(2-3 mm) sections are submitted for fixation and histologic processing.  There 
have been several articles published recently that support this observation 
including one from 2002 (5 years before the ASCO/CAP guidelines were 
published!).  In fact, I would like someone to show me where the scientific 
evidence is for supporting these guidelines.  Remember, these are 
guidelines; you are permitted to experiment, validate, and write-up your own 
fixation policy for your institution.

Arber D:  Effect of prolonged formalin fixation on the immunohistochemical 
reactivity of breast markers.  Appl Immunohistochem Mol Morphol 2002;10:183-186.

Ibarra JA, Rogers LW:  Fixation time does not affect expression of HER2/neu.  
Am J Clin Pathol 2012;134:594-596.

Tong LC, Nelson N, Tsourigiannis J, et al.:  The effect of prolonged fixation 
on the IHC evaluation of ER, PR, and HER2 expression in invasive breast cancer: 
a prospective study.  Am J Surg Pathol 2011;35:545-552.

I apologize to the authors of the other studies, but I had immediate access to 
these references since I gave a lecture on this topic today.

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) 545-1596
(860) 545-2204 Fax


 Gudrun Lang gu.l...@gmx.at 10/8/2012 3:31 PM 
Is there any evidence, that NBF-fixation for 72 hours alters Her2 staining, so 
that there's  a diagnostic difference (pos./neg.)? publications with data?
Personal experience?
I have the feeling, that there is a mythos of overfixation. Anybody else ...?
I saw turning up and down of Her2 results due to non-standardized 
staining-protocols.  
But I think a protocol, that fits to a 48 hours-fixed tissue fits also to 72 
hours.

Gudrun Lang


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[Histonet] RE: Negative Controls

[Richard Cartun]

The Evidence should come from your own laboratory.  Just because we don't run 
Negative reagent controls in my laboratory doesn't mean it's appropriate for 
you to discontinue their use for your laboratory.  Your laboratory Medical 
Director needs to make this decision based on what he/she sees (or doesn't see) 
on your Negative reagent controls.  In my experience with polymer detection 
we rarely see nonspecific staining due to the detection reagents on our 
Negative reagent controls.  As I have stated before, I have given my 
pathologist colleagues the option of ordering a Negative reagent control if 
they feel they need it (after reviewing the original immunoperoxidase stains) 
and, in over 5 years, I have only seen a handful of orders (mostly for tissues 
that have endogenous pigment).  If you are seeing a lot of nonspecific 
reactivity on your Negative reagent controls that complicates interpretation 
then you should run them.  I don't; therefore, I am preserving precious tissue 
for important testing and saving our institution thousands of dollars each year.

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) 545-1596
(860) 545-2204 Fax


 Ian R Bernard ibern...@uab.edu 10/4/2012 9:28 AM 
This is the key. What is the evidence based research/studies to support this?  
I will continue with negative controls until I am able to get peer reviewed 
research to support this. 

Besides overkill maybe pricey ($$) at times or not (since it is just slides) 
but from what I learned this past week at NSH 2012 Vancouver workshop: There 
are other important costs for us to consider thus we need to count the cost of 
poor quality. 

We learned that there are three types of other costs to consider in the medical 
laboratory: prevention, appraisal and failure (internal and external) costs.  
According to our workshop presenter from Vancouver, his or the research shows 
that failure costs are a whole lot more than the cost of prevention and 
appraisal. Therefore a focus on things like time, patients, reputation and 
staff costs is necessary as well as money.

IB




-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Pardue, Judith
Sent: Friday, August 17, 2012 1:08 PM
To: histonet@lists.utsouthwestern.edu 
Subject: [Histonet] Negative Controls

Does anyone know of any articles talking about not using negative controls when 
using a polymer based detection system.

 

Judith Pardue

Memorial Hospital

Chattanooga, Tn.

judith_par...@memorial.org 

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[Histonet] RE: Antibody validation

[Richard Cartun]

There is no one right answer for the number of cases needed to validate an 
antibody for diagnostic immunohistochemistry.  That decision must be made by 
the laboratory's medical director, not an outside organization.  Many of the 
primary antibodies available today have proven track records and we certainly 
do not need to re-invent the wheel here.

What I find helpful is a Prospective Validation where I continue to add cases 
to our original antibody validation file (Excel spreadsheet) that prove that 
the antibody is doing what it should be doing and that there is no analytical 
drift.

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) 545-1596
(860) 545-2204 Fax

 Sebree Linda A lseb...@uwhealth.org 9/26/2012 8:43 AM 
Joe,

We are abiding by the CAP 10/10 guidelines when at all possible and then
we compare our results with another method or same method but other lab,
i.e. reference or another clinical lab willing to trade slides with us.
The comparison part is where we are having issues as we, not me
personally, don't want to pay a reference lab for the comparison work so
we rely on others in our Histonet family willing to run our slides.
And of course, we're squeezing as many cases on a single slide as
possible.  

As to your question about 5/5 or more, CAP leaves it up to each lab as
to whether its feasible and possible to obtain their recommended quota.

Interesting thread as my days are spent in the middle of this exercise.

Linda Sebree 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joe
Nocito
Sent: Tuesday, September 25, 2012 5:35 PM
To: 'Vanessa Perez'; 'Vickroy, Jim'; histonet@lists.utsouthwestern.edu 
Subject: RE: [Histonet] Changing from Ventana IView Detection Kit
toVentana Ultraview kit

We are having a lively discussion about having 10 known positives and 10
known negatives to validate new antibodies. Many years ago we set up 5
and 5 even before CAP thought of the idea. This year's checklist added
the 10 and 10 part, but it is up to the medical director.
What is everyone else doing out there? We are using the Ventana
UltraView detection kits. Everyone who uses these kits know how
expensive they are.
Is 5 and 5 sufficient or should go by CAP recommendations?

Joe Nocito

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vanessa
Perez
Sent: Tuesday, September 25, 2012 2:37 PM
To: Vickroy, Jim; histonet@lists.utsouthwestern.edu 
Subject: RE: [Histonet] Changing from Ventana IView Detection Kit to
Ventana Ultraview kit

As far as lot to lot validation that's all we do. Use same control and
compare both.  

Now validating a new detection kit is a whole different story.  Here I
just made a checklist of all the antibodies we do and had the doc sign
off on each stain with the new kit.  
If you want you can do a slide of each with same control one with the
iview and one with the ultraview.
All depends on how your doc wants to validate it.

Vanessa 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy,
Jim
Sent: Tuesday, September 25, 2012 1:58 PM
To: histonet@lists.utsouthwestern.edu 
Subject: [Histonet] Changing from Ventana IView Detection Kit to Ventana
Ultraview kit

We are trying to decide how to validate our stains when we switch from
Ventana's IView kit to their Ultraview Kit.

I have reviewed the CAP question on this and find the following wording:

The performance of new lots of antibody and detection system reagents
are compared with old lots before or concurrently with being placed into
service.
Note:   Parallel staining is required to control for
variables such as disparity in the lots of detection reagents or
instrument function.  New lots of primary and detection reagents must be
   compared to the previous lot using an
appropriate panel of control tissues.   This comparison must be made on
slides cut from the same control block.

Evidence:   Written procedure and records of verification of new reagent
lots.

For new lots of antibodies we have been running the new lot and
comparing with the previous lot by reviewing the control slide from the
old lot to the new lot.

Is this sufficient?   Wording that bothers me is appropriate panel of
tissues

Thanks for your input.

James Vickroy BS, HT(ASCP)

Surgical  and Autopsy Pathology Technical Supervisor Memorial Medical
Center
217-788-4046



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[Histonet] Question

[Richard Cartun]

I was asked by a colleague if there is testing for fibrinogen storage disease 
that can be performed on fixed tissue.  I told her that I did not know, but I 
would ask the experts.  Thank you.

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) 545-1596
(860) 545-2204 Fax



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Re: [Histonet] PAN CKMNF116, picking up dendritic cells?

[Richard Cartun]

It should label dendritic cells since it reacts with cytokeratin 8.  These 
cells have been shown to contain cytokeratin protein by immunoblotting.  I use 
this reactivity as an internal positive control.

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) 545-1596
(860) 545-2204 Fax

 jAswigueAlatan msjaswigue.ala...@gmail.com 9/24/2012 9:14 PM 
Dear Histonetters,
Has anyone out there experienced problem with optimizing PanCK MNF116
antibody? Our CKMNF116 stains dendritic cells on lymph nodes using Ventana
protocol:
CC1 - 8 mins,
Ab incubation time 16 mins,
Post primary peroxidase inhib selected.
Basically, it should stain cytokeratins, but it stains dendritic cells as
well. What would be the possible causes and solutions. Any suggestions
would be greatly appreciated. Many thanks.

Joy
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Re: [Histonet] charge code for send out's?

[Richard Cartun]

We now request a FedEx or UPS account number for all outside requests for 
pathology materials from our Department.  It is the responsibility of the 
requesting hospital/laboratory/company to provide this since they will be 
providing a consultation, performing IHC/molecular testing, or conducting 
research on our patient's pathology material.

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) 545-1596 Office
(860) 545-2204 Fax


 pathr...@comcast.net 9/7/2012 1:16 PM 



Fellow techs, 

  

I am wondering  what you do with charges for slides that are requested to be 
sent to another facility. Is there a CPT code that can be used for billing for 
the shipment, do you charge the patient or physician who requests the slides to 
be sent out or do you pay for the shipping yourself ? 

  

Thanks, 

Ron Martin
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Re: [Histonet] charge code for send out's?

[Richard Cartun]

I forgot to add that if the patient requests that their slides be sent-out to 
another institution for consultation, it is appropriate to have them pay for 
the shipping of the slides.

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) 545-1596 Office
(860) 545-2204 Fax


 Richard Cartun rcar...@harthosp.org 9/9/2012 10:16 AM 
We now request a FedEx or UPS account number for all outside requests for 
pathology materials from our Department.  It is the responsibility of the 
requesting hospital/laboratory/company to provide this since they will be 
providing a consultation, performing IHC/molecular testing, or conducting 
research on our patient's pathology material.

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) 545-1596 Office
(860) 545-2204 Fax


 pathr...@comcast.net 9/7/2012 1:16 PM 



Fellow techs, 

  

I am wondering  what you do with charges for slides that are requested to be 
sent to another facility. Is there a CPT code that can be used for billing for 
the shipment, do you charge the patient or physician who requests the slides to 
be sent out or do you pay for the shipping yourself ? 

  

Thanks, 

Ron Martin
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[Histonet] Question regarding retrospective testing

[Richard Cartun]

I know that this had been discussed before, but I believe regulations have 
changed and I need to find out what other laboratories are currently doing when 
it comes to retrospective testing (histochemical stains, IHC, molecular 
testing, etc.) on cytology and surgical pathology specimens that have already 
been signed-out.

When can you add the result(s) and bill the test(s) to the original pathology 
report versus re-accessioning the specimen (with a new date-of-service) and 
reporting and billing under the new accession number?

Thanks,

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) 545-1596 Office
(860) 545-2204 Fax




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Re: [Histonet] p16

[Richard Cartun]

In order to troubleshoot, one would need to know the following:

Test tissue
Fixation
Antibody clone, dilution, and incubation time
Detection system
Antigen retrieval
Positive control tissue

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) 545-1596 Office
(860) 545-2204 Fax


 Gerald Davydov geralddavy...@gmail.com 7/20/2012 9:17 AM 
P16 stain demonstrates week nuclear stain. Any ideas how to correct?

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[Histonet] Negative Reagent Control

[Richard Cartun]

Most of you know that I have been advocating for the elimination of the 
Negative Reagent Control when using a non-avidin-biotin detection system 
(polymer) in immunohistochemical testing.  In my opinion, it is a waste of 
healthcare dollars and, more importantly, precious patient specimen.  Last year 
at the NSH IHC Forum in Denver I met James Dvorak, MT(ASCP) from the College of 
American Pathologists.  We had a long discussion about this and he agreed to 
support my position within CAP.  With the support of James, and the help of Dr. 
Regan Fulton (from the CAP IHC Committee), the wording on the CAP Anatomic 
Pathology checklist for question ANP.22570 will be changed.  The new wording 
includes the following sentence:

Immunohistochemical tests using polymer-based detection systems (biotin-free) 
are sufficiently free of background reactivity to obviated the need for a 
negative reagent control and such controls may be omitted at the discretion of 
the laboratory director.

I announced this change at the 2012 NSH IHC/ISH Forum this past weekend in 
Windsor, CT to loud applause.  This one change stands to save the healthcare 
system millions of dollars.  Thank you Jim and Dr. Fulton for making this 
happen!

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] congenital syphilis

[Richard Cartun]

Immunohistochemical testing for Treponema pallidum is the preferred method of 
identification.  There are labs (including my own) that offer this.

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) 545-1596 Office
(860) 545-2204 Fax


 Bell, Mandy mandy.b...@chomp.org 7/11/2012 7:31 AM 
Hi,



I was hoping someone would have a suggestion for a stain for congenital 
syphilis on a placenta.  Our pathologist wants this done- I know a 
warthinstarry or steiner would work, but we do not do either of these stains.  
Would a diff-quik stain work?



Thanks,



Mandy Bell  HTL(ASCP)



Community Hospital of the Monterey Peninsula

2 Harris Court Suite B3/B4

Monterey, CA  93940



(831) 647-4791

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[Histonet] GBS IHC

[Richard Cartun]

Does anyone know of a good antibody to Group B Streptococci (GBS) that works on 
formalin-fixed, paraffin embedded tissue?  I had a wonderful mAb from a company 
in Canada, but they went out of business.  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] Renal Core Biopsy

[Richard Cartun]

Are you referring to biopsies done for medical renal disease or tumor?

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) 545-1596 Office
(860) 545-2204 Fax


 Wilson A wilson6...@yahoo.com 5/27/2012 11:19 AM 

  Hello,
  I would like to know how you guys receive your renal core biopsy. Our 
Pathologists said they were having problem getting the biopsy out of the little 
renal biopsy bottle sent from the Radiology Dept.
   
Thanks,
Wilson
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[Histonet] Lab Office position

[Richard Cartun]

I know someone here in Connecticut who is thinking about re-locating to the 
Melbourne/Palm Bay area of Florida.  She currently works in a busy Anatomic 
Pathology office in a hospital doing specimen accessioning, consult 
accessioning, slide(s) send-outs, slide filing, etc.  Are there any jobs in 
this part of FL for a person with this skill-set?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] IHC for p21, p27, and RB

[Richard Cartun]

What has been people's experience with immunohistochemical staining for p21, 
p27, and Retinoblastoma (RB) gene protein on formalin-fixed, paraffin-embedded 
human tissue?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] Antibody titer

[Richard Cartun]

Yes, I always want to see the immunoreactivity drop-off (or even disappear) 
with a higher dilution(s).  Otherwise, you might be wasting antibody by using a 
dilution that is too concentrated.  Also, be careful with the recommended 
dilution.  That dilution is only applicable if you are using the exact same 
staining conditions.

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) 545-1596 Office
(860) 545-2204 Fax


 Courtney Pierce courtney.pie...@quintiles.com 5/23/2012 12:57 PM 
When you titer a new antibody you go one below and one above the recommend 
dilution. If you find that the one above the dilution works do you go then out 
two more to make sure they don't work? This is a question in our lab right now.

Courtney Pierce
IHC Specialist
Quintiles
Translational RD - Oncology
Innovation
Navigating the new health

610 Oakmont Lane
Westmont, IL 60559

Office: + 630-203-6234
courtney.pie...@quintiles.com 

clinical | commercial | consulting | capital


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[Histonet] Old cryostat for parts

[Richard Cartun]

We have an old Miles Tissue-Tek II cryostat that is going to be discarded 
unless someone would like it for parts.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] cryptosopridia

[Richard Cartun]

Yes, most testing is performed in the Microbiology Laboratory; however, I have 
an IHC test for formalin-fixed, paraffin-embedded tissue.

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) 545-1596 Office
(860) 545-2204 Fax


 Webb, Dorothy L dorothy.l.w...@healthpartners.com 5/11/2012 10:11 AM 
What stain is anyone using for cryptosporidia in histology??  I thought this 
was more of a microbiology test.  Could use some help please!!

Thanks,

Dorothy Webb



  
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[Histonet] Who pays ......

[Richard Cartun]

for the express shipping when another medical institution requests a patient's 
pathology slides and/or unstains or paraffin block for additional testing?  In 
my opinion, the requesting institution should provide a FedEx, UPS or other 
account number for this.  After all, they will be billing the patient's 
insurance for the consult and/or special testing that is to be performed.  This 
is a major cost to our Department that, as you know, cannot be billed to 
insurance.  I have instructed our staff to ask for an account number; many 
facilities supply one, others do not.  What do you do at your facility?  Thank 
you.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] Biospecimen collection

[Richard Cartun]

This inquiry applies to those of you collecting human tissue for research.  I 
am being asked to develop pricing for the following activities regarding 
collection of biospecimens from surgery, image-guided biopsies, endoscopic 
biopsies, bone marrow biopsies, and body fluids:

1.  Collection of fresh tissue and freezing in liquid nitrogen.
2.  Collection of fresh tissue and placement in tissue culture media.
3.  Preparation of one paraffin block containing formalin-fixed tissue.
4.  The preparation of one unstained slide from a paraffin block.

I would appreciate hearing from those of you who might already have charges 
established for these activities.  Thank you very much for your time.  Happy 
National Medical Laboratory Professionals Week to all!

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] Leica Peloris Processor

[Richard Cartun]

In my experience, no.  Our current IHC/ISH is as good, if not better than what 
we were getting with our former processors.

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) 545-1596 Office
(860) 545-2204 Fax


 Joe W. Walker, Jr. joewal...@rrmc.org 4/20/2012 3:47 PM 
Hello all,

I am new to your listserve.  I am wondering if anyone has experience with the 
Leica Peloris processor.  Specifically, has anyone noticed if the higher 
processing temperatures has affected any IHC staining results or FISH results.

Looking forward to responses,

Joe W. Walker, Jr. SCT(ASCP)CM
Anatomical Pathology Manager
Rutland Regional Medical Center
160 Allen Street, Rutland, VT 05701
Phone: 802.747.1790  Fax:802.747.6525
NEW EMAIL: joewal...@rrmc.orgmailto:joewal...@rrmc.org
www.rrmc.orghttp://www.rrmc.org

Our Vision: To be the Best Healthcare System in New England
Rutland Regional...Vermont's 1st Hospital to Achieve Both ANCC Magnet 
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Re: [Histonet] Batch Controls

[Richard Cartun]

As the laboratory Director, I can sign-off on the positive control slides or my 
staff can do it since I have delegated this responsibility to them.  We all use 
a different color pen to mark the slide(s) O.K. so we always know who 
signed-off on the control slide.  All positive controls are filed by date (the 
date is printed on the label).  I believe that we can back-track (using the 
staining logs) to identify which machine the control was run on (if needed).

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) 545-1596 Office
(860) 545-2204 Fax


 Amy Self as...@georgetownhospitalsystem.org 4/18/2012 9:55 AM 
Good Morning and Happy Wednesday to everyone,

For those of you that are running batch controls with your IHC stains I have a 
couple of questions for you.

What is your process for review and documentation of the batch control slide?

How do you label/identify this slide for easy retrieval? (Do you identify this 
slide by date run or stain run)


Thanks in advance for everyone's help,

Amy

Amy Self
Georgetown Hospital System
843-527-7179
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[Histonet] know error system - prostate biopsies

[Richard Cartun]

I am curious how many of you working in hospital or non-hospital Anatomic 
Pathology labs are using the know error system for prostate biopsy/patient 
DNA confirmation?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] Aetna and In-Office Lab Accreditation

[Richard Cartun]

This was released today.

Richard

Statline Special Alert:
New Evidence Links Self-Referral Labs to Increased Utilization, Lower
Cancer Detection Rates
Study co-funded by CAP Appears in April 2012 Issue of Health Affairs 
April 9—Self-referring urologists billed Medicare for nearly 75% more
anatomic pathology (AP) specimens compared to non self-referring
physicians, according to a study published today in a leading health
care policy journal. Furthermore, the study found no increase in cancer
detection for the patients of self-referring physicians-in fact, the
detection rate was 14% lower than that of non self-referring
physicians.

These findings, from an independent study co-funded by the CAP, provide
the first clear evidence that self-referral of anatomic pathology
services leads to increased utilization, higher Medicare spending, and
lower rates of cancer detection. The study, led by renowned Georgetown
University health care economist Jean Mitchell, PhD, will appear in the
April 2012 issue of Health Affairs and is now available on the
journal’s website.




 Daniel Schneider dlschnei...@gmail.com 4/9/2012 4:47 PM 
This is all about the money. The rest is rationalization.

The reason a group of non-pathologist physicians opens an in-house
pathology lab and hires an employee pathologist is first and foremost
to harvest profit from pathology reimbursement. Be a fly on the wall in
the
partners' meetings and you would know that's what they are talking
about.

To suggest otherwise is disingenuous.

And the implication that the generalist anatomic pathologist is
unqualified
to be signing out skins, prostates, GI's and whatever is
reprehensible.
This is not cardiac bypass surgery, and AP pathologists *are* trained
to do
all of the above. I eagerly defer to subspecialty expert consultants
as
needed, but most of the time they're not needed.

Hospital labs that see few, if any skins, prostates, GI's, are only in
that
pickle because of the cherrypicking they've already been subjected to.

*in-office AP labs are an emerging frontier of employment for
histologists
and pathologists.  In an era of high unemployment, another source of
employment for our professions is a good thing.*

Really? The jobs follow the specimens. Given the same number of
specimens,
there's the same number of jobs, more or less, just under different
circumstances and in different locations   Unless you're suggesting
that
in-office labs will generate increased specimens, and thus increased
jobs
though overutilization, i.e. excessive numbers of unnecessary biopsies
and
abuse of the patient and the taxpayer.  In which case I have to say
there's
a grain of truth. And the truth hurts.  And it's not  a good thing.

None of this should be taken as criticism of histotechs and
pathologists
who find themselves working in an in-office lab. I know there's bills
to
pay, families to take care of, and god knows it's hard for a
pathologist to
find a job these days with the numbers our residency programs keep
churning
out (but that's another rant...).

Dan Schneider, MD
Amarillo, TX












On Mon, Apr 9, 2012 at 12:52 PM, jdcoch...@aol.com wrote:


 Histonetters:

 In-office AP labs provide a valuable service to the practices they
serve
 by facilitating 1) better communication between pathologists and
ordering
 clinicians, 2) quality metrics that are practice-specific, and 3)
high
 volume, sub-specialization for both histotechnologists and
pathologists.
  In other words, the more of one type of histopathology a lab does
(e.g.,
 skin, prostate, GI), the better it gets.  Most people would not think
of
 having their cardiac bypass surgery done at a community hospital
doing
 50/year; you want to go where more than 500/year are done.  In
 histopathology, the kinds of volume you want are in the thousands for
each
 tissue type.  Many hospital labs do little skin or prostate
histology
 anymore.  Many sub-specialty in-office AP labs may do thousands of
cases of
 one tissue type every year.

 Aside from that, in-office AP labs are an emerging frontier of
employment
 for histologists and pathologists.  In an era of high unemployment,
another
 source of employment for our professions is a good thing.

 This requirement by an insurer for accreditation will help to
validate
 these in-office AP labs' commitment to quality and put them on the
level
 with their hospital counterparts.

 John D. Cochran, MD, FCAP





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Re: [Histonet] AFB by IHC

[Richard Cartun]

Yes, you can do IHC for mycobacteria; however, there are issues with 
specificity depending on the primary antibody that you use.  I have been using 
a polyclonal antibody from Dako (no longer available) for many years and 
although it is very sensitive for identifying mycobacteria, it does cross-react 
with other bacteria.  I have not found a monoclonal antibody (yet) that works 
on formalin-fixed, paraffin-embedded tissue.  In addition, your IHC assay has 
to be exquisitely clean in order to trust the rare immunoreactivity that may be 
present.

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) 545-1596 Office
(860) 545-2204 Fax


 Amy Self as...@georgetownhospitalsystem.org 4/3/2012 11:48 AM 
My pathologist wants an AFB stain done by IHC.  Is this stain/procedure even 
doable and if so where?

Thanks in advance for your help,  Amy



Amy Self
Georgetown Hospital System
843-527-7179
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[Histonet] IHC for interferon gamma

[Richard Cartun]

Has anyone succeeded in doing IHC for interferon gamma on formalin-fixed, 
paraffin-embedded tissue?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] Fixatives for breast

[Richard Cartun]

1.) Formalin, 2.) Formalin, and 3.) Formalin.

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) 545-1596 Office
(860) 545-2204 Fax


 LaSalette Charette las.chare...@comcast.net 3/21/2012 12:59 PM 
What are the best fixatives for breast specimens? Also what the most commonly 
used fixatives out there?

LaSalette


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Re: [Histonet] IHC + control question

[Richard Cartun]

I know that many labs run Vimentin for this, but please give consideration to 
running a nuclear marker as well especially since some of our predictive 
markers (ER and PR) are nuclear proteins.  In my opinion, Vimentin is very 
robust and may show-up even when the tissue is not adequately fixed and/or 
processed.

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) 545-1596 Office
(860) 545-2204 Fax


 Chiriboga, Luis luis.chirib...@nyumc.org 3/6/2012 9:01 AM 
Posting for a colleague:

Which of the following choices

Cytokeratin (NOS)
Vimentin
s-100
Cd45
Desmin

Would be the best to use as an internal positive control for fixation and 
processing?
Any supporting literature/references/docuemntation would be very helpful...

Thanks
Luis
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Re: [Histonet] Cytokeratin AE1/AE3

[Richard Cartun]

It may be specific labeling of extra-follicular dendritic cells that contain 
low molecular weight cytokeratin and, if your IHC assay is truly optimized, you 
won't be able to get rid of it.  I use the LMW CK mAb clone 5D3 that labels 
CK8/18 and I see this reactivity all the time.  I like it because it serves as 
an internal positive control.

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) 545-1596 Office
(860) 545-2204 Fax


 Joanne Clark jcl...@pcnm.com 2/28/2012 11:27 AM 
Hi Histonetters, I am having some issues with my Cytokeratin AE1/AE3.  We use 
the antibody from DAKO and do HIER on it before staining.  We run AE1/AE3 as a 
protocol on sentinel lymph nodes from breast cases that were negative on frozen 
section to rule out micro metastases and what my pathologists sometimes sees is 
staining that looks like it's running in-between the cells.  It is not an 
indication of metastases but my pathologists want me to get rid of it.  Have 
any of you seen anything like this?  I would especially appreciate the opinion 
of Samuri Pathologist on this if it isn't too much trouble.

Thanks all!

Joanne Clark, HT
Histology Supervisor
Pathology Consultants of New Mexico
Roswell
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[Histonet] mAb to Serotonin

[Richard Cartun]

Does anyone have a good monoclonal antibody to Serotonin that they would 
recommend for diagnostic immunohistochemistry performed on formalin-fixed, 
paraffin-embedded human tissue?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] (no subject)

[Richard Cartun]

Complete loss.  You can see patchy immunoreactivity in tumors with these 
markers. 

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) 545-1596 Office
(860) 545-2204 Fax


 Freeman, Carol carol.free...@utoledo.edu 2/16/2012 9:56 AM 


Good Morning Histonet,

Ok, We are just starting up with MSI testing in our facility and a
question has popped up about diagnosis of these slides...  Are you
looking for a COMPLETE LOSS of this protein in the tumor, or just a loss
of some expression.?  So if you have a normal piece of tissue staining
uniform and then a tumor of that same tissue showing vague patchy
staining in some cells and a loss in other cells of interest are you
considering that a loss or not.   Does the tumor have to show a COMPLETE
loss of this protein...  Any answer is appreciated.

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[Histonet] Brucellosis

[Richard Cartun]

I have a consult (transplant kidney biopsy) that I believe is infected with 
Brucella.  My IHC test is positive, but I have never seen a human case before.  
Can someone familiar with this disease forward me a photo or a good reference 
that shows the typical morphology of this organism in human tissue?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] H. pylori

[Richard Cartun]

Keep in mind that many of the commercially-available monoclonal antibodies to 
H. pylori do not label Helicobacter helilmannii, often seen in children, 
especially those with exposure to animals.

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) 545-1596 Office
(860) 545-2204 Fax


 Rathborne, Toni trathbo...@somerset-healthcare.com 2/14/2012 10:21 AM 
 
Happy Valentines Day!

Our lab is looking into ordering H. pylori now and I was wondering what clone, 
or whose antibody everyone is using.
As always, thanks for your responses. I know I can always count on this group 
to offer opinions and suggestions :)

Toni




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[Histonet] Question - Pancreatic CA Research

[Richard Cartun]

We have a patient with pancreatic cancer that is close to death.  The patient 
has requested that her body be donated for pancreatic cancer research.  Is 
there anyone in the Histonet Community that is working in pancreatic cancer 
research that can help me with this patient's request?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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RE: [Histonet] RAC Medicare Audits - PAs

[Richard Cartun]

I don't know.  I was hoping that there is someone in the Histonet community 
that is familiar with this.

Richard

 McMahon, Loralee A loralee_mcma...@urmc.rochester.edu 2/1/2012 8:56 AM 
 
I haven't heard that one.   Do they mean present physically or present as in 
their office reading slides, but a phone call or page away? 

Loralee McMahon, HTL (ASCP)
Immunohistochemistry Supervisor
Strong Memorial Hospital
Department of Surgical Pathology
(585) 275-7210

From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Richard Cartun 
[rcar...@harthosp.org] 
Sent: Tuesday, January 31, 2012 7:19 PM
To: Histonet
Subject: [Histonet] RAC Medicare Audits - PAs

Is anyone familiar with the new requirement effective January 1st, 2012 that 
states that Pathologists' Assistants can no longer teach residents unless a 
pathologist is present?

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] RAC Medicare Audits - PAs

[Richard Cartun]

Is anyone familiar with the new requirement effective January 1st, 2012 that 
states that Pathologists' Assistants can no longer teach residents unless a 
pathologist is present?

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] clostridium and bacterial spores in tissue sections

[Richard Cartun]

Hi Liz:

I have used IHC to identify Clostridia on formalin-fixed tissue.

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) 545-1596 Office
(860) 545-2204 Fax


 Elizabeth Chlipala l...@premierlab.com 1/14/2012 12:58 PM 
Hello everyone

I need a bit of help.  I have to stain for clostridium and bacterial spores in 
tissue sections.  I have come across a few references to staining these on 
smears but not on tissue sections.  I did find one reference that used 
Ziehl-Neelsen to stain terminal spores from clostridium tetani.  Does anyone 
out there know if the stain they use in microbiology for smears will work on 
tissue sections?  Any advice would be appreciated.

Thanks in advance

Liz

Elizabeth A. Chlipala, BS, HTL(ASCP)QIHC
Manager
Premier Laboratory, LLC
PO Box 18592
Boulder, CO 80308-1592
(303) 682-3949 office
(303) 682-9060 fax
(303) 881-0763 cell
www.premierlab.comhttp://www.premierlab.com

Ship to address:

1567 Skyway Drive, Unit E
Longmont, CO 80504

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Re: [Histonet] new anitbody

[Richard Cartun]

You need to prove that the antibody labels its intended target and that there 
is no cross-reactivity with unrelated proteins.  The number of cases needed to 
do this will depend on the antibody's track record and its purpose.  For 
example, antibodies used to identify predictive targets (ER, PR, and HER2 in 
breast CA) will require more cases to complete your validation since patients 
are being treated based on the presence or absence of these targets.  Some IHC 
experts will tell you that you need to run 25, 50, or maybe even 100 cases 
(positive and negative) to validate an antibody.  I tell people that you need 
to run enough cases so that your pathologists feel comfortable interpretating 
that test.  After all, they are the ones that sign-off on these tests.  When 
bringing a new antibody on-board, read the antibody product data sheet and the 
pathology literature, and then sit down with your pathologist and create a 
reasonable validation plan.  In my opinion, far too much money is being 
wasted running unnecessary slides for validation purposes.

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) 545-1596 Office
(860) 545-2204 Fax


 Amber McKenzie amber.mcken...@gastrodocs.net 1/3/2012 4:06 PM 
I know when you get a new instrument you have to validate every antibody 
against previous stained slides on the original instrument, but what actions 
must be taken for a new antibody?  Besides, putting the protocol in and running 
control slides.


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[Histonet] Antibody to Cryptococcus

[Richard Cartun]

Unfortunately, we have used the last micro-liter of our Cryptococcus antibody 
that we obtained from DAKO years ago.  Since DAKO no longer sells this antibody 
I am wondering if anyone is using another commercially-available antibody to 
label Cryptococcus in formalin-fixed tissue with immunohistochemistry?

Happy Holidays to all my friends and colleagues working in the field of 
Histology.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] control block log

[Richard Cartun]

I use FileMaker Pro software to keep track of our IHC controls.  I created a 
control tissue file that includes the following:  Control #, Case #, Tissue 
site, Diagnosis, DOS, Time in formalin, Processing date, Number of blocks 
submitted, and then a Comment field for the immunoreactivity for each 
antibody tested.  Every file can then be searched by anyone of the data fields. 
 For example, if we need a control for Parvovirus we would type in Parvovirus 
in the Diagnosis or Comment fields and then every control tissue tested 
positive (or negative) for Parvovirus would be identified.

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) 545-1596 Office
(860) 545-2204 Fax


 stephen.cla...@hcahealthcare.com 12/21/2011 10:25 AM 

Hi.  I was wondering if anyone would be willing to share a copy of their 
control block log.  I'm creating a new one and want to see what others are 
doing, for reference.  I'm just looking for a blank one.
Thanks,

Steve Clark
Histology Supervisor
Grand Strand Regional Medical Center
843-692-1486 Lab
843-692-1459 Desk
stephen.cla...@hcahealthcare.com 

 [cid:image001.gif@01C9DADA.65BB9E10] 





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[Histonet] IF on lung tissue

[Richard Cartun]

Does anyone still do direct immunofluorescence on frozen lung tissue looking 
for immune-complexes, and do you find it helpful clinically?  Thanks.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] Question - CPT Coding 88321

[Richard Cartun]

I'm confused (what's new!).  I'm being told there is no technical component 
(TC) for 88321 (slide consultation).  Is that correct?  There has to be a 
technical component to cover accessioning.  Thanks for your help.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] Pathologists' Assistants - Survey

[Richard Cartun]

I need your help.  This question is for Anatomic Pathology Laboratories located 
in hospitals where the pathologists are in private practice.

Do you employ Pathologists' Assistants in your Anatomic Pathology Laboratory?  
If so, are they employed by the hospital or do the pathologists employ them?

Thank you for your time.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] release of tissues back to patient

[Richard Cartun]

In the state of Connecticut, the only agency licensed to handle human tissue or 
remains (other than hospitals) is a funeral home.  Therefore, our policy is to 
only release tissue or remains to a funeral home after the patient or family 
has made the appropriate arrangements with them.

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) 545-1596 Office
(860) 545-2204 Fax


 Hutton, Allison ahut...@dh.org 11/8/2011 12:57 PM 
We had a question come up regarding giving patient's back their placentas 
(patient's request) after delivery.  Our general rule is not to return tissues, 
except for religious reasons.  We are now trying to come up with a concrete SOP 
for (or not) returning tissues.  I was curious what other institutions are 
doing in regards to this topic.  I know laws vary by location but I am looking 
for a general idea.
Thank you in advance,
Allison
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RE: [Histonet] SALARY

[Richard Cartun]

I think that's low.  If you find a good candidate with years of experience I 
would pay them whatever it takes to get them in the door.  It's like Free 
Agency in baseball; if you want a good player, you need to put the money on 
table.  Histotechnologists are the most valuable employees in the laboratory 
today! 

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) 545-1596 Office
(860) 545-2204 Fax


 Pratt, Caroline caroline.pr...@uphs.upenn.edu 10/28/2011 9:21 AM 
I would say $28 to $32 dollars an hour depending on experience and education.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
kcasti...@frii.com 
Sent: Friday, October 28, 2011 7:54 AM
To: Histonet@lists.utsouthwestern.edu 
Subject: [Histonet] SALARY

HI EVERYONE,

WOULD LIKE TO KNOW WHAT LEAD TECHS AND SUPERVISORS ARE GETTING PAID 
THESE DAYS.  HAVE A FELLOW HISTO PERSON THAT IS RUNNING THEIR OWN DERM 
LAB AND DOING MOHS ALSO.  THANKS FOR YOUR HELP.  KRISTY

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[Histonet] Question - Prostate biopsy reports

[Richard Cartun]

How many of you who are reading prostate biopsy specimens in a hospital 
laboratory incorporate a diagram of the prostate in your report that shows the 
anatomical location of benign, PIN, and adenocarcinoma pathology in each 
quadrant?  Thanks.

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) 545-1596 Office
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Re: [Histonet] Slide/Block Retention

[Richard Cartun]

We currently keep slides and paraffin blocks (surgical pathology) for 17 years; 
I would keep more, but laboratory administration keeps tell me to discard 
because we don't have sufficient storage space.  It's not unusual for me to 
receive a request for a block(s) from the 1990's for IHC, molecular, or genetic 
testing especially now that we have entered the arena for Personalized 
Medicine.  Also, I find myself re-testing specimens from the 1990's and 2000's 
with new generation antibodies, probes, and detection systems.

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) 545-1596 Office
(860) 545-2204 Fax


 Dessoye, Michael J mjdess...@wvhcs.org 10/3/2011 9:50 AM 
Hello Histonet,
 
What policy is everyone following for slide and block retention?  We are
not CAP, however we currently keep slides and blocks for 10 years.  My
director wants to decrease that period to 2 years, which is the Joint
Commission standard.  I would like to keep 10 years because we
frequently are asked to send slides for consult and review that are
several years old.  It is also helpful when looking for hard-to-find
control tissue.  However these reasons are apparently not sufficient.  
 
I'm leaning towards keeping the 10 year policy, but I need additional
justification.  Or does anyone think the 2 year period is sufficient?
 
Thanks,
Mike
 
Michael J. Dessoye, M.S. | Histology Supervisor | Wyoming Valley Health
Care System | mjdess...@wvhcs.org mailto:mjdess...@wvhcs.org  |
575 N. River Street | Wilkes Barre, PA 18764 | Tel: 570-552-1485 | Fax:
570-552-1526 
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Re: [Histonet] Block age/labile epitopes - UPDATE

[Richard Cartun]

An interesting article on this subject came out earlier this year from
Stephen Hewitt's work group at the NCI.  Their work shows that the loss
of antigenicity in archival formalin-fixed, paraffin-embedded tissue
sections is due to the presence of water, both endogenously (poor
processing) and exogenously (humidity).  I've listed the reference
below:

Xie R, Chung J-Y, Ylaya K, et al.:  Factors influencing the degradation
of archival formalin-fixed, paraffin-embedded tissue sections.  J
Histochem Cytochem 59:356-365, 2011.

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) 545-1596 Office
(860) 545-2204 Fax


 Rene J Buesa rjbu...@yahoo.com 9/25/2011 11:36 AM 
Andrea:
Under separate cover I am sending an article I wrote on the subject of
epitope oxidation including some  of theose easier to oxidize.
As to when a block is too old to be useless for IHC, that depends on
the epitope and the way the blocks have been stored.
I have been able to use 25 years old blocks and  the only thing you
have to do is to go deep into the block to reach an area where the
epitopes have not been oxidized yet.
René J.

--- On Sat, 9/24/11, Andrea T. Hooper andreahoo...@rocketmail.com
wrote:


From: Andrea T. Hooper andreahoo...@rocketmail.com
Subject: [Histonet] Block age/labile epitopes
To: Histonet histonet@lists.utsouthwestern.edu
Date: Saturday, September 24, 2011, 11:44 PM


Just curious as to at what shelf-life people consider their blocks too
old to rely on for IHC data? Along those lines I am wondering about
labile antigens ... does anyone know how fast epitopes may disappear
from blocks and what are some good examples of labile epitopes/antigens?
As usual any references or papers citations would be helpful.

Thank you!
Andrea Hooper
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[Histonet] IHC for TSPY

[Richard Cartun]

Does anyone offer immunohistochemical testing for the Y-encoded TSPY protein 
in testicular biopsy tissue?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] Antibody to Cryptococcus

[Richard Cartun]

For years (maybe decades) I have used Dako's rabbit polyclonal antibody to 
Cryptococcus for IHC staining of human tissue.  The antibody is no longer 
available and our last remaining vial is almost empty.  Can anyone recommend 
another antibody that works on formalin-fixed tissue?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] Immunotech

[Richard Cartun]

Does anyone know if Immunotech (France) is still around and, if so, do they 
have a distributor here in the US?  We obtained an antibody to CD1a (clone O10) 
from them years ago through a distributor in Maine whose telephone number is no 
longer active.  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] cam 5.2

[Richard Cartun]

I have used CK-CAM5.2 for years with excellent results.  However, for the past 
several years I have been using Leica-Microsystems' low molecular weight CK 
antibody, clone 5D3, that labels cytokeratins 8 and 18.  I highly recommend 
it.

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) 545-1596 Office
(860) 545-2204 Fax


 Cynthia Pyse cp...@x-celllab.com 7/28/2011 12:23 PM 
Hello Histonetters

What company is everyone buying their Cam 5.2 antibody from? Thanks for the
information.

 

Cindy Pyse, CLT, HT (ASCP)

Laboratory/Histology Supervisor

X-Cell Laboratories

e-mail cp...@x-celllab.com 

 

 

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Re: [Histonet] Controls with patient specimen on same slide

[Richard Cartun]

We do not put our positive control tissue on the test slide; we run batch 
controls.  Many of the unstained slides (breast, GI, and prostate biopsies) 
that we use for IHC testing are cut in our Histology Laboratory as part of a 
part-type slide protocol.  For example, we cut 7 slides, 2 sections on each 
slide, for breast biopsies and stain #1, 4, and 7 with HE, and then use (if 
needed) #2, 3, 5, and 6 for IHC.  Therefore, it would be very difficult for us 
to place the positive control tissue on the same slide.  In addition, I receive 
a lot of consult cases from other hospitals where they send us unstained slides 
for testing.  Once again, it would be difficult to place the positive control 
tissue on the same slide and it would slow us down in terms of starting those 
slides once they arrive.  However, I think the main reason we don't pursue 
putting the positive control tissue on the same slide is the fact that it would 
consume an enormous amount of control tissue.

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) 545-1596 Office
(860) 545-2204 Fax


 Rathborne, Toni trathbo...@somerset-healthcare.com 7/19/2011 3:27 PM 

Hi,
I'm interested in knowing how many of you are performing ihc with the control 
tissue and the patient tissue on the same slide. I have seen slides available 
which have designated areas for each tissue to be placed so there will not be 
any confusion. If you're doing it, have you encountered any problems? What 
benefits have you noticed since implementing this process? Are your 
pathologists in favor of this?  If you're not, why not?
Thanks,
Toni


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Re: [Histonet] IHC for H. pylori

[Richard Cartun]

We only run IHC for H. pylori when the appropriate inflammatory background is 
present or when the patient has tested positive in the past and we receive a 
follow-up gastric specimen where bugs are not identified on HE.

Running H. pylori IHC on every gastric biopsy is uncalled for and borders on 
Fraud and Abuse.

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) 545-1596 Office
(860) 545-2204 Fax


 Joanne Clark jcl...@pcnm.com 7/13/2011 2:22 PM 
Hi All, was wondering how everyone does their IHC for H. pylori.  Do you 
automatically run it on all biopsies of the stomach, or do you screen first 
with a giemsa and run IHC on the ones that are negative by giemsa?  Thanks for 
the input!

Joanne Clark, HT
Histology Supervisor
Pathology Consultants of New Mexico
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[Histonet] Question - Anatomic Pathology Manager

[Richard Cartun]

How many Hospital-based Pathology Departments with 55,000 surgical specimens, 
100,000 PAPs, and 6,000 non-GYN cytology cases have separate managers for 
Cytology and Histology?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] Dpc4 IHC

[Richard Cartun]

Is anyone doing IHC for the Dpc4 gene product for adenocarcinoma in biopsy 
specimens of the pancreas and bile duct and, if so, do you find it useful?  
Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] HCV testing

[Richard Cartun]

Is anyone doing PCR testing for Hepatitis C Virus on formalin-fixed, 
paraffin-embedded tissues?  If so, can you find the virus in tissues other than 
liver?  Maybe in blood within vessels?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] question on H pylori

[Richard Cartun]

We use IHC on cases that show the appropriate inflammatory background.  Please 
note that histochemical stains may not identify intracellular H. pylori.

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) 545-1596 Office
(860) 545-2204 Fax


 Setlak, Lisa lset...@childrensmemorial.org 6/7/2011 2:12 PM 
I was just curious what everyone is using for standard of care regarding H =
Pylori..is everyone doing IHC or are you doing a Giemsa?
Thanks,
Lisa
Lisa M. Van Valkenberg, B.S., HT- ASCP
Histology Manager
2300 Children's Plaza
Chicago, IL 60614
773-868-8949



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[Histonet] Submission of tonsils to pathology

[Richard Cartun]

What is your policy on the submission of tonsils to pathology for examination 
(gross or microscopic)?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] Submission of tonsils to Pathology - #2

[Richard Cartun]

I apologize; I should have stated my question differently.  Our Children's 
Hospital wants to stop sending tonsils to Pathology unless the surgeon requests 
pathological examination.  An article published in Otolaryngology-Head and Neck 
Surgery (Nelson et al.) concluded that pathologic examination of tonsils is not 
a cost-effective use of limited health care resources.  Zero cases of 
unsuspected pathology were identified on planned gross specimen evaluation 
(n=4186) and positive pathologic findings on microscopic analysis (n=1066) were 
only identified in post-transplant patients.

Have any of you exempted tonsils from submission to Pathology?  If not, maybe 
we should.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] Re: Her2 CAP survey

[Richard Cartun]

Everyone who experiencing problems with the CAP HER2 survey slides needs to 
contact the CAP to document the problem and request replacement slides.

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) 545-1596 Office
(860) 545-2204 Fax


 Jayne Halli jayne.ha...@avera.org 5/5/2011 3:01 PM 
Cap validation Her2 slides we got one slide stained great, the other one
did not, controls and cases all stained good. We use the Dako system. 

 

Jayne Halli HT,ASCP,QIHC

Avera McKennan Histology 

800 East 21st street

Sioux Falls, SD 57117

(605)322-7142

 

my new e-mail address is jayne.ha...@avera.org 

 



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Re: [Histonet] Her/2

[Richard Cartun]

Yes, our slides look weak.  I did slides for another hospital and they look 
weak as well.  I have already contacted the CAP to see if they have received 
any other complaints.

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) 545-1596 Office
(860) 545-2204 Fax


 Marcia Funk fu...@mercyhealth.com 5/4/2011 12:54 PM 
CAP validation Her/2 slides not staining as clear as before.  Is anyone else 
having any issues ? We use the Ventana system and our daily IHC slides are 
staining
and controls are working well.  Is there a coating on these slides from CAP ? 
Thanks for any help ?
Marcia Funk HT,QIHC
 
 
 
Marcia Funk 
Histology Laboratory
Mercy Medical Center North Iowa
Mason City, IA, 50401
641-428-7907
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Re: [Histonet] IHC validation

[Richard Cartun]

In my opinion, only if it affects immunoreactivity.

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) 545-1596 Office
(860) 545-2204 Fax


 Ring, Mary L mary.l.r...@healthpartners.com 4/19/2011 3:04 PM 
Does a change in the type of hematoxylin counterstain require any re-validation 
of IHC stains?
Thanks for your help!

Mary Ring, HT, QIHC
Regions Hospital, St Paul, Mn


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Re: [Histonet] Controls for IPs

[Richard Cartun]

This response is late due to the overwhelming time commitments of NCAA 
Basketball Tournaments.

The only multi-tissue control we use is for HER2 protein overexpression.  In 
my opinion, multi-tissue controls are completely unnecessary for every-day 
use for the majority of IHC tests that we do.   They are expensive and 
time-consuming to prepare and, as you pointed out, consume valuable tissue.  
Multi-tissue controls should be used during primary antibody optimization and 
validation studies; they are not needed for routine testing.

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) 545-1596 Office
(860) 545-2204 Fax


 Bauer, Karen L. bauer.ka...@mayo.edu 3/8/2011 10:16 AM 
Hello,
 
It seems we go back and forth between multi-tissue control blocks and
single tissue control blocks when it comes to immunostaining.  
 
In the past we used single blocks and still continue to use some for the
IPs that are rarely used.  Then, switched to creating multi-tissue
blocks for ease of use.  It's so nice to cut control slides ahead of
time and just pull them out and add our patient tissue.  But... we find
that the multi-tissue blocks are using up hard to find tissue.  For
example, we have a melanoma skin in one of the MTBs for the HMB45 and
Melan A stains, but that MTB is used more for the CK7, CK20 and TTF-1
stains.  Basically, that melanoma skin is just being wasted.  
 
I'm considering going back to the single block controls and was
wondering what other labs are doing.  What is the concensus in HistoLand
in regards to IP control blocks/tissues?
 
Thanks much!!
 
Karen
 
Karen L. Bauer HTL/HT (ASCP)
Histology Supervisor
Department of Pathology - Luther Hospital
Luther Midelfort - Mayo Health System
bauer.ka...@mayo.edu 
 
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[Histonet] IDH1 R132H IHC

[Richard Cartun]

Is anyone doing IHC for the IDH1 R132H point mutation for astrocytoma and 
oligodendroglioma in formalin-fixed, paraffin-embedded brain tissue using the 
H09 clone?  If so, how do you get the antibody?  Directly from Germany or is 
there someone here in the USA that carries it?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] use of destained sections in IHC?

[Richard Cartun]

Yes, you can use HE-stained slides for IHC; however, if your lesion/tumor is 
negative and there is no internal positive control, then you may be dealing 
with a false negative result.  Having said that, we have had good luck with the 
majority of proteins we have tested.

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) 545-1596 Office
(860) 545-2204 Fax


 Robin Dean robin_d...@compbio.com 2/23/2011 2:43 PM 
Hi all,

 

Is it possible to de-stain HE stained  paraffin sections and re-use them
for IHC staining??? Does anything special have to be done? Will it only work
for some epitopes/stains? Does anyone have suggestions on how to do this? I
am being asked to do this and don't want to waste my time if it won't work.
I would appreciate any suggestions anyone might have 

 

Thank you,

 

Robin

 

Robin R. Dean, Ph.D.

Senior Scientist  Study Director

Comparative Biosciences, Inc.

786 Lucerne Dr.

Sunnyvale, CA

(408) 738-8060

robin_d...@compbio.com 

 

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Re: [Histonet] CAP question ANP.22970

[Richard Cartun]

Here's an excellent reference -  Ross JS: Saving Lives with Accurate HER2 
Testing Am J Clin Pathol  2010;134:183-184.

I quote, A number of experts in the field have now agreed that a laboratory 
performing HER2 testing in the US patient population should have a HER2+ rate 
of approximately 16% with a range of 12% to 20%.

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) 545-1596 Office
(860) 545-2204 Fax


 Martha Ward mw...@wfubmc.edu 2/1/2011 12:57 PM 
We are having our inspection this spring and I am working to get all our 
procedures, etc. ready.  I am having trouble finding benchmark information for 
comparison for HER2 to comply with this question - ...the laboratory at least 
annually compares its patient results with published benchmarks,   We are 
using the Dako Herceptest.  I spoke with Dako tech services and they did not 
have any information.   What are other labs using for a benchmark.

Thanks in advance for all your help.

Martha Ward, MT (ASCP) QIHC
Assistant Manager
Molecular Diagnostics Lab
Dept. of Pathology
Wake Forest University Baptist Medical Center
Winston-Salem, NC 27157
336-716-2104

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RE: [Histonet] CPT code 88363

[Richard Cartun]

No; you can not bill the patient for this.  You should charge the attorney for 
the work you do.

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) 545-1596 Office
(860) 545-2204 Fax


 DANIEL HEWITT dhew...@hvhs.org 2/10/2011 3:25 PM 
How about pulling blocks and cutting blank slides for an attorney who
does not represent our hospital? We don't have to do this very much but
it does come up.

Thanks
Daniel Hewitt
Histology Supervisor, HVS
412-749-7371

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-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Richard
Cartun
Sent: Thursday, February 10, 2011 11:23 AM
To: Mike Pence; Histonet; Thomas Podawiltz
Subject: RE: [Histonet] CPT code 88363

I think so.

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) 545-1596 Office
(860) 545-2204 Fax


 Mike Pence mpe...@grhs.net 2/10/2011 9:19 AM 
Is this a code that can be used even if you have your molecular done
somewhere else?

Mike

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of
Podawiltz, Thomas
Sent: Wednesday, February 09, 2011 2:43 PM
To: Richard Cartun; Histonet
Subject: RE: [Histonet] CPT code 88363


It is my understanding that it used for examaination and selection of
retrieved archival (ie,previously diagnosed) tissue for molecular
analysis (eg, KRAS mutational analysis). 
page 440 of the 2011 AMA CPT , professional edition. 



Tom Podawiltz, HT (ASCP)
Histology Section Head/Laboratory Safety Officer
LRGHealthcare
603-524-3211 ext: 3220

From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Richard Cartun
[rcar...@harthosp.org] 
Sent: Wednesday, February 09, 2011 1:12 PM
To: Histonet
Subject: [Histonet] CPT code 88363

Is anyone using the above CPT code for reviewing old pathology slides
prior to ordering IHC testing or can it only be used for slide review
prior to ordering molecular testing?  Thanks.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] CPT code 88363

[Richard Cartun]

Is anyone using the above CPT code for reviewing old pathology slides prior 
to ordering IHC testing or can it only be used for slide review prior to 
ordering molecular testing?  Thanks.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] Consult accessioning question

[Richard Cartun]

When accessioning a case for consultation, do you use the date on the paperwork 
from the referring hospital/pathologist as the new Date-of-service?  If so, 
what do you do when the paperwork gives a date (say Friday) and then the 
specimen is not sent out until the following Monday?  Thank you.

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) 545-1596 Office
(860) 545-2204 Fax



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[Histonet] C3d

[Richard Cartun]

Is anyone using a Commercially-available C3d (not CD3) antibody for 
identifying antibody-mediated rejection in formalin-fixed cardiac transplant 
tissue?  Thanks.

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) 545-1596 Office
(860) 545-2204 Fax



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Re: [Histonet] RE: decalcifying bone marrows after processing

[Richard Cartun]

Hi Becky:

How long is the specimen in formalin before you put it in Cal Rite decal? 
Thanks.

Richard

Richard W. Cartun, Ph.D.
Director, Histology  Immunopathology
Director, Biospecimens
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 545-1596
(860) 545-0174 Fax
 Garrison, Becky 01/14/11 5:44 PM  
We process bone marrow biopsies the same day received. We use a combination 
decal/ fixative solution (Cal Rite decal) with good results. We keep in this 
solution a minimum of 3 hours before moving to 
tissue processor where first 2 solutions are a total of 3 hours in 
formalin. Although most bone marrow biopsies are received by 2:00 - 3:00pm; 
we've had some received as late as 4:00pm with good results. 
Our clinicians place the bone marrow core in pre-filled formalin at the 
point of collection, also. 

The Cal Rite is a combination of formaldehyde, formic acid and methanol. 

Becky Garrison 
Pathology Supervisor 
Shands Jacksonville 
Jacksonville, FL 32209 
904-244-6237, phone 
904-244-4290, fax 
904-393-3194, pager 

-Original Message- 
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Powers, Kerry 
Sent: Friday, January 14, 2011 4:32 PM 
To: histonet@lists.utsouthwestern.edu 
Subject: [Histonet] decalcifying bone marrows after processing 

I was wondering if anyone has any experience with, or is it even possible to, 
decalcify bone marrows after they are processed. Our pathologist would like to 
be able to process bone marrows the same day we receive them, but most of the 
time there just isn't enough time to allow for proper fixation and then proper 
decalcification. She asked if we could process them and then decalcify and I 
have yet to find an answer to this question. Please help!! 

Thank you, 

Kerry Powers 
Comanche Country Memorial Hospital 
Department of Pathology 
3401 W Gore, Lawton OK 73505 
(580) 355-8699 ext. 3359 
Fax: (580) 585-5462 
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Re: [Histonet] Need help with p16 pricing

[Richard Cartun]

We use the mtm predilute mAb with excellent results.  Due to the
sensitivity of our detection (Leica-Microsystems' Bond Polymer Refine
kit), we are able to dilute it to 1:10 and still obtain outstanding
immunoreactivity.

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) 545-1596 Office
(860) 545-2204 Fax


 Rhonda Henshall-Powell rlhenshall_pow...@yahoo.co.uk 1/11/2011
6:18 PM 
Hello All,

I am having a hard time getting list price on MTM's p16 CINtec kit for
histology - anyone using is out there?  Is this the only IVD test on the
market?  What are people using? is it cost effective?

CINtec® Histology: Part No. 9517

Thanks,
Rhonda




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