[Histonet] Re: Frozen Sections
Lorraine asks: Hi, I need to ask Histoland a questionHow many HT departments provide assistance to the pathologist in the performance of frozen sections (cutting and staining of slides) to be evaluated by the pathologist? This has to do more with the prestige of the pathologist(s) in the laboratory than with the actual need. Even if I'm doing the frozen section myself, I appreciate having a second person to stain the slide - it considerably improves turnaround if I'm having trouble cutting the section. Many younger pathologists do not have adequate skills in cutting frozen sections, and really need somebody to cut the sections. I cut hundreds of them during my residency, and thousands during my research fellowship, but not every pathologist has this experience. On a different topic, most formaldehyde neutralizers are simply sodium bisulfite (a.k.a. metabisulfite), but you have to have the cachet of an expensive brand-name to keep the inspectors and managers happy. Bob Richmond Samurai Pathologist Maryville TN ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Frozen sections for Immunoflouresence
Are you using pre-cut control slides? From: histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edu] on behalf of Vickroy, Jim [vickroy@mhsil.com] Sent: Tuesday, September 02, 2014 10:51 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Frozen sections for Immunoflouresence Lately we are experiencing an issue where the tissue sections are coming off of the slide during the staining process. We have always used positive charged slides and have not experienced this problem on a routine case. We do not fix the slides but allow them to air dry for Immunology. Some have suggested a quick fixation in acetone or 95% ETOH. This doesn't seem to correct the problem and we don't find the IF stains work as well. We have tried a different batch of slides and are looking into a different kind of coating for the slides. Our regular frozen sections stay on the slides. We are using OCT. The only other thing I have noticed is that maybe it's my imagination but the OCT in the block surrounding the kidney biopsy seems a little softer than normal. I did try a different mounting medium and maybe the softness was my imagination. Has anyone else experienced this problem and if so how did you correct it? The lab is air conditioned so I don't think the humidity is the main factor. The Immunology staff changed all of their reagents so we have reduced that variable hopefully. We are using Leica positive charged slides. (I have found that the Apex control box slides from Leica are a little better than the regular Apex slides. Any ideas? Jim This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ~~ This email and any files transmitted with it are confidential, and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error contact the Help Desk for Cape Cod Healthcare. helpd...@capecodhealth.org ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Frozen sections for Immunoflouresence
Hi Jim, You mention that the OCT seems a little softer. Could it be that the sections are thicker than you usually produce. Check the Frozen section HE to check this. If sections are thicker they will tend to detach from the slides. Regards Tony Henwood JP, MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Laboratory Manager Senior Scientist, the Children's Hospital at Westmead Adjunct Fellow, School of Medicine, University of Western Sydney Tel: 612 9845 3306 Fax: 612 9845 3318 Pathology Department the children's hospital at westmead Cnr Hawkesbury Road and Hainsworth Street, Westmead Locked Bag 4001, Westmead NSW 2145, AUSTRALIA -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Wednesday, 3 September 2014 12:51 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Frozen sections for Immunoflouresence Lately we are experiencing an issue where the tissue sections are coming off of the slide during the staining process. We have always used positive charged slides and have not experienced this problem on a routine case. We do not fix the slides but allow them to air dry for Immunology. Some have suggested a quick fixation in acetone or 95% ETOH. This doesn't seem to correct the problem and we don't find the IF stains work as well. We have tried a different batch of slides and are looking into a different kind of coating for the slides. Our regular frozen sections stay on the slides. We are using OCT. The only other thing I have noticed is that maybe it's my imagination but the OCT in the block surrounding the kidney biopsy seems a little softer than normal. I did try a different mounting medium and maybe the softness was my imagination. Has anyone else experienced this problem and if so how did you correct it? The lab is air conditioned so I don't think the humidity is the main factor. The Immunology staff changed all of their reagents so we have reduced that variable hopefully. We are using Leica positive charged slides. (I have found that the Apex control box slides from Leica are a little better than the regular Apex slides. Any ideas? Jim This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet * This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient, please delete it and notify the sender. Views expressed in this message and any attachments are those of the individual sender, and are not necessarily the views of The Sydney Children's Hospitals Network. This note also confirms that this email message has been virus scanned and although no computer viruses were detected, The Sydney Childrens Hospital's Network accepts no liability for any consequential damage resulting from email containing computer viruses. * ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Frozen sections (UNCLASSIFIED)
Hi Juan, I am not sure of any ASCP guidelines nor jurisdiction over CLIA requirements. It is my understanding all US laboratories have to follow the CLIA set guidelines for performing all laboratory testing. Qualified HT or HTLs can gross complicated (high Complexity) testing under specific CLIA guidelines. CLIA guidelines have a grandfather clause for high complexity testing of experienced techs prior to (I think the exact date is) Sept 1996 that can demonstrate experience of the high complexity testing. Following Sept 1996 the educational guidelines set in for any high complexity laboratory testing requirements. Michael -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bassett, Juan L CTR (US) Sent: Wednesday, January 15, 2014 8:54 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] FW: Frozen sections (UNCLASSIFIED) Classification: UNCLASSIFIED Caveats: NONE Hi LeAnn, Please note my response below. -Original Message- From: Bassett, Juan L CTR (US) Sent: Wednesday, January 15, 2014 7:39 AM To: 'Michael LaFriniere' Cc: 'stonet-boun...@lists.utsouthwestern.edu' Subject: RE: Frozen sections (UNCLASSIFIED) Classification: UNCLASSIFIED Caveats: NONE Michael, Based on my experience the pathologist or pathologists asst. are qualified to submit the specimen to be sectioned during a Frozen section procedure. And the pathologist asst. is allowed with the pathologist's approval/acknowledgement. Qualified HT and HTL's can gross non complicated specimens within normal tissue grossing procedures. There could be legal issues involved with a technician's unilateral decision during a frozen section procedure! To get more accurate feedback on this topic , I suggest you contact the ASCP with your consideration. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Michael LaFriniere Sent: Tuesday, January 14, 2014 1:46 PM To: Leann M. Murphy; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Frozen sections Hi Leann, Dependant on the case and how much tissue comes in from the OR, In my many years...I have on many occasions grossed and placed tissue for FS on chuck, and performed the frozen section, had it under the scope looking at it prior to the Pathologist coming in for DX.(why) because we have experience and it's a comfort level the pathologists under their guidance and supervision, Many of us have the experience to do this especially if you are grandfathered or have the required education under the CLIA regs to gross. I don't know of any regulation other than what I have mentioned above that would not allow the experienced HT to perform this operation. Michael Michael R. LaFriniere, HT (ASCP) Executive Director Capital Choice Pathology Laboratory 12041 Bournefield Way, Suite A * Silver Spring, MD 20904 P: 240.471.3427 * F: 240.471.3401 * Cell 410-940-8844 michael.lafrini...@ccplab.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Leann M. Murphy Sent: Monday, January 13, 2014 10:35 AM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] Frozen sections Good morning, I know all histotechs help cut and stain frozen sections. Is there any organization out there that has the histotechnician gross the frozen section tissue and place on the frozen section chuck to cut without the Pathologist in the room. If anyone does this please tell me why? And if your organization doesn't do this please tell me why. I am having a debate with our Pathologists over this question. Thank You, LeAnn Murphy Aultman Hospital Canton, Ohio ___ 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 Classification: UNCLASSIFIED Caveats: NONE Classification: UNCLASSIFIED Caveats: NONE ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Frozen sections
Hi Leann, Dependant on the case and how much tissue comes in from the OR, In my many years...I have on many occasions grossed and placed tissue for FS on chuck, and performed the frozen section, had it under the scope looking at it prior to the Pathologist coming in for DX.(why) because we have experience and it's a comfort level the pathologists under their guidance and supervision, Many of us have the experience to do this especially if you are grandfathered or have the required education under the CLIA regs to gross. I don't know of any regulation other than what I have mentioned above that would not allow the experienced HT to perform this operation. Michael Michael R. LaFriniere, HT (ASCP) Executive Director Capital Choice Pathology Laboratory 12041 Bournefield Way, Suite A * Silver Spring, MD 20904 P: 240.471.3427 * F: 240.471.3401 * Cell 410-940-8844 michael.lafrini...@ccplab.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Leann M. Murphy Sent: Monday, January 13, 2014 10:35 AM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] Frozen sections Good morning, I know all histotechs help cut and stain frozen sections. Is there any organization out there that has the histotechnician gross the frozen section tissue and place on the frozen section chuck to cut without the Pathologist in the room. If anyone does this please tell me why? And if your organization doesn't do this please tell me why. I am having a debate with our Pathologists over this question. Thank You, LeAnn Murphy Aultman Hospital Canton, Ohio ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Frozen sections
Our pathologists prefer to perform all aspects of frozen section preparation. We will stain for them, but they would rather gross and section themselves. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Leann M. Murphy Sent: Monday, January 13, 2014 10:35 AM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] Frozen sections Good morning, I know all histotechs help cut and stain frozen sections. Is there any organization out there that has the histotechnician gross the frozen section tissue and place on the frozen section chuck to cut without the Pathologist in the room. If anyone does this please tell me why? And if your organization doesn't do this please tell me why. I am having a debate with our Pathologists over this question. Thank You, LeAnn Murphy Aultman Hospital Canton, Ohio ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Frozen Sections
Gary - Our institution follows the exact procedure listed by Wanda, copied below. - Terri Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Laboratory Holy Redeemer Hospital and Medical Center 1648 Huntingdon Pike Meadowbrook, PA 19046 (215) 938-3676 phone (215) 938-3689 fax We require an additional requisition with additional specimens labeled and numbered correctly in sequential order. In other words, if a second and third specimen is sent, the 2nd requisition will mark the #1 specimen as Previously sent for FS and the additional specimens will be listed in the #2, #3, spot on the requisition. Wanda WANDA G. SMITH, HTL(ASCP)HT Pathology Supervisor TRIDENT MEDICAL CENTER 9330 Medical Plaza Drive Charleston, SC 29406 - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
