RE: [Histonet] Cautery-Like Artefact
I have had experience with various artifacts with rapid, microwave- assisted processing, including where it does resemble cautery artifact ( especially with skin, other highly polar tissue types, and liver cores) . It seems to have to do with the mechanism of heating with microwaves and the tissue types. After I did a little research on the physics of MW energy and the amount of resistance heat generation to MW energy of different of tissues, ( related to polarity-water), I was able to draw conclusions about causes and effects on different tissues. Sometimes people want to work with this as with conventional processing- but it works differently, and has different variables. The thickness and surface area are even more important, but also the MW cycles and other fine details of the energy/heat during the program have to be optimized. I recall you can view this in the operating system of the instrument in a graph, and I was able to work with the vendor to assist with the task of refining the programs. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Mon, 19 Aug 2013 19:55:07 -0400 From: renafa...@gmail.com To: rhe...@lumc.edu Subject: Re: [Histonet] Cautery-Like Artefact CC: histonet@lists.utsouthwestern.edu Is it possible the specimens are drying out bon the edges before being placed in fixative? Rena Fail On Mon, Aug 19, 2013 at 4:55 PM, Roger Heyna rhe...@lumc.edu wrote: We are experiencing a staining artefact on our HE's, most commonly seen on skin specimens, but also observed on other specimen types as well. Within the dermis and subcutaneous regions of the skin specimens, there are portions of what should be collagen that appear homogenized and stained with hematoxylin, instead of the usual eosin staining. It's often on the edge of the section and varies in size between different specimens. The pathologist is normally able to read around it, but there have been cases that were made more difficult to diagnosis by this artefact. Our pathologists believe this artefact resembles cautery artefact, but the dermatologists insist they are not using cautery during collection. We have a large derm service, and most of our derm specimens fix overnight. We have both microwave and conventional processing, and the artefact specimens have been processed on both. All of these specimens have grossing ink on them. Any thoughts on what could be causing this? If it's not cautery, does it seem like a fixation issue? Has anyone seen grossing ink affect processing? Thanks ahead of time for your help. Roger ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Cautery-Like Artefact
Drying is always a problem, with conventional or MW processing. So I agree rule that out first. Joelle Weaver MAOM, HTL (ASCP) QIHC From: tony.henw...@health.nsw.gov.au To: rhe...@lumc.edu; bbrinegar...@gmail.com Date: Tue, 20 Aug 2013 01:35:20 + Subject: RE: [Histonet] Cautery-Like Artefact CC: histonet@lists.utsouthwestern.edu In this case I would also look at fixation time - increase it as much as possible. Regards Tony Henwood JP, MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Laboratory Manager Senior Scientist Tel: 612 9845 3306 Fax: 612 9845 3318 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 Roger Heyna Sent: Tuesday, 20 August 2013 7:25 AM To: Beth Brinegar Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Cautery-Like Artefact Most of the derms are processed on Milestone's Pathos microwave processor. The processing program is 5 hours long. Roger Beth Brinegar bbrinegar...@gmail.com 8/19/2013 4:04 PM How long is your overnight processing run? Are these specimens being processed on an eight hour run, a four hour run, or something like a rapid run? On Monday, August 19, 2013, Roger Heyna wrote: We are experiencing a staining artefact on our HE's, most commonly seen on skin specimens, but also observed on other specimen types as well. Within the dermis and subcutaneous regions of the skin specimens, there are portions of what should be collagen that appear homogenized and stained with hematoxylin, instead of the usual eosin staining. It's often on the edge of the section and varies in size between different specimens. The pathologist is normally able to read around it, but there have been cases that were made more difficult to diagnosis by this artefact. Our pathologists believe this artefact resembles cautery artefact, but the dermatologists insist they are not using cautery during collection. We have a large derm service, and most of our derm specimens fix overnight. We have both microwave and conventional processing, and the artefact specimens have been processed on both. All of these specimens have grossing ink on them. Any thoughts on what could be causing this? If it's not cautery, does it seem like a fixation issue? Has anyone seen grossing ink affect processing? Thanks ahead of time for your help. Roger -- Beth Brinegar HTL(ASCP) Anatomic Pathology Supervisor Mercy Medical Center Cedar Rapids, IA 52403 * 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 mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Cautery-Like Artefact
Roger: Any artifact that is hematoxylin (+) and resembles a cautery i.e. without cellular details at all is either caused by an actual cautery procedure, by incomplete fixation or by drying out. Your dermatologists attest they are not using cautery, so that can be eliminated. You wrote they are fixed overnight so it is very likely that fixation is close to appropriate, so fixation can be eliminated also. Additionally had this artifact appear in all your Bx. fixation would be the culprit. You wrote that the artifact appears both in conventional and in MW tissue processing so processing with MW oven can be eliminated. Then the only cause not eliminated is drying out and it has to occur before fixation. The issue is now determining when the Bx. dries out and if you receive all your Bx. in fixative, the drying out has to occur at the dermatologist's office. Sometime between the moment the Bx. is taken and is placed in the fixative the margins of the Bx. driy out. Answers to some questions will allow you to narrow down the problem: 1- is this artifact more frequent during the periods when the air in your area is drier, i.e., are there variations in the frequency during different months? 2- is this artifact more frequent in Bx. from some dermatologists than from others? 3- does the artifact present variations in the intensity of the drying, meaning that it can be concluded that the drying times can be identified? I think that you should tally this artifact frequency and intensity against months of the year and referring dermatologists. You may even end with enough information to write something about this artifact after all. René J. From: Roger Heyna rhe...@lumc.edu To: histonet@lists.utsouthwestern.edu Sent: Monday, August 19, 2013 4:55 PM Subject: [Histonet] Cautery-Like Artefact We are experiencing a staining artefact on our HE's, most commonly seen on skin specimens, but also observed on other specimen types as well. Within the dermis and subcutaneous regions of the skin specimens, there are portions of what should be collagen that appear homogenized and stained with hematoxylin, instead of the usual eosin staining. It's often on the edge of the section and varies in size between different specimens. The pathologist is normally able to read around it, but there have been cases that were made more difficult to diagnosis by this artefact. Our pathologists believe this artefact resembles cautery artefact, but the dermatologists insist they are not using cautery during collection. We have a large derm service, and most of our derm specimens fix overnight. We have both microwave and conventional processing, and the artefact specimens have been processed on both. All of these specimens have grossing ink on them. Any thoughts on what could be causing this? If it's not cautery, does it seem like a fixation issue? Has anyone seen grossing ink affect processing? Thanks ahead of time for your help. Roger ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Cautery-Like Artefact
Thank you everyone for your feedback. I will report back if we are able to identify the problem variable. Since we've already addressed processing cycles, we'll start by checking that the cassettes aren't allowed to dry out before processing and then enlist some help at our dermatology clinic to investigate their specimen collection methods. Roger Rene J Buesa rjbu...@yahoo.com 8/20/2013 9:27 AM Roger: Any artifact that is hematoxylin (+) and resembles a cautery i.e. without cellular details at all is either caused by an actual cautery procedure, by incomplete fixation or by drying out. Your dermatologists attest they are not using cautery, so that can be eliminated. You wrote they are fixed overnight so it is very likely that fixation is close to appropriate, so fixation can be eliminated also. Additionally had this artifact appear in all your Bx. fixation would be the culprit. You wrote that the artifact appears both in conventional and in MW tissue processing so processing with MW oven can be eliminated. Then the only cause not eliminated is drying out and it has to occur before fixation. The issue is now determining when the Bx. dries out and if you receive all your Bx. in fixative, the drying out has to occur at the dermatologist's office. Sometime between the moment the Bx. is taken and is placed in the fixative the margins of the Bx. driy out. Answers to some questions will allow you to narrow down the problem: 1- is this artifact more frequent during the periods when the air in your area is drier, i.e., are there variations in the frequency during different months? 2- is this artifact more frequent in Bx. from some dermatologists than from others? 3- does the artifact present variations in the intensity of the drying, meaning that it can be concluded that the drying times can be identified? I think that you should tally this artifact frequency and intensity against months of the year and referring dermatologists. You may even end with enough information to write something about this artifact after all. René J. From: Roger Heyna rhe...@lumc.edu To: histonet@lists.utsouthwestern.edu Sent: Monday, August 19, 2013 4:55 PM Subject: [Histonet] Cautery-Like Artefact We are experiencing a staining artefact on our HE's, most commonly seen on skin specimens, but also observed on other specimen types as well. Within the dermis and subcutaneous regions of the skin specimens, there are portions of what should be collagen that appear homogenized and stained with hematoxylin, instead of the usual eosin staining. It's often on the edge of the section and varies in size between different specimens. The pathologist is normally able to read around it, but there have been cases that were made more difficult to diagnosis by this artefact. Our pathologists believe this artefact resembles cautery artefact, but the dermatologists insist they are not using cautery during collection. We have a large derm service, and most of our derm specimens fix overnight. We have both microwave and conventional processing, and the artefact specimens have been processed on both. All of these specimens have grossing ink on them. Any thoughts on what could be causing this? If it's not cautery, does it seem like a fixation issue? Has anyone seen grossing ink affect processing? Thanks ahead of time for your help. Roger ___ 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] Cautery-Like Artefact
We are experiencing a staining artefact on our HE's, most commonly seen on skin specimens, but also observed on other specimen types as well. Within the dermis and subcutaneous regions of the skin specimens, there are portions of what should be collagen that appear homogenized and stained with hematoxylin, instead of the usual eosin staining. It's often on the edge of the section and varies in size between different specimens. The pathologist is normally able to read around it, but there have been cases that were made more difficult to diagnosis by this artefact. Our pathologists believe this artefact resembles cautery artefact, but the dermatologists insist they are not using cautery during collection. We have a large derm service, and most of our derm specimens fix overnight. We have both microwave and conventional processing, and the artefact specimens have been processed on both. All of these specimens have grossing ink on them. Any thoughts on what could be causing this? If it's not cautery, does it seem like a fixation issue? Has anyone seen grossing ink affect processing? Thanks ahead of time for your help. Roger ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Cautery-Like Artefact
How long is your overnight processing run? Are these specimens being processed on an eight hour run, a four hour run, or something like a rapid run? On Monday, August 19, 2013, Roger Heyna wrote: We are experiencing a staining artefact on our HE's, most commonly seen on skin specimens, but also observed on other specimen types as well. Within the dermis and subcutaneous regions of the skin specimens, there are portions of what should be collagen that appear homogenized and stained with hematoxylin, instead of the usual eosin staining. It's often on the edge of the section and varies in size between different specimens. The pathologist is normally able to read around it, but there have been cases that were made more difficult to diagnosis by this artefact. Our pathologists believe this artefact resembles cautery artefact, but the dermatologists insist they are not using cautery during collection. We have a large derm service, and most of our derm specimens fix overnight. We have both microwave and conventional processing, and the artefact specimens have been processed on both. All of these specimens have grossing ink on them. Any thoughts on what could be causing this? If it's not cautery, does it seem like a fixation issue? Has anyone seen grossing ink affect processing? Thanks ahead of time for your help. Roger -- Beth Brinegar HTL(ASCP) Anatomic Pathology Supervisor Mercy Medical Center Cedar Rapids, IA 52403 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Cautery-Like Artefact
Most of the derms are processed on Milestone's Pathos microwave processor. The processing program is 5 hours long. Roger Beth Brinegar bbrinegar...@gmail.com 8/19/2013 4:04 PM How long is your overnight processing run? Are these specimens being processed on an eight hour run, a four hour run, or something like a rapid run? On Monday, August 19, 2013, Roger Heyna wrote: We are experiencing a staining artefact on our HE's, most commonly seen on skin specimens, but also observed on other specimen types as well. Within the dermis and subcutaneous regions of the skin specimens, there are portions of what should be collagen that appear homogenized and stained with hematoxylin, instead of the usual eosin staining. It's often on the edge of the section and varies in size between different specimens. The pathologist is normally able to read around it, but there have been cases that were made more difficult to diagnosis by this artefact. Our pathologists believe this artefact resembles cautery artefact, but the dermatologists insist they are not using cautery during collection. We have a large derm service, and most of our derm specimens fix overnight. We have both microwave and conventional processing, and the artefact specimens have been processed on both. All of these specimens have grossing ink on them. Any thoughts on what could be causing this? If it's not cautery, does it seem like a fixation issue? Has anyone seen grossing ink affect processing? Thanks ahead of time for your help. Roger -- Beth Brinegar HTL(ASCP) Anatomic Pathology Supervisor Mercy Medical Center Cedar Rapids, IA 52403 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Cautery-Like Artefact
Hi Roger, If I may refer to my earlier post: Another cause of anomalous staining is drying of the biopsy prior to fixative immersion. This can result in non-specific immunohistochemical staining as well as sub-optimal histochemical staining. Drying of the edges of biopsies, like skin, can result in morphology not unlike that seen after cautery. I have also seen it in biopsies that had been inadvertently placed on alcowipes (pads soaked in alcohol used for disinfecting skin prior to procedures) as well as biopsies placed on absorbent filter-like cards. Regards Tony Henwood JP, MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Laboratory Manager Senior Scientist Tel: 612 9845 3306 Fax: 612 9845 3318 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 Roger Heyna Sent: Tuesday, 20 August 2013 6:55 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Cautery-Like Artefact We are experiencing a staining artefact on our HE's, most commonly seen on skin specimens, but also observed on other specimen types as well. Within the dermis and subcutaneous regions of the skin specimens, there are portions of what should be collagen that appear homogenized and stained with hematoxylin, instead of the usual eosin staining. It's often on the edge of the section and varies in size between different specimens. The pathologist is normally able to read around it, but there have been cases that were made more difficult to diagnosis by this artefact. Our pathologists believe this artefact resembles cautery artefact, but the dermatologists insist they are not using cautery during collection. We have a large derm service, and most of our derm specimens fix overnight. We have both microwave and conventional processing, and the artefact specimens have been processed on both. All of these specimens have grossing ink on them. Any thoughts on what could be causing this? If it's not cautery, does it seem like a fixation issue? Has anyone seen grossing ink affect processing? Thanks ahead of time for your help. Roger * This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient, please delete it and notify the sender. Views expressed in this message and any attachments are those of the individual sender, and are not necessarily the views of The Sydney Children's Hospitals Network. This note also confirms that this email message has been virus scanned and although no computer viruses were detected, The Sydney Childrens Hospital's Network accepts no liability for any consequential damage resulting from email containing computer viruses. * ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Cautery-Like Artefact
In this case I would also look at fixation time - increase it as much as possible. Regards Tony Henwood JP, MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Laboratory Manager Senior Scientist Tel: 612 9845 3306 Fax: 612 9845 3318 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 Roger Heyna Sent: Tuesday, 20 August 2013 7:25 AM To: Beth Brinegar Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Cautery-Like Artefact Most of the derms are processed on Milestone's Pathos microwave processor. The processing program is 5 hours long. Roger Beth Brinegar bbrinegar...@gmail.com 8/19/2013 4:04 PM How long is your overnight processing run? Are these specimens being processed on an eight hour run, a four hour run, or something like a rapid run? On Monday, August 19, 2013, Roger Heyna wrote: We are experiencing a staining artefact on our HE's, most commonly seen on skin specimens, but also observed on other specimen types as well. Within the dermis and subcutaneous regions of the skin specimens, there are portions of what should be collagen that appear homogenized and stained with hematoxylin, instead of the usual eosin staining. It's often on the edge of the section and varies in size between different specimens. The pathologist is normally able to read around it, but there have been cases that were made more difficult to diagnosis by this artefact. Our pathologists believe this artefact resembles cautery artefact, but the dermatologists insist they are not using cautery during collection. We have a large derm service, and most of our derm specimens fix overnight. We have both microwave and conventional processing, and the artefact specimens have been processed on both. All of these specimens have grossing ink on them. Any thoughts on what could be causing this? If it's not cautery, does it seem like a fixation issue? Has anyone seen grossing ink affect processing? Thanks ahead of time for your help. Roger -- Beth Brinegar HTL(ASCP) Anatomic Pathology Supervisor Mercy Medical Center Cedar Rapids, IA 52403 * 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
