[Histonet] margins without frozen
If the margin is grossly close, then re-excision without a frozen is entirely appropriate. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] cassette labelers, etc
The response by M. Mihalik nails the problem. Anything that is batched (cassette labeling, slide labeling, case labeling) is known to be high risk for mistakes even though it may seem to be more efficient. On-demand-labeling is the key to significantly reducing identification errors. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Procedure manual review
All procedures must be reviewed annually (and that means WITHIN 12 months, not just once a calender year) This may be done by the appropriate supervisor or pathologist, not necessarily the Director (Director must review all new or changed procedures) The review should confirm that the procedure in operation matches what really happens. The laboratory must have in place a mechanism that demonstrates that the users of those procedures are familiar with them (and without digging up the CAP standards, i rely on my memory that this must also be documented in some format on an annual basis). I believe we accomplish this with an annual signed statement from the employees confirming they are familiar with the procedures they use. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] rapid h and e
We have never noticed any significant cell loss if dehemoglobinzing is done on bloody smears either before or after regular staining (as noted, this is used ONLY when the smear is very bloody. If it is very bloody there can be very significant obscuration. This is especially true of liver FNA's). As for regular staining, we have not found that the addition of OG offers anything special (the rare case of keratinized cells still stands out with the regular h and e stain). Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] rapid h and e
We use the same materials and timing we use for a frozen section, which as a cytopathologist works just fine for me. Approx 1 min Hematox, several dips wash, dips in blueing UNTIL BLUE (people tend to shorten this critical step), no more than 5 dips in eos, 100 ETOH X 2, xylene dipped until runs smooth, coverslip. Takes about 1 min 45 sec. If there was a lot of blood, one can start with quick fix and dips in acid alcohol, or the histo people can destain and restain the case at a later date. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Saponin
Lots of blood can be a problem in cyto specimens, especially smears. If you are making smears from fresh specimens in particular you may elute the obscuring hemoglobin by dipping the smear directly in acid alcohol (i think 5% hcl-95% etoh). We do this frequently for CT guided FNA's (particularly of the liver and thyroid, which tend to be bloody). We also do this post facto on those smears even when they have already been stained with H and E. The red cell stroma disappears into the background). Just lift the coverslip and back up to 95%, use acid alcohol ( i think it is sold on the commercial market as differentiating agent), and then start staining process all over. With fresh specimens you can see the hemoglobin elute from the surface while you dip the slide. We typically go back into regular 95% Etoh just to get rid of the acid background (effects the blueing down the line). Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] eosin
I think the use in a processor becomes a local culture. I think everyone in my community does it (someone spread the word), so now we all do. I believe that we are all putting it in the last alcohol. It really makes facing a block on minute pieces a whole lot easier. We found marking the tissue directly tedious, and it didn't persist as well in the processing. Because there is often so little visible material in our FNA cell blocks, we mark the histogel pellet with Davidson ink, and when the tech has just faced off the ink, he/she knows its time to start collecting sections. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] formalin containers
We haven't heard anything about this (and we were inspected at the end of July). If you have any additional information, please post it. It is a little hard to image a locking Lid on a disposable plastic container of reasonable cost that is large enough to hold a a total colon resection or large mastectomy. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] FX
it's too cold. set your cryostat at 20. put your tumb on the block Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] fx
that's suppose to be put your thumb on the block. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] clinical trial blocks
The fundamental philosophy that we have is that we do not want to stand in the way of the patient receiving any kind of treatment. That being said, we also have the policy that whether or not we own the material (patients are actually suppose to sign an admission consent that says they give up any ownership rights), we are clearly the legal custodians of the material, and as such are responsible for insuring that no irreparable distruction occurs. So, we prefer to not send out blocks unless the clilnical trial says there are no alternatives. We contact them and ask if we can send recuts from which they can obtain the information they desire. We also review what we have. If we have only one section, we cut a recut for the file before sending out any blocks. If we have only one block, with not much in it, we again discuss the issue with the trial coordinator. We do insist on return of the block, and assuming that there is an outside review of the material, we insist on a copy of the report. We also have the patient sign a release informing them that they need to understand that this process may exhaust any tissue that would be useful for some other new treatment which may come up down the line. Since we have to pull this material for review and usually make recuts, we bill the clinical trial. Years back, they never had any budget allowances for this, and it was always a hassle. More recently, we get a lot less BS. They know they have to pay, and they do. Unfortunately, nothing is free any more. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] change in CPT coding rule
The change in place now allows for billing multiple blocks from the same specimen for the same special stain (it isn't just immunos) BUT you must justify this (should be done by a statement in the report micro). You are not permitted just because you wanted to stain multiple blocks to increase your chance of identifying the target, rather you must indicate that EACH additional block presents additional information. This could be assumed to always be the case for sentinel nodes (you are specifically looking for tumor in each block), but would not be true if you have a multiple blocks of a lung tumor that you were testing for some specifc marker. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR
Have you validated this processing? Leaving the tissue in 70% alcohol for 48 hours is not standard, and thus requires all of the hassles associated with validation. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Phyllis Thaxton Sent: Wednesday, October 13, 2010 7:32 AM To: Kuhnla, Melissa; Mahoney,Janice A; Mike Pence; Joyce Cline; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR We run a weekend (Friday til Monday AM) breast run where the tissues are in 10% NBF for 8 hours, then in 70% alcohol for 48 hours in order to complete processing on Monday morning. So far no problems. Phyllis Thaxton HT(ASCP)QIHC DCH Regional Medical Center Tuscaloosa, AL From: Kuhnla, Melissa melissa.kuh...@chsli.org To: Mahoney,Janice A janice.maho...@alegent.org; Mike Pence mpe...@grhs.net; Joyce Cline joyce.cl...@wchsys.org; histonet@lists.utsouthwestern.edu Sent: Tue, October 12, 2010 12:02:32 PM Subject: RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR I disagree. Prolonged formalin fixation (over 48 hrs), diminishes signals -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mahoney,Janice A Sent: Tuesday, October 12, 2010 12:05 PM To: 'Mike Pence'; Joyce Cline; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR Formalin fixation time does not impact the results of FISH as it does IHC. Jan M Omaha -Original Message- From: Mike Pence [mailto:mpe...@grhs.net] Sent: Tuesday, October 12, 2010 11:00 AM To: Mahoney,Janice A; Joyce Cline; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR I don't think it matters if you do Her2 by FISH or IHC the time is still 48hr. I hope I am wrong, but I don't think I am. Mike -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mahoney,Janice A Sent: Tuesday, October 12, 2010 10:25 AM To: 'Joyce Cline'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR We have decided to reflex to FISH those breasts that do not fall within the recommended formalin fixation time. We do work on Saturdays so it is only the rare 3 day weekends that this comes into play. Jan M Omaha -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joyce Cline Sent: Tuesday, October 12, 2010 10:10 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] New Cap Guidelines for Her2 and ER/PR Does anyone have any experience with storing formalin fixed breast tissue in 70% before processing? I am trying to comply with the new guidelines set forth by CAP and ASCO with regard to Her2 and ER/PR and since my lab does not operate on the weekend we have been well above the 48 hour recommended formalin fixation time. Does 70% affect antigenicity for either Her2 or ER/PR? Any information or suggestions will be greatly appreciated. Thanks :) Ronda Souders Hagerstown Medical Laboratory 301-665-4980 fax 301-665-4941 ronda.soud...@wchsys.orgmailto:ronda.soud...@wchsys.org * CONFIDENTIALITY NOTICE * This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Sponsored by Catholic Health Initiatives and Immanuel, Alegent Health is faithful to the healing ministry of Jesus Christ, providing high quality care for the body, mind and spirit of every person. The information contained in this communication, including attachments, is confidential and private and intended only for the use of the addressees. Unauthorized use, disclosure, distribution or copying is strictly prohibited and may be unlawful. If you received this communication in error, please inform us of the erroneous delivery by return e-mail message from your computer. Additionally, although all attachments have been scanned at the source for viruses, the recipient should check any attachments for the presence of viruses before opening. Alegent Health accepts no liability for
[Histonet] relaxation of her2 standards
Don't hold your breath. I have had multiple conversations with at least one of the primary individuals who set the standards and i have not detected ANY willingness to modify the standards and that includes a hard and fast insistence on good validation for ANYTHING that differs from standard processing. If you are not in compliance you are asking for a world of hurt (which may extend to the patient). Of course, your other comments about the tissue management are right on. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Quality Assurance for Histology
Why would you want to have the pathologists fill out a QA sheet for a function you have already performed (and should document). This would seem to be a meaningless exercise (ie, waste of time) for the pathologist. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Podawiltz, Thomas Sent: Monday, October 11, 2010 8:28 AM To: 'Rene J Buesa'; histonet@lists.utsouthwestern.edu; Laurie Colbert Subject: RE: [Histonet] Quality Assurance for Histology I actually randomly review the slides before they are sent to the Pathologist any slide with incomplete sections, chatter or other major defects get re-cut at that time. Since doing this complaints from the Pathologist disappeared about the quality of the slides they were getting. They get the QA form with the last book of slides for the day. They fill it out then give it back to me. Works well for us. I do know this will not work for others, but it works for us. Tom -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Monday, October 11, 2010 11:21 AM To: histonet@lists.utsouthwestern.edu; Laurie Colbert Subject: Re: [Histonet] Quality Assurance for Histology After many different forms and many efforts to make the pathologists to provide feed back about the quality of the sections and procedures, this is what I finished doing: to ask the pathologists to simply separate the slides they considered of poor quality and those unacceptable for diagnoses. It was then my job to define the problem and to addressed it with the histotech who made the slide, to determine the re-training or any other administrative action deemed necessary. After I did that I started to receive slides while before seldom any pathologist was willing to use any time to evaluate the slides. In all reality they are quite busy to take time to fill forms that, in any event, I also had to review, re-evaluate and discuss with the histotech. This procedure worked very well for me and the quality of the work was improved considerably, as well as the rejections diminished. Try this approach. René J. --- On Mon, 10/11/10, Laurie Colbert laurie.colb...@huntingtonhospital.com wrote: From: Laurie Colbert laurie.colb...@huntingtonhospital.com Subject: [Histonet] Quality Assurance for Histology To: histonet@lists.utsouthwestern.edu Date: Monday, October 11, 2010, 11:08 AM I am revising our daily QA sheet that we hand out to the pathologists with the HE's in the morning. I would like to gather some ideas from other sites. Does anyone have a form/chart that they would be willing to share with me? Laurie Colbert Huntington Hospital Pasadena CA ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet THIS MESSAGE IS CONFIDENTIAL. This e-mail message and any attachments are proprietary and confidential information intended only for the use of the recipient(s) named above. If you are not the intended recipient, you may not print,distribute, or copy this message or any attachments. If you have received this communication in error, please notify the sender by return e-mail and delete this message and any attachments from your computer. Any views or opinions expressed are solely those of the author and do not necessarily represent those of LRGHealthcare. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Quality Assurance for Histology
Sorry, you are right about that. But, one wonders, if the problem has been solved before they get the slides, what's the usefulness of the activity (that would be a CAP debate) Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: Laurie Colbert [mailto:laurie.colb...@huntingtonhospital.com] Sent: Monday, October 11, 2010 9:07 AM To: Tench, Bill; Podawiltz, Thomas; Rene J Buesa; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Quality Assurance for Histology Actually, it is a CAP requirement: ANP.11713 There is documented evidence of daily review of the technical quality of histologic preparations by the pathologist. -Original Message- From: Tench, Bill [mailto:bill.te...@pph.org] Sent: Monday, October 11, 2010 9:02 AM To: Podawiltz, Thomas; Rene J Buesa; histonet@lists.utsouthwestern.edu; Laurie Colbert Subject: RE: [Histonet] Quality Assurance for Histology Why would you want to have the pathologists fill out a QA sheet for a function you have already performed (and should document). This would seem to be a meaningless exercise (ie, waste of time) for the pathologist. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Podawiltz, Thomas Sent: Monday, October 11, 2010 8:28 AM To: 'Rene J Buesa'; histonet@lists.utsouthwestern.edu; Laurie Colbert Subject: RE: [Histonet] Quality Assurance for Histology I actually randomly review the slides before they are sent to the Pathologist any slide with incomplete sections, chatter or other major defects get re-cut at that time. Since doing this complaints from the Pathologist disappeared about the quality of the slides they were getting. They get the QA form with the last book of slides for the day. They fill it out then give it back to me. Works well for us. I do know this will not work for others, but it works for us. Tom -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Monday, October 11, 2010 11:21 AM To: histonet@lists.utsouthwestern.edu; Laurie Colbert Subject: Re: [Histonet] Quality Assurance for Histology After many different forms and many efforts to make the pathologists to provide feed back about the quality of the sections and procedures, this is what I finished doing: to ask the pathologists to simply separate the slides they considered of poor quality and those unacceptable for diagnoses. It was then my job to define the problem and to addressed it with the histotech who made the slide, to determine the re-training or any other administrative action deemed necessary. After I did that I started to receive slides while before seldom any pathologist was willing to use any time to evaluate the slides. In all reality they are quite busy to take time to fill forms that, in any event, I also had to review, re-evaluate and discuss with the histotech. This procedure worked very well for me and the quality of the work was improved considerably, as well as the rejections diminished. Try this approach. René J. --- On Mon, 10/11/10, Laurie Colbert laurie.colb...@huntingtonhospital.com wrote: From: Laurie Colbert laurie.colb...@huntingtonhospital.com Subject: [Histonet] Quality Assurance for Histology To: histonet@lists.utsouthwestern.edu Date: Monday, October 11, 2010, 11:08 AM I am revising our daily QA sheet that we hand out to the pathologists with the HE's in the morning. I would like to gather some ideas from other sites. Does anyone have a form/chart that they would be willing to share with me? Laurie Colbert Huntington Hospital Pasadena CA ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet THIS MESSAGE IS CONFIDENTIAL. This e-mail message and any attachments are proprietary and confidential information intended only for the use of the recipient(s) named above. If you are not the intended recipient, you may not print,distribute, or copy this message or any attachments. If you have received this communication in error, please notify the sender by return e-mail and delete this message and any attachments from your computer. Any views or opinions expressed are solely those of the author and do not necessarily represent those
[Histonet] CAP programs
There are now online CAP PIP programs. I have done one on prostate. Also there are online programs for the cytology part. Review the catalogue. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] change in immuno machines
If you changed machines, you need to validate the staining on that machine just as if you never had the first machine. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] giving back tissue
In all of this discussion, it is important to understand that there are significant variations in state laws that relate to this issue, so if this problem arises, have your hospital/lab attorney check into state laws very carefully. In California, the laboratory may not own the tissue (again, depending on releases never read but signed by the patient on admission) but it clearly is the responsible custodian. This applies to sending out slides and blocks for research and for clinical testing. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] decal arteries
We routinely decal these. Most often for part of a day, but if really dense, overnight. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] billing consults
we ask the consultant to bill the patient's insurance. If they don't do that, they bill the hospital and the hospital passes the charges on to the patient. we do not make any distinction based on where the request for the consultation came from (us, the patient, the treating clinician). The patient is the beneficiary of the service. On the very rare case when it clearly is an issue of intellectual curiosity (i can think of only 3 examples), the practice will pay the charge. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] returning tissue
We do not return any tissue to patient unless there is a religious request that must be initiated by the patient (ie, staff are not permitted to offer this option--we consider that coaching). Then it is a big hassle with the issues of hazard exposure, disposal, etc. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] caris and genoptix experience
We have had almost identical experiences with both organizations. Caris has been informed that it is not welcome; genoptix is on the same list Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] tonsils
I have seen malignancy in tonsils that did not show a 5 cm difference in the gross size. I would be very concerned about missing a significant lesion using that criterion. Dr Bill Tench Assoc Dir. Lab Services Chief Cytology Palomar Medical Center 555 E. Valley Parkway Escondido, Ca 92025 Voice: 760-739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] (no subject)
You need to review all of the notes that go with the standard: NOTE: Microwave devices should be placed in an appropriate ventilation hood to contain airborne chemical contaminants and potentially infectious agents. Before operation of the microwave device, flammable and corrosive reagents should be removed from the hood, to prevent fire or chemical damage to the electronic components of the device. Microwave devices used outside a fume hood should have an integral fume extractor that is certified by the manufacturer for use in a clinical laboratory. The effectiveness of ventilation should be monitored at least annually. This checklist requirement does not apply if only non-hazardous reagents (and non-infectious specimens) are used in the device (e.g. water, certain biological stains, paraffin sections). The laboratory should consult the MSDS sheets received with reagents and stains to assist in determining proper handling requirements and safe use. This checklist item does not apply to microwave devices that are designed by the manufacturer to operate without venting. How much of this applies to you? What are you microwaving? If it is nonhazardous, as indicated above, then this is an N/A. Or, is this a device designed to operate without venting? If situation #1 above applies, then yes, you must comply. Reading the detail in the notes is critical to understanding the standards. They are a lot more detailed and specific than what I have seen in the past in other regulatory resources. Dr Bill Tench Assoc Dir. Lab Services Chief Cytology Palomar Medical Center 555 E. Valley Parkway Escondido, Ca 92025 Voice: 760-739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] cutting standards
I asked this question earlier in the spring. someone sent me some national standards from surveys, so if you go to the archives you should find this information. i will see if i can find the information. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] gross specimen retention
We generally do not return specimens to patients, so this is not so much of an issue for us. We do retain processed specimens longer than 2 weeks (more like 2 months). Fresh placentas (requiring refrigerated storage) are an exception. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] preparation of frozen sections
So as a pathologist, i have to ask you why you would want to air dry a section? From a diagnostic perspective, we consider air dried samples unacceptable in my lab. All of our standard histologic interpretation is based on fixed sections. So, why not drop the slide in a jar or ETOH and keep it there until you are ready to stain? Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] grossing manual
Yes, you do need a standard procedure manual for the management of all of your specimens. Life has gotten more complicated with the reporting standards now in place for reporting cancer which includes the gross examination. A good start for the non-neoplastic cases would be the appendix of a good surgical pathology text like Rosai (i haven't seen the latest editions, but i think it is still there). Other standard references also have this information. And then, go to the CAP website and download the standard protocols and convert them to how your pathologists want them. All of this may be online, but you also need a copy in the gross room. It's a pretty sizable job if you don't have any of it done already. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content scanned by the Axway MailGate. MailGate uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code. For more information on Axway products please visit www.axway.com. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] correct CPT code
You need to be more specific about what it is you are doing. If you are looking at imprints or smears intraoperatively then the correct code is 88333. I would say that neither a PA or HT is qualified for this job, but a cytotech is. If anyone other than a pathologist does it, however, you cannot charge for it. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Houston, Ronald Sent: Monday, August 09, 2010 12:09 PM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] correct CPT code How do others code analysis of renal bxs and cilia bxs for specimen adequacy; and can this be performed by a PA and/or HT who is CLIA qualified to gross? I know of 88172, but this is for adequacy of FNA specimens; can you use 88329, pathology consultation during surgery? Thanks Ronnie Ronnie Houston, MS HT(ASCP)QIHC Anatomic Pathology Manager ChildLab, a Division of Nationwide Children's Hospital www.childlab.com 700 Children's Drive Columbus, OH 43205 (P) 614-722-5450 (F) 614-722-2899 ronald.hous...@nationwidechildrens.orgmailto:ronald.hous...@nationwidec hildrens.org www.NationwideChildrens.orghttp://www.NationwideChildrens.org - Confidentiality Notice: The following mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. The recipient is responsible to maintain the confidentiality of this information and to use the information only for authorized purposes. If you are not the intended recipient (or authorized to receive information for the intended recipient), you are hereby notified that any review, use, disclosure, distribution, copying, printing, or action taken in reliance on the contents of this e-mail is strictly prohibited. If you have received this communication in error, please notify us immediately by reply e-mail and destroy all copies of the original message. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content scanned by the Axway MailGate. MailGate uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code. For more information on Axway products please visit www.axway.com. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] correct CPT code
OK, so that's a different story (and we look at renal cores for glomeruli as well). I believe the correct code for that is 88329--intraoperative consultation. It is not a frozen section so that code, 88331, does not apply. Again, I believe that to be paid, this activity must be performed by a pathologist. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: Houston, Ronald [mailto:ronald.hous...@nationwidechildrens.org] Sent: Monday, August 09, 2010 12:57 PM To: Tench, Bill Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] correct CPT code Bill, I'm specifically referring to visualization of a renal biopsy under a dissecting scope to see if the specimen is adequate for analysis (i.e. are there glomeruli present?) and examining a ciliary biopsy, again under dissecting microscope, to check for the presence of motile cilia Ronnie Houston Anatomic Pathology Manager Nationwide Children's Hospital Columbus OH 43205 (614) 722 5450 -Original Message- From: Tench, Bill [mailto:bill.te...@pph.org] Sent: Monday, August 09, 2010 3:17 PM To: Houston, Ronald Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] correct CPT code You need to be more specific about what it is you are doing. If you are looking at imprints or smears intraoperatively then the correct code is 88333. I would say that neither a PA or HT is qualified for this job, but a cytotech is. If anyone other than a pathologist does it, however, you cannot charge for it. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Houston, Ronald Sent: Monday, August 09, 2010 12:09 PM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] correct CPT code How do others code analysis of renal bxs and cilia bxs for specimen adequacy; and can this be performed by a PA and/or HT who is CLIA qualified to gross? I know of 88172, but this is for adequacy of FNA specimens; can you use 88329, pathology consultation during surgery? Thanks Ronnie Ronnie Houston, MS HT(ASCP)QIHC Anatomic Pathology Manager ChildLab, a Division of Nationwide Children's Hospital www.childlab.com 700 Children's Drive Columbus, OH 43205 (P) 614-722-5450 (F) 614-722-2899 ronald.hous...@nationwidechildrens.orgmailto:ronald.hous...@nationwidec hildrens.org www.NationwideChildrens.orghttp://www.NationwideChildrens.org - Confidentiality Notice: The following mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. The recipient is responsible to maintain the confidentiality of this information and to use the information only for authorized purposes. If you are not the intended recipient (or authorized to receive information for the intended recipient), you are hereby notified that any review, use, disclosure, distribution, copying, printing, or action taken in reliance on the contents of this e-mail is strictly prohibited. If you have received this communication in error, please notify us immediately by reply e-mail and destroy all copies of the original message. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content scanned by the Axway MailGate. MailGate uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code. For more information on Axway products please visit www.axway.com. - [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content
[Histonet] dissection aide
I don't see much advantage of this over plain old Carnoy's fixative, other than missing the wiff of choroform. Ethanol should not be a problem with IHC, but as you said, revalidation is required. The magic number of nodes is 12. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content scanned by the Axway MailGate. MailGate uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code. For more information on Axway products please visit www.axway.com. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] REFRIG FORMALIN
You must have a heck of a lot of space in the frig. I am envious. I don't think refrigerating your specimens would create any problems. Everyone i know stores them in some inconvenient corner of a morgue at room temperature. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content scanned by the Axway MailGate. MailGate uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code. For more information on Axway products please visit www.axway.com. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] special stain storage
The critical issue that your CLIA, or perhaps CAP, inspector is going to be asking is: is it necessary to storage stain reagent X in a refrigerator with a temperature range of Y. That answer lies in your procedure. If it says refrigerate (perhaps with a range) reagent X, then you must document that you have done so by tracking the frig temperature. If it really is not necessary to refrigerate the reagent (perhaps it is done so just to keep it from evaporating) indicate that in the procedure. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content scanned by the Axway MailGate. MailGate uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code. For more information on Axway products please visit www.axway.com. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] powder stain expiration
If the manufacturer has not included an expiration date for these, i think there probably isn't one. I would call the CAP LAP folks and ask them about that. When this kind of issue arises during an inspection, it is always better to call while the inspectors are still there. You can get an answer right then and there and it will save everyone a lot of time and hassle. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content scanned by the Axway MailGate. MailGate uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code. For more information on Axway products please visit www.axway.com. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] hpv testing on head and neck ca's
We do p16 on squamous ca of the head and neck region routinely Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content scanned by the Axway MailGate. MailGate uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code. For more information on Axway products please visit www.axway.com. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] decontamination of cryostat
I would suggest that if you are a CAP certified lab that you read the appropriate section in the current LAP standards list. The note associated with the standard is pretty specifiic. I believe that if you use the cryostat daily, you need to decontaminate once a week, but i don't have the standard available. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content scanned by the Axway MailGate. MailGate uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code. For more information on Axway products please visit www.axway.com. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] workload limits
I am a little concerned about some possible misunderstandings regarding slide limits, so below is a CAP article written on the topic that still applies. Understand that the elevated limits for image related instruments (which now include the ThinPrep Imager and the SurePath GS systems) have specific limits set for specific ways those instruments are used--and they are not the same for both instruments). Note well, liquid based paps do NOT count as 1/2 slides under any circumstances. You can only get to 200 slides per day if you are using the ThinPrep Imager and ONLY looking at fields of view. If you have to do a full manual review of the slide, you must reduce you limit accordingly. CAP Today August 2004 Special Section Q A Q. We use a combination of manual and location-guided screening in my laboratory. How do I calculate cytotechnologist workload limits in this setting? A. Maximum workload limits should be calculated based on the following factors: Manual versus computer-assisted screening. CLIA regulations specify a 100-slide maximum limit for manual screening in 24 hours over a minimum eight-hour work day. This translates to a maximum screening rate of 12.5 slides per hour for manual screening. The Centers for Medicare and Medicaid Services recently set the maximum workload limit for location-guided screening at 200 slides per day. This limit is equivalent to 25 slides per hour for location-guided screening. All Pap tests count as whole slides. Slides from nongynecologic cases count as whole slides except for concentration and liquid-based techniques that confine the material to less than one-half of the slide surface, which may be counted as one-half slides. Quality control and five-year retrospective rescreens are also included in the workload accounting. Number of hours spent screening. The maximum workload limit should be prorated based on the total number of hours spent screening, using the 12.5 slides per hour maximum rate for manual screening and 25 slides per hour for computer-assisted screening. This time does not include computer data entry, reporting, and other duties. Cytotechnologist ability, experience, QC data, etc. It must be emphasized that the maximum workload limits are the maximum allowable by CLIA/CMS and are not to be used as a productivity goal. Each cytotechnologist's workload limit should be carefully determined and individualized based on expertise, time spent screening, and screening method(s) used. Here are a few scenarios to illustrate maximum workload limit calculations in different settings: Cytotechnologist A works in a high-volume laboratory and screens Paps using location-guided screening. She is a highly skilled cytotechnologist with 10 years of experience and has no other duties (no data entry or reporting, no answering phone). Her maximum workload limit is 200 slides per day over eight hours (25 slides/hour). This case scenario is a rare exception. Most cytotechnologists have other duties or have a lower personal workload limit set by the laboratory supervisor and medical director. Cytotechnologist B's laboratory just brought a computerized imaging system in house and is gradually making a transition to computer-assisted screening. She now screens about two hours per day using the computer-assisted device and three hours per day screening Paps manually. She spends the rest of her day doing clerical and cytopreparatory work. Her maximum workload allowed by CLIA is: (2 hrs x 25 slides/hr) + (3 hrs x 12.5 slides/hr)=87.5 slides Cytotechnologist C screens Paps every morning using location-guided screening and screens nongyns in the afternoon. Today he spent four hours screening Paps. Although the maximum limit by CLIA would be 25 x 4=100, his individual maximum screening limit is set a bit lower (20 slides per hour), so his maximum limit is 80 for four hours of screening. This afternoon is busy with several FNAs, each of about 20 slides. With four hours left of screening time at 12.5 slides per hour, he is allowed by CLIA to screen a maximum of 50 slides this afternoon. However, his individual workload limit is less, and he will be permitted to screen a maximum of 35 of the FNA slides, and other cytotechnologists will screen the rest. Although computer-assisted screening methods afford greater productivity, care should be taken to set reasonable maximum workload limits based on the ability of the individual cytotechnologist, to avoid compromising screening accuracy. Theresa M. Voytek, MD Department of Pathology Bill Tench Palomar Medical Center 555 E Valley Parkway Escondido, Ca 92025 Voice: 760-739-3037 Fax: 760-739-2604 [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review,
[Histonet] Re Grossing assistants
I would suggest that you review the archives on this topic. There has been much discussion recently. The short answer is that ANYONE performing ANY grossing in the AP laboratory must meet the requirements for high complexity testing. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 [None] made the following annotations - NOTICE: This email message is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. This message has been content scanned by the Axway MailGate. MailGate uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code. For more information on Axway products please visit www.axway.com. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] afb contamination
We had a problem with contamination on our AFB stains, and we discovered that it was the control slide flaking off in the copland jar which was being used for staining the control and target slide at the same time (makes sense as a real control'). We identified these contaminants because they were frequently large clusters (by large I would say 4-8 organisms) which we almost never see in real cases, and fortunately, they were also not in the same plane of focus (but that can be subtle). they did create problems. Our solution was to stain the control separately from the case. No more problems. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 mail2.pph.org made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] charging for cytospins
Can you charge for two different stains for the urine cytospin? The answer to this question is a depends. If you are just doing any of the optional stains that may be used on a cytology preparation (namely Pap, HE, romanovsky) you are NOT permitted to charge for each of these (they are not considered special stains). If you did an iron stain, or melanin stain, or mucin stain, you could charge separately for these special stains. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 mail2.pph.org made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Grossing assistants-pathologist assistants
Yes, the Pathology Assistant national organization is a great resource as is the CAP. As I said before, please remember that the CAP inspection standards represent compliance with FEDERAL CMS standards. I would encourage contact with the CAP LAP in regard to these FEDERAL standards. Individual states may also have requirements specific for that state, which certainly may complicate things, so contact with your state pathology society will help with that. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 mail2.pph.org made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] urine cytology
I don't think I know of any labs that do air dried Diff quik type stains on urine cytologies any more. You need to use some sort of concentration technique, and the most frequently used for labs without liquid-base processing apparatus is the cytospin. Several companies make cytospin devices. High quality preparation with good fixation is critical, as is specimen quality. If you don't have training in cytology (at least cytology preparation) I would stay away from this. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 mail2.pph.org made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Grossing assistants
The rules are established by CMS through CLIA regulations. They are applied based on the complexity of the activity. Grossing is considered high complexity and thus is subject to rather stringent rules (which become more complicated because there are grandfather clauses). For years, the CAP took a more liberal view of how various parts of the grossing activity could be defined. CMS reviews the CAP standards. So, the result is a tightening of those standards (ie, don't blame the CAP for this one). The CAP has provided rather clear cut guidelines, and if you find them confusing, then you may contact the LAP program there and someone will assist you. You may ask the CAP to lobby for you (which I suspect they have done) or you can appeal to CMS (which will largely not listen to anything reasonable, and if it does, will tell you it will take multiple years to make any changes). Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of histonet-requ...@lists.utsouthwestern.edu Sent: Sunday, May 16, 2010 10:24 AM To: histonet@lists.utsouthwestern.edu Subject: [BULK] Histonet Digest, Vol 78, Issue 22 -- -- Message: 2 Date: Sat, 15 May 2010 17:46:58 -0400 From: Robert Richmond rsrichm...@gmail.com Subject: [Histonet] Re: Grossing Technician Qualifications To: histonet@lists.utsouthwestern.edu Message-ID: aanlktinp8attp0bpdbthkldm-8nx5sjphnrl3agrl...@mail.gmail.com Content-Type: text/plain; charset=ISO-8859-1 Tanisha Neely HT(ASCP) asks: Are the guidelines for a tech who is strictly limited to grossing anatomic pathology specimens different than for those of a full time histotech? Could a bachelor degree'd person with the right course work qualify for this position? If so, does anyone have documentation of this? I'd like to present this as a staffing option to my management if possible. Well, I'm giving a talk on the subject to the Tennessee Society for Histotechnology meeting in Chattanooga, and I'm pretty confused about the question of who's allowed to gross - the rules seem to be changing, and different certifying organizations have different requirements. If somebody can spell out in detail who it is that's requiring what, I'd appreciate it. Bob Richmond Samurai Pathologist Knoxville TN -- mail2.pph.org made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] histogel technique
Next day, pellet cells and resuspend them in a small amount (100-200 microliters) of Histogel or Agar. When the gel cools cut the microcentrifuge tube open with a scalpel or razor blade. Now you have a nice cell pellet shaped like the bottom of your centrifuge tube, and you can treat it just like any piece of tissue. Pop it in a tissue processing cassette and then to your ethanol dehydrating steps. We use histogel routinely for clinical specimens. We have found several things that improve the process: 1)after you pellet the cells and decant, use a cotton tip swab to pick up the last little droplet of fluid adjacent to the button. It will hold together much better. 2)after you have added histogel, vortex and centrifuge to pellet. Put tube in ice bath, add a few drops of formalin, and wait a few minutes. With minimal prodding the plug will essentially pour out of the tube. No need to cut. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of histonet-requ...@lists.utsouthwestern.edu Sent: Thursday, May 13, 2010 7:41 AM To: histonet@lists.utsouthwestern.edu Subject: [BULK] Histonet Digest, Vol 78, Issue 17 Send Histonet mailing list submissions to histonet@lists.utsouthwestern.edu To subscribe or unsubscribe via the World Wide Web, visit http://lists.utsouthwestern.edu/mailman/listinfo/histonet or, via email, send a message with subject or body 'help' to histonet-requ...@lists.utsouthwestern.edu You can reach the person managing the list at histonet-ow...@lists.utsouthwestern.edu When replying, please edit your Subject line so it is more specific than Re: Contents of Histonet digest... Today's Topics: 1. RE: FFPE cell pellet prep (JR R) 2. xylene substitutes (Perry, Margaret) 3. RE: AMT Cover (Jones, Laura) 4. RE: AMT Cover (wanda.sm...@hcahealthcare.com) 5. RE: AMT Cover (Jennifer Anderson) 6. RE: RE: AMT Cover (Terri Brown) 7. RE: AMT Cover (Bell, Lynne) 8. RE: AMT Cover (Elliott, Rachel A.) 9. 2010 Louisiana Society for Histotechnology State Meeting - Reservation Extension! (Montina Van Meter) 10. Re: Xylene substitutes (V. Neubert) 11. Gastric biopsies (Cristi stephenson) 12. RE: Forwarding Request for Control Mehtod (Tony Henwood) 13. Re: Gastric biopsies (Brandi Higgins) 14. Re: Gastric biopsies (susanfpl...@aim.com) 15. How do I subscribe? (Michelle MacVeigh-Aloni) 16. job opening for cytology/ FISH and histology supervisor - Florida (dcoj...@tampabay.rr.com) 17. RE: Gastric biopsies (Gill, Caula A.) 18. RE: Are Histotechs considered exempt employees? (Heckford, Karen - SMMC-SF) 19. RE: Gastric biopsies (Cynthia Pyse) 20. Re: Gastric biopsies (Rene J Buesa) 21. RE: Gastric biopsies (Weems, Joyce) 22. RE: Gastric biopsies (Joyce Cline) 23. Tilapia Fish Eye (Marquisha Paul) -- Message: 1 Date: Wed, 12 May 2010 10:36:15 -0700 From: JR R rosenfeld...@hotmail.com Subject: RE: [Histonet] FFPE cell pellet prep To: histonet@lists.utsouthwestern.edu Message-ID: bay135-w681d7f121be89ca27acdcdb...@phx.gbl Content-Type: text/plain; charset=iso-8859-1 Here's how I do it. I hate the lens paper method. I transfer suspended cells from a T75 flask to a 50 ml Falcon tube and centrifuge at 400 X g for 5 minutes. Aspirate most of the media so that cells plus media are about 1 ml. Transfer cells plus media to a 1.7 ml microcentrifuge tube. Pellet cells at 400 x G for 5 minutes. Rinse with PBS if needed. Suspend cells in NBF and fix over night. Next day, pellet cells and resuspend them in a small amount (100-200 microliters) of Histogel or Agar. When the gel cools cut the microcentrifuge tube open with a scalpel or razor blade. Now you have a nice cell pellet shaped like the bottom of your centrifuge tube, and you can treat it just like any piece of tissue. Pop it in a tissue processing cassette and then to your ethanol dehydrating steps. Jerry Ricks Research Scientist University of Washington Department of Pathology Date: Wed, 12 May 2010 06:50:14 -0700 From: kmerriam2...@yahoo.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] FFPE cell pellet prep Sorry - I forgot to put a subject line. Good morning, I am trying to make some nice FFPE cell pellet blocks, but I seem to lose a lot of cells along the way (especially when trying to take the cells out of the tube). We are fixing the cells in NBF, spinning them down, adding 70% and spinning down again. At that point, I am trying to scoop out the cells (with a weighing scoop) and wrap them in lens paper for processing. I am
[Histonet] routine specials
Grumpy old pathologist trying to pay attention to costs: Livers: if the biopsy was for anything other than metastatic ca, then retic, trichrome, and iron are pretty much standard. If for met ca, you are wasting money. Gastrics for h pylori: Just because the GI guys asked for it doesn't mean there is any chance it is there. In my practice, the pathologist MUST request the stain, and only if there is histologic evidence to support the dx (or the GI really whines). We did an internal study and found in 6 months ZERO (0) cases that were positive when there was no supporting histologic change. (we do immunos) In 95% of the cases (or more) the bugs are easily identified on H and E (you just gotta look) Bone Marrows: doing an iron is pretty much standard. Smear is best, at least in my lab, because it seems to go away in blocks. Esophagus bx: lots of folks want alcian blue for Barrett's. Again, more than 95% of the time, the dx is obvious and the special is superfluous. Gastric bx: same issue with alcian blue. It is purported to increase the sensitivity for intestinal metaplasia. I find it hard to believe that a competent pathologist cannot interpret IM without a special stain in more than 98% (or greater) of the cases. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of histonet-requ...@lists.utsouthwestern.edu Sent: Thursday, May 13, 2010 7:41 AM To: histonet@lists.utsouthwestern.edu Subject: [BULK] Histonet Digest, Vol 78, Issue 17 Send Histonet mailing list submissions to histonet@lists.utsouthwestern.edu To subscribe or unsubscribe via the World Wide Web, visit http://lists.utsouthwestern.edu/mailman/listinfo/histonet or, via email, send a message with subject or body 'help' to histonet-requ...@lists.utsouthwestern.edu You can reach the person managing the list at histonet-ow...@lists.utsouthwestern.edu When replying, please edit your Subject line so it is more specific than Re: Contents of Histonet digest... Today's Topics: 1. RE: FFPE cell pellet prep (JR R) 2. xylene substitutes (Perry, Margaret) 3. RE: AMT Cover (Jones, Laura) 4. RE: AMT Cover (wanda.sm...@hcahealthcare.com) 5. RE: AMT Cover (Jennifer Anderson) 6. RE: RE: AMT Cover (Terri Brown) 7. RE: AMT Cover (Bell, Lynne) 8. RE: AMT Cover (Elliott, Rachel A.) 9. 2010 Louisiana Society for Histotechnology State Meeting - Reservation Extension! (Montina Van Meter) 10. Re: Xylene substitutes (V. Neubert) 11. Gastric biopsies (Cristi stephenson) 12. RE: Forwarding Request for Control Mehtod (Tony Henwood) 13. Re: Gastric biopsies (Brandi Higgins) 14. Re: Gastric biopsies (susanfpl...@aim.com) 15. How do I subscribe? (Michelle MacVeigh-Aloni) 16. job opening for cytology/ FISH and histology supervisor - Florida (dcoj...@tampabay.rr.com) 17. RE: Gastric biopsies (Gill, Caula A.) 18. RE: Are Histotechs considered exempt employees? (Heckford, Karen - SMMC-SF) 19. RE: Gastric biopsies (Cynthia Pyse) 20. Re: Gastric biopsies (Rene J Buesa) 21. RE: Gastric biopsies (Weems, Joyce) 22. RE: Gastric biopsies (Joyce Cline) 23. Tilapia Fish Eye (Marquisha Paul) -- Message: 1 Date: Wed, 12 May 2010 10:36:15 -0700 From: JR R rosenfeld...@hotmail.com Subject: RE: [Histonet] FFPE cell pellet prep To: histonet@lists.utsouthwestern.edu Message-ID: bay135-w681d7f121be89ca27acdcdb...@phx.gbl Content-Type: text/plain; charset=iso-8859-1 Here's how I do it. I hate the lens paper method. I transfer suspended cells from a T75 flask to a 50 ml Falcon tube and centrifuge at 400 X g for 5 minutes. Aspirate most of the media so that cells plus media are about 1 ml. Transfer cells plus media to a 1.7 ml microcentrifuge tube. Pellet cells at 400 x G for 5 minutes. Rinse with PBS if needed. Suspend cells in NBF and fix over night. Next day, pellet cells and resuspend them in a small amount (100-200 microliters) of Histogel or Agar. When the gel cools cut the microcentrifuge tube open with a scalpel or razor blade. Now you have a nice cell pellet shaped like the bottom of your centrifuge tube, and you can treat it just like any piece of tissue. Pop it in a tissue processing cassette and then to your ethanol dehydrating steps. Jerry Ricks Research Scientist University of Washington Department of Pathology Date: Wed, 12 May 2010 06:50:14 -0700 From: kmerriam2...@yahoo.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] FFPE cell pellet prep Sorry - I forgot to put a subject line. Good morning, I am trying to make some nice FFPE cell
[Histonet] clo test
The Clo test is a clinical lab test. You need to go to that part of the CPT coding book (sorry I don't have it available). 88300 is an anatomic code (gross only, ie, it requires examination of a piece of tissue or foreign body) and is entirely inappropriate for this test. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of histonet-requ...@lists.utsouthwestern.edu Sent: Wednesday, May 05, 2010 1:36 PM To: histonet@lists.utsouthwestern.edu Subject: [BULK] Histonet Digest, Vol 78, Issue 6 Hi everyone, I am looking to see what CPT code everyone is using for reading Clo Tests in the pathology department. I have heard of using 87081 but I am not sure if this is accurate as this is for culture and the CLO is biochemical reaction not a culture. Currently I have been using 88300 gross only. Any help would be appreciated. Thank you, Amy Farnan *** mail2.pph.org made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Cap guidelines and Clia
It is important to understand that CLIA is the driving force for most of the various regulations promulgated by CAP, and this is true of the issue regarding the requirements for Gross room assistants. The CAP simply tries to interpret the morass of regulatory garbage into understandable standards, which must be approved by CLIA. There are some CAP standards that have grown out of good laboratory practices and not specific CLIA regulations, but this is not one of them. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 mail2.pph.org made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Patient ID on cassettes
A statement was made in a previous posting indicating CAP requirements for 2 unique identifiers throughout the entire analytic process: To conform to CAP and state regulations that require two unique patient identifiers on a specimen at all analytical steps. The CAP standards GEN 40491, ANP 11460, and ANP12092 specifically indicate two unique identifiers on the PRIMARY specimen container, not on every container throughout the process, and there are notes explaining the requirements. There may be variations in State laws, but these are the most up to date CAP standards. There is no need to go through a lot of contortions adding additional information to cassettes. (however, at least the ones we use also have a side panel which can be written on) Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of histonet-requ...@lists.utsouthwestern.edu Sent: Sunday, April 25, 2010 10:01 AM To: histonet@lists.utsouthwestern.edu Subject: [BULK] Histonet Digest, Vol 77, Issue 31 Send Histonet mailing list submissions to histonet@lists.utsouthwestern.edu To subscribe or unsubscribe via the World Wide Web, visit http://lists.utsouthwestern.edu/mailman/listinfo/histonet or, via email, send a message with subject or body 'help' to histonet-requ...@lists.utsouthwestern.edu You can reach the person managing the list at histonet-ow...@lists.utsouthwestern.edu When replying, please edit your Subject line so it is more specific than Re: Contents of Histonet digest... Today's Topics: 1. Patient ID on cassettes (Jeffrey Silverman) 2. Re: Gram stain (Maxim Peshkov) 3. Best books for the HTL? (Paula Sicurello) -- Message: 1 Date: Sat, 24 Apr 2010 10:28:55 -0700 (PDT) From: Jeffrey Silverman pathmas...@yahoo.com Subject: [Histonet] Patient ID on cassettes To: joyce.cl...@wchsys.org Cc: histonet@lists.utsouthwestern.edu Message-ID: 690158.71961...@web08.mail.gq1.yahoo.com Content-Type: text/plain; charset=iso-8859-1 To conform to CAP and state regulations that require two unique patient identifiers on a specimen at all analytical steps, and to cope with a persnickety cassette labeller that is down more than up, we have taken to writing the patient's first and last initials in the upper left corner of the writing surface of the cassette, above the S10- . Our pencil sharpeners are running non -stop but it works. Only problem is when a block is sent out for IHC the returned slides are labelled with the initials as part of the reference slides accession numbers and my boss doesn't care for that. Originally we dropped the S in S10- and replaced with the initials to get a little more room, now we added back the S and placed initials above S10-. Patient safety dictates that a prossector verify a match among the labelled cassette and the labelled specimen containers and against the requisition and the number dictated into the gross computer/transcriber. Case by case, on every case. There is no substitute. As for placing the wrong cassettes on the wrong specimen containers, that seems to me to be pure carelessness and a disciplinary issue if it continues. When labelling, matching the initials that the microtomist writes on the slide with the patient's name printed on the slide labels provides a final ID double check if the numbers on the slide get transcribed incorrectly. The initials thing takes minimal effort, but you need to be able to write small LOL. Jeff Silverman. -- Message: 2 Date: Sat, 24 Apr 2010 23:08:48 +0400 From: Maxim Peshkov maxim...@mail.ru Subject: Re: [Histonet] Gram stain To: Perry, Margaret margaret.pe...@sdstate.edu Cc: histonet@lists.utsouthwestern.edu Message-ID: 573298402.20100424230...@mail.ru Content-Type: text/plain; charset=windows-1251 Margaret: We uses 1% aqueous neutral red as red counterstain with very good results. Do not forget rinse slides at 10-15 secs in DW with 1-2 drop of glacial acetic acid before neutral red and after this, because this dye have red color at pH 6. Sincerely, Maxim Peshkov, Russia, Taganrog. ---Original message--- Date: Fri, 23 Apr 2010 16:25:30 -0500 From: Perry, Margaret margaret.pe...@sdstate.edu Subject: [Histonet] Gram stain To: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Message-ID: fca5ef47f9bc694cbb4c58fea04219634ccfb69...@sdsu-mbx.jacks.local Content-Type: text/plain; charset=us-ascii Now that I'm done with my rant I have a real question. We are trying to do a gram stain on fish and the safranine O is staining everything red. What other stain
[Histonet] histotech positions in San Diego area
Life is uncertain, but We may have an opening in the future. You may send resumes directly to this email address and I will forward them on to the appropriate people. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of histonet-requ...@lists.utsouthwestern.edu Sent: Monday, April 26, 2010 10:02 AM To: histonet@lists.utsouthwestern.edu Subject: [BULK] Histonet Digest, Vol 77, Issue 32 Send Histonet mailing list submissions to histonet@lists.utsouthwestern.edu To subscribe or unsubscribe via the World Wide Web, visit http://lists.utsouthwestern.edu/mailman/listinfo/histonet or, via email, send a message with subject or body 'help' to histonet-requ...@lists.utsouthwestern.edu You can reach the person managing the list at histonet-ow...@lists.utsouthwestern.edu When replying, please edit your Subject line so it is more specific than Re: Contents of Histonet digest... Today's Topics: 1. Re: [IHCRG] ER clone 1D5 or SP1 ? (Richard Cartun) 2. Region 1 conference (Amos Brooks) 3. Re: [IHCRG] ER clone 1D5 or SP1 ? (ancillaryp...@mac.com) 4. Mysterious artifact on GI biopsies HE stain (Urim, Lyudmila) 5. paraformaldayhde (Perry, Margaret) 6. RE: Mysterious artifact on GI biopsies HE stain (Weems, Joyce) 7. anti 8 hydroxyguanosine (Fabrice gankam) 8. RE: Mysterious artifact on GI biopsies HE stain (Mike Pence) 9. Any Histology openings in San Diego area? (Jill Cox) 10. (no subject) (Urim, Lyudmila) 11. Re: Two antibodies from the same host with tyramide (Johnson, Teri) 12. RE: (no subject) (Kaye Ryan) 13. RE: (no subject) (Nails, Felton) 14. RE: Best books for the HTL? (Morken, Tim) 15. RE: (no subject) (Jesus Ellin) 16. RE: [IHCRG] ER clone 1D5 or SP1 ? (Van Eyck, Deb) 17. RE: [IHCRG] ER clone 1D5 or SP1 ? (Patsy Ruegg) -- Message: 1 Date: Sun, 25 Apr 2010 15:04:28 -0400 From: Richard Cartun rcar...@harthosp.org Subject: [Histonet] Re: [IHCRG] ER clone 1D5 or SP1 ? To: 'ih...@googlegroups.com' ih...@googlegroups.com, 'histonet@lists.utsouthwestern.edu' histonet@lists.utsouthwestern.edu,jtay...@meriter.com Message-ID: 4bd459fb.7400.007...@harthosp.org Content-Type: text/plain; charset=US-ASCII I have looked at several clones over the years and I prefer clone 6F11. Richard Richard W. Cartun, Ph.D. 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 4/23/2010 11:17 AM I'm wondering which clone of ER most labs are using? Thanks, Jean Taylor, HT(ASCP)QIHC IHC Tech Meriter Health Services Madison, WI -- Subscription settings: http://groups.google.com/group/ihcrg/subscribe?hl=en -- Message: 2 Date: Sun, 25 Apr 2010 19:14:49 -0400 From: Amos Brooks amosbro...@gmail.com Subject: [Histonet] Region 1 conference To: histonet@lists.utsouthwestern.edu Message-ID: y2z582736991004251614m979ddea5yea99650b77ced...@mail.gmail.com Content-Type: text/plain; charset=ISO-8859-1 Hi, I would like to ask if anyone has any photos of the Region 1 conference to consider emailing them to me. I was going to post some on the Region 1 Conference web page and possibly put some in the Paraffin Press. If you are interested, please drop me a line. Thanks, Amos amosbro...@gmail.com -- Message: 3 Date: Sun, 25 Apr 2010 20:36:18 -0400 From: ancillaryp...@mac.com Subject: [Histonet] Re: [IHCRG] ER clone 1D5 or SP1 ? To: ihcrg Group (E-mail) ih...@googlegroups.com,histonet netserver histonet@lists.utsouthwestern.edu Message-ID: 0d48ea46-525d-45a6-bfcd-24662d59f...@mac.com Content-Type: text/plain; charset=us-ascii; format=flowed; delsp=yes When we started our lab 3 years ago, we began with SP1 from day 1, so I don't have any experience with either 1D5 or 6F11 except in my previous labs. 1D5 is an excellent clone, and seems to be more specific than SP1 in the work-up of metastatic carcinoma of unknown primary site, based on the published literature. The advantage of 6F11 is that, for those of us who use the Allred scoring system, it's the only clone that was clinically validated by Harvey et al. (JCO 1999) for this purpose. I agree with Rich. For those who use SP1, it's a very good clone as a predictive marker in breast cancer. But again, in the setting of metastatic workup, it is NOT recommended, as it will pick up too many primary lung cancers and some colon
[Histonet] CLIA requirements
You may define whatever QA monitors for grossing that you wish. These are not CLIA mandated, but contribute to improved performance. When it comes to the individuals doing the grossing, you need to understand that this has been interpreted as a high complexity activity with strict CLIA requirements (see recent postings and CAP standards). Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 mail2.pph.org made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] CPT coding question
Michelle, the example that you raised of having two tonsils, one with a stitch, isn't quite the same as your problem. The two tonsils would otherwise not be identifiable as left or right. That is not a problem with a fetus and a placenta. Each is separately identifiable and each should be coded separately. You will simplify any coding review if each is a separate line on your report. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 mail2.pph.org made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: [BULK] Histonet Digest, Vol 76, Issue 45
For placentas, you will find that you get consistently good sections if you gross the placenta fresh, take the samples you will want from the cord, disc and make a membrane role (which is easily done if they are not fixed). Fix your samples overnight and trim for blocks the next day. For the membrane role, grab the free edge of the membrane with a large forceps, role the membrane up on the forceps toward the disc, stick two pins through the space between the forceps, and cut from disc, then slightly release grip on forceps and slide role into formalin cup. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of histonet-requ...@lists.utsouthwestern.edu Sent: Wednesday, March 31, 2010 7:42 AM To: histonet@lists.utsouthwestern.edu Subject: [BULK] Histonet Digest, Vol 76, Issue 45 Send Histonet mailing list submissions to histonet@lists.utsouthwestern.edu To subscribe or unsubscribe via the World Wide Web, visit http://lists.utsouthwestern.edu/mailman/listinfo/histonet or, via email, send a message with subject or body 'help' to histonet-requ...@lists.utsouthwestern.edu You can reach the person managing the list at histonet-ow...@lists.utsouthwestern.edu When replying, please edit your Subject line so it is more specific than Re: Contents of Histonet digest... Today's Topics: 1. Coverslipping with SubX (Vanessa Avalos) 2. Haunted cryostat/Thanks! (mtitf...@aol.com) 3. GMS on decal tissue (Morken, Tim) 4. questions (Webb, Dorothy L) 5. Re: her2 validation (Pat Laurie) 6. FREE MONEY! (Jackie M O'Connor) 7. RE: questions (Garrison, Becky) 8. Thermo's Excelsior Tissue Processor Program's (Akemi Allison-Tacha) 9. re: cyto prep tech (Kim Tournear) 10. her-2 neu validation (Debbie Nannenga) 11. RE: questions (Tony Henwood) 12. RE: RE: Leica Paraplast (connie grubaugh) 13. (no subject) (Green JumpyOne) 14. Fwd: [Histonet] (no subject) (Malika Benatti) 15. RE: Thermo's Excelsior Tissue Processor Program's (Heckford, Karen - SMMC-SF) 16. RE: RE: Leica Paraplast (Nails, Felton) 17. Thermo Fisher Excelsior Tissue Processor Programs (Ann Bennett) 18. Texas Society for Histotechnology April 23-25, 2010 (kdwyer3...@aol.com) 19. cassette labels erased by processor (Catherine Breen) 20. RE: her2 validation (Weems, Joyce) 21. RE: cassette labels erased by processor (Sherwood, Margaret ) 22. FW: [Histonet] cassette labels erased by processor (Cheri Miller) 23. Re: cassette labels erased by processor (Malika Benatti) -- Message: 1 Date: Tue, 30 Mar 2010 11:15:38 -0700 From: Vanessa Avalos vava...@allergydermatology.com Subject: [Histonet] Coverslipping with SubX To: 'HISTONET LISTS' histonet@lists.utsouthwestern.edu Message-ID: 01cad035$00d2f5b0$0278e1...@com Content-Type: text/plain; charset=us-ascii Is anyone using SubX ? I am trying it out and am having some difficulty coverslipping. I am using the Subx glue as directed since Acrymount didn't seem to work as well. I still get a hazy film under the glass and am getting big air bubbles as well. I can eventually get them out but its just takes a while and you know how time is precious when you have a line of slides to stain. The process is not as smooth as before. I really would like this to work out for me and eliminate xylene. Any suggestions?? Vanessa Fax: 602-277-2134 -- Message: 2 Date: Tue, 30 Mar 2010 14:44:26 -0400 From: mtitf...@aol.com Subject: [Histonet] Haunted cryostat/Thanks! To: histo...@pathology.swmed.edu Message-ID: 8cc9e5028adfb36-1500-2...@webmail-m010.sysops.aol.com Content-Type: text/plain; charset=us-ascii Thank you everyone who responded to my problem with a Leica CM 1850 cryostat turning itself off. About 11 people responded with tips. Thank you!! The Histonet is great!! In answer to some enquirys: 1) The cryostat is set to defrost at 2 a.m.. The manual says it defrosts for an hour. Jackie O' Conner asks if it is set to go back on after the defrost. I have no idea. It defrosts well the rest of the time, and turns itself back on. Brian Cornett-Early recommends changing the start device on the compressor. 2) Someone else asked if power is getting to the cryostat - Yes, when it turns itself off, the on/off switch is on off. All you have to do is flip the switch and it starts pumping and cooling. 3) Mari Ann Mailhiot with Leica recommends changing a cicuit breaker on the side of the compressor. That is probably where we will start. Mari Ann works for Leica so it sounds like good advice. Thank you everyone. Since it
[Histonet] technologist productivity
I apologize in advance if I offend anyone with this inevitably touchy question. In the last two years we have lost one older histotechnologist, and the routine reliable services of another of that group and are now facing the issue of what can be expected from their replacements. I have little feel for this other than my experience with these and other previous employees, so I am hoping that some of you would be willing to share your thoughts/data with me either in response on this listserv, or alternatively off line directly to my email address. I am interested in some numbers on how many blocks one could expect to have embedded within an hour, with break down for simple larger or single pieces vs multiple small bx's like GI bx's or prostate needle bx's. I am looking for similar information in regard to the number of sections one could expect to be cut in an hour from routine blocks (and for this purpose, small and large bxs should be included in the same analysis-there is so much variation in regard to the number of sections that labs routinely cut from smalls, so just a general mix of the number of slides would be helpful.) Thank you in advance for sharing-we are just trying to maintain reasonable expectations from our new/replacement technologists. Bill Tench Associate Dir. Laboratory Services Chief, Cytology Services Palomar Medical Center 555 E. Valley Parkway Escondido, California 92025 bill.te...@pph.org Voice: 760- 739-3037 Fax: 760-739-2604 mail2.pph.org made the following annotations - Confidential E-Mail: This e-mail is intended only for the person or entity to which it is addressed, and may contain information that is privileged, confidential, or otherwise protected from disclosure. Dissemination, distribution, or copying of this e-mail or the information herein by anyone other than the intended recipient is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail, and destroy the original message and all copies. - ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
