“Some things have to be believed to be seen.” – Ralph Hodgson

What is the optimum length of time to “Fix” tissue samples with Formalin in the routine Histology lab, before proceeding to tissue processing? I know we have all been taught that we must “complete fixation” first, but what does that really mean and why don’t we need a better standard? I think we can all agree that the most common fixative used in the Histology laboratory is 10% Formalin (rapidly penetrates, denatures proteins, stops enzymatic degradation and cross-links proteins), but can do not agree on an optimal fixation time? There is too much variation in practice and the CAP/ASCO guidelines for breast tissue (what about other tissue types?) does not really help to set a standard that we can use an acceptable variation range. Breast tissue must be fixed for a minimum of 6 hours and no more than 48 hours with needle cores (are they not breast tissue?) being are exempt and have only a suggestion of a minimum of 1 hour, but testing is discouraged on specimens that have been fixed for 1 or 2 hours. I don’t know about you, but I continue to be confused and again ask, what is the optimum Formalin fixation time for tissue samples?

Let’s reopen the fixation discussion and I have several questions for you to consider. What are we really trying to accomplish with our fixation techniques? What is the minimum and maximum time in Formalin, with an acceptable variation range, before proceeding to an alcoholic solution? I propose that we are creating a process that stabilizes tissue samples and produces a consistent artifact for the reviewing pathologist. If you agree with me, then what would be the minimum time in Formalin, 4 hours, 6 hours, 12 hours or 24 hours? And what would be the maximum time? What is the acceptable variation?

Fixation is a process, a process that should be standardized, of stabilization anatomical features in biological tissue that allows us to produce consistent results in a controlled manner. That’s what I think, what do you think?

“It’s better to look where you’re going than to see where you’ve been.” – Anonymous

It is way past time for all Histology labs to step out of the dark and embrace a standardized Test Method Validation Protocol: Standardized documentation and process control is an integral part of Good Laboratory Practices. This standard must be used [...]

“Tell me and I will forget, show me and I will remember, involve me and I’ll understand.” – Confucius
 
We have all encountered the difficulties in educating, training and re-training employees to work in a Quality and efficient way in the Histology Lab. I think we can agree that there are many obstacles and reasons why [...]

Once a new technology rolls over you, if you’re not part of the steamroller, you’re part of the road. - Stewart Brand
There is a technology that has been used in the Histotechnology for many years that is preparing to explode and promises to change all our lives - Digital Imaging. This technology will transform the Pathologists daily [...]

The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency. - Bill Gates
The Histology Lab, as we know it today, is rapidly being transformed and consolidated to create the [...]

It is easier to change the specification to fit the program than vice versa.-Alan Perlis
The Histology Automation Revolution is coming! the Histology Automation Revolution is coming!
For the past ten years, we in the field have been told to watch for the technology rider to gallop to our labs and announce that new automation is here. The [...]

“The three purposes of thinking: To solve problems, To create opportunities and To enrich the human condition.” - Abraham Lincoln
I recently had the opportunity to visit the wonderful country of South Africa and found that it does not matter whether you are in Phoenix, Pittsburgh, Johannesburg or for that matter, any part of this great [...]

“If you think of standardization as the best that you know today, but which is to be improved tomorrow, you get somewhere.” – Henry Ford
The first step of Standardization in Histology, not just in a single lab, was taken when it was decided to use one fixative for routine specimens, 10% Neutral Buffered Formalin (NBF). [...]

Greetings! I recently attended the 34th Annual National Society for Histotechnology Symposium/Convention and I have been thinking just what did I gain from this particular experience. I have participated in many NSH Conventions in the past, but this meeting really seemed to me to be the push towards CHANGE.