Podcast
Questions and Answers
What is the primary purpose of using a fixative in tissue processing?
What is the primary purpose of using a fixative in tissue processing?
- To enhance the natural color of the tissue
- To increase tissue solubility for better staining
- To accelerate the decomposition process
- To prevent bacterial decomposition and autolysis (correct)
During gross examination of a solid organ, what is the maximum thickness allowed for slices?
During gross examination of a solid organ, what is the maximum thickness allowed for slices?
- 10 mm
- 3 mm
- 5 mm (correct)
- 7 mm
Which of the following is NOT a requirement for fixative during the fixation process?
Which of the following is NOT a requirement for fixative during the fixation process?
- Should accelerate cellular decomposition (correct)
- Should preserve tissue in its natural state
- Should be non-toxic and non-allergic
- Should be economically viable
How should tissue samples be labeled prior to processing to prevent smudging?
How should tissue samples be labeled prior to processing to prevent smudging?
What is the role of clearing processes in tissue processing?
What is the role of clearing processes in tissue processing?
What is the primary purpose of fixation in tissue processing?
What is the primary purpose of fixation in tissue processing?
Which fixative is known for its effectiveness in immuno-histochemistry techniques?
Which fixative is known for its effectiveness in immuno-histochemistry techniques?
What is the fastest fixative among the options provided?
What is the fastest fixative among the options provided?
Which group of fixatives is known for its penetration speed and nuclear detail?
Which group of fixatives is known for its penetration speed and nuclear detail?
What is the first step in the paraffin tissue processing technique?
What is the first step in the paraffin tissue processing technique?
Which of the following is a disadvantage of using mercurial fixatives?
Which of the following is a disadvantage of using mercurial fixatives?
What is the purpose of the clearing process in tissue processing?
What is the purpose of the clearing process in tissue processing?
Which fixation method is considered the most perfect among the techniques discussed?
Which fixation method is considered the most perfect among the techniques discussed?
Which of the following is not a component of the major groups of fixatives?
Which of the following is not a component of the major groups of fixatives?
Which of the following statements is true regarding paraffin embedding?
Which of the following statements is true regarding paraffin embedding?
What is the optimal pH range for fixation to achieve the best results?
What is the optimal pH range for fixation to achieve the best results?
Which fixative is primarily associated with Bouin's solution?
Which fixative is primarily associated with Bouin's solution?
What is the recommended volume ratio of fixative to tissue for effective fixation?
What is the recommended volume ratio of fixative to tissue for effective fixation?
During gross examination, what is typically done with the specimen once it is received?
During gross examination, what is typically done with the specimen once it is received?
What is the maximum thickness of sections that can typically be made from paraffin-embedded tissues?
What is the maximum thickness of sections that can typically be made from paraffin-embedded tissues?
Why might different colored inks be used during specimen examination?
Why might different colored inks be used during specimen examination?
Which process allows fixed tissue to be transformed into a suitable form for microscopic sectioning?
Which process allows fixed tissue to be transformed into a suitable form for microscopic sectioning?
What effect does increasing the temperature have on the fixation process?
What effect does increasing the temperature have on the fixation process?
What characteristic of the fixative is crucial for the effective penetration into tissues?
What characteristic of the fixative is crucial for the effective penetration into tissues?
What temperature range is typically maintained within a cryostat for freezing tissue sections?
What temperature range is typically maintained within a cryostat for freezing tissue sections?
What is the primary purpose of the clearing process in tissue preparation?
What is the primary purpose of the clearing process in tissue preparation?
Which step must occur before staining paraffin-embedded tissue sections?
Which step must occur before staining paraffin-embedded tissue sections?
What is the primary purpose of using strong mineral acids in the decalcification process?
What is the primary purpose of using strong mineral acids in the decalcification process?
When performing sectioning with a microtome, what is a crucial characteristic of the knife used?
When performing sectioning with a microtome, what is a crucial characteristic of the knife used?
Which solvent is used to transition slides from paraffin to alcohol during the deparaffinization process?
Which solvent is used to transition slides from paraffin to alcohol during the deparaffinization process?
What is the main advantage of using EDTA for decalcification of tissues?
What is the main advantage of using EDTA for decalcification of tissues?
What is the purpose of coverslipping stained tissue sections?
What is the purpose of coverslipping stained tissue sections?
What is one disadvantage of using organic acids such as acetic acid in the decalcification process?
What is one disadvantage of using organic acids such as acetic acid in the decalcification process?
Which method has been shown to reduce the time required for embedding fixed tissues significantly?
Which method has been shown to reduce the time required for embedding fixed tissues significantly?
Which of the following should be avoided in the sectioning of tissues with a microtome?
Which of the following should be avoided in the sectioning of tissues with a microtome?
What is the primary purpose of dehydration in tissue processing?
What is the primary purpose of dehydration in tissue processing?
Which factor does NOT influence the duration tissues are kept in each alcohol strength during dehydration?
Which factor does NOT influence the duration tissues are kept in each alcohol strength during dehydration?
Which clearing agent is noted for its tolerance to small amounts of water in tissues, though it is more expensive than xylene?
Which clearing agent is noted for its tolerance to small amounts of water in tissues, though it is more expensive than xylene?
What is a major disadvantage of using acetone as a dehydrant in tissue processing?
What is a major disadvantage of using acetone as a dehydrant in tissue processing?
Which statement correctly describes the clearing process in tissue processing?
Which statement correctly describes the clearing process in tissue processing?
What is indicated by the term 'turbulence' during the dehydration process?
What is indicated by the term 'turbulence' during the dehydration process?
Which of the following conditions affects the number of steps during dehydration?
Which of the following conditions affects the number of steps during dehydration?
Why is extensive exposure to clearing agents considered harmful to tissue?
Why is extensive exposure to clearing agents considered harmful to tissue?
The freezing technique is regarded as the most common method of tissue processing.
The freezing technique is regarded as the most common method of tissue processing.
Formaldehyde is considered the best fixative for preservation due to its rapid penetration into tissue.
Formaldehyde is considered the best fixative for preservation due to its rapid penetration into tissue.
Mercurial fixatives can cause hardness in tissue but facilitate excellent nuclear detail.
Mercurial fixatives can cause hardness in tissue but facilitate excellent nuclear detail.
The celloidin technique is primarily used for biopsy samples as it provides the fastest processing.
The celloidin technique is primarily used for biopsy samples as it provides the fastest processing.
Oxidizing agents are classified as one of the five major groups of fixatives used in histology.
Oxidizing agents are classified as one of the five major groups of fixatives used in histology.
10% neutrally buffered formalin is the standard solution used for aldehyde fixation.
10% neutrally buffered formalin is the standard solution used for aldehyde fixation.
Alcohols, such as methanol and ethanol, are unsuitable for cytologic smears due to their slow action.
Alcohols, such as methanol and ethanol, are unsuitable for cytologic smears due to their slow action.
Dehydration involves the abrupt removal of water from tissue using a single grade of ethyl alcohol.
Dehydration involves the abrupt removal of water from tissue using a single grade of ethyl alcohol.
During the dehydration process, turbulence can cause damage or distortion to cellular components.
During the dehydration process, turbulence can cause damage or distortion to cellular components.
The volume of alcohol used for dehydration should be 10-20 times that of the tissue.
The volume of alcohol used for dehydration should be 10-20 times that of the tissue.
Xylene is an alcohol-soluble substance commonly used in the clearing process.
Xylene is an alcohol-soluble substance commonly used in the clearing process.
Chloroform is considered a rapid clearing agent despite being a health hazard.
Chloroform is considered a rapid clearing agent despite being a health hazard.
Toluene is three times less expensive than xylene and works well in clearing tissues.
Toluene is three times less expensive than xylene and works well in clearing tissues.
The duration for which tissues are kept in alcohol depends solely on the size of the tissue.
The duration for which tissues are kept in alcohol depends solely on the size of the tissue.
Formalin is only used in the dehydration step and not in any other part of tissue preparation.
Formalin is only used in the dehydration step and not in any other part of tissue preparation.
Methyl salicylate is rarely used in clearing due to its low cost and pleasant aroma.
Methyl salicylate is rarely used in clearing due to its low cost and pleasant aroma.
The primary tool used for sectioning tissues is called a cryostat.
The primary tool used for sectioning tissues is called a cryostat.
Deparaffinization is necessary before applying water soluble dyes to the tissues.
Deparaffinization is necessary before applying water soluble dyes to the tissues.
Frozen sections are generally processed using automated stainers for efficiency.
Frozen sections are generally processed using automated stainers for efficiency.
EDTA is known for its quick action in decalcifying dense cortical bone.
EDTA is known for its quick action in decalcifying dense cortical bone.
Strong mineral acids can quickly remove calcium but can damage cellular morphology.
Strong mineral acids can quickly remove calcium but can damage cellular morphology.
The usual temperature range maintained within a cryostat is about 0 to -10 degrees Celsius.
The usual temperature range maintained within a cryostat is about 0 to -10 degrees Celsius.
Acetic and formic acids are classified as strong acids for decalcification processes.
Acetic and formic acids are classified as strong acids for decalcification processes.
Sections of tissue need to be embedded in paraffin to be properly stained.
Sections of tissue need to be embedded in paraffin to be properly stained.
The process of coverslipping a stained section involves applying a thin glass cover.
The process of coverslipping a stained section involves applying a thin glass cover.
Histological technique aims solely to preserve the structural integrity of the tissue in preparation for microscopic examination.
Histological technique aims solely to preserve the structural integrity of the tissue in preparation for microscopic examination.
Specimens thicker than 1 cm will have their fixation compromised and typically cannot be processed effectively.
Specimens thicker than 1 cm will have their fixation compromised and typically cannot be processed effectively.
Using far fewer steps can significantly reduce the time required for embedding fixed tissues.
Using far fewer steps can significantly reduce the time required for embedding fixed tissues.
The maximum recommended thickness for tissue samples submitted for histopathology is 5 mm.
The maximum recommended thickness for tissue samples submitted for histopathology is 5 mm.
Decalcification is a necessary process for all types of tissue specimens submitted for histopathological examination.
Decalcification is a necessary process for all types of tissue specimens submitted for histopathological examination.
The primary function of histological fixation is to preserve the architecture of the tissue after exposure to a variety of reagents.
The primary function of histological fixation is to preserve the architecture of the tissue after exposure to a variety of reagents.
Dimethoxypropane (DMP) serves only as a dehydrating agent and does not react chemically with water.
Dimethoxypropane (DMP) serves only as a dehydrating agent and does not react chemically with water.
The critical shrinkage point of collagen is approximately 75°C.
The critical shrinkage point of collagen is approximately 75°C.
Paraffin shrinks 12% in volume upon solidifying, while Paraplast plus shrinks 14% by volume.
Paraffin shrinks 12% in volume upon solidifying, while Paraplast plus shrinks 14% by volume.
Biopsy specimens should be transported in a metal container with 10% formalin to prevent autolysis.
Biopsy specimens should be transported in a metal container with 10% formalin to prevent autolysis.
Once a biopsy is obtained, it should be immediately placed in a container without any fixative.
Once a biopsy is obtained, it should be immediately placed in a container without any fixative.
Automation in tissue processing typically involves instruments that require manual timing adjustments.
Automation in tissue processing typically involves instruments that require manual timing adjustments.
In ulcerated tumors, biopsies should only be taken from the diseased tissue for proper diagnosis.
In ulcerated tumors, biopsies should only be taken from the diseased tissue for proper diagnosis.
Crushing or squeezing tissue with forceps is recommended during biopsy procedures.
Crushing or squeezing tissue with forceps is recommended during biopsy procedures.
The embedding process is critical because tissues must be oriented properly in the paraffin block.
The embedding process is critical because tissues must be oriented properly in the paraffin block.
Acetone is preferred as the dehydrating agent due to its effectiveness in the processing of all types of tissues.
Acetone is preferred as the dehydrating agent due to its effectiveness in the processing of all types of tissues.
Flashcards
Dehydration
Dehydration
Gradual removal of water from tissue using increasing concentrations of alcohol to prevent shrinking.
Clearing
Clearing
Replacing alcohol with a substance (like xylene) that dissolves paraffin wax for embedding.
Tissue Dehydration Steps
Tissue Dehydration Steps
Dehydration involves a series of increasing alcohol concentrations (e.g., 70%, 95%, 100%).
Clearing Agent
Clearing Agent
Signup and view all the flashcards
Xylene
Xylene
Signup and view all the flashcards
Tissue Shrinkage
Tissue Shrinkage
Signup and view all the flashcards
Alcohol Concentration Gradient
Alcohol Concentration Gradient
Signup and view all the flashcards
Clearing Time
Clearing Time
Signup and view all the flashcards
Tissue Processing
Tissue Processing
Signup and view all the flashcards
Fixation
Fixation
Signup and view all the flashcards
Formalin
Formalin
Signup and view all the flashcards
Fixatives
Fixatives
Signup and view all the flashcards
Histology Laboratory
Histology Laboratory
Signup and view all the flashcards
Paraffin Technique
Paraffin Technique
Signup and view all the flashcards
Specimen Accession
Specimen Accession
Signup and view all the flashcards
Biopsy
Biopsy
Signup and view all the flashcards
Automated tissue processor
Automated tissue processor
Signup and view all the flashcards
Sectioning
Sectioning
Signup and view all the flashcards
Frozen sections
Frozen sections
Signup and view all the flashcards
Cryostat
Cryostat
Signup and view all the flashcards
Staining
Staining
Signup and view all the flashcards
Paraffin wax deaffination
Paraffin wax deaffination
Signup and view all the flashcards
Coverslipping
Coverslipping
Signup and view all the flashcards
Decalcification
Decalcification
Signup and view all the flashcards
Mineral acids (decalcification)
Mineral acids (decalcification)
Signup and view all the flashcards
Organic acids (decalcification)
Organic acids (decalcification)
Signup and view all the flashcards
Fixative Role
Fixative Role
Signup and view all the flashcards
Why Fixative is Important
Why Fixative is Important
Signup and view all the flashcards
Types of Fixatives
Types of Fixatives
Signup and view all the flashcards
Tissue Processing Steps
Tissue Processing Steps
Signup and view all the flashcards
Blocking and Labeling Tissues
Blocking and Labeling Tissues
Signup and view all the flashcards
Oxidizing Agents
Oxidizing Agents
Signup and view all the flashcards
Picrates
Picrates
Signup and view all the flashcards
Fixation Penetration
Fixation Penetration
Signup and view all the flashcards
Fixation Temperature
Fixation Temperature
Signup and view all the flashcards
Fixative Concentration
Fixative Concentration
Signup and view all the flashcards
Fixation Time Interval
Fixation Time Interval
Signup and view all the flashcards
Gross Examination
Gross Examination
Signup and view all the flashcards
Ink Marking
Ink Marking
Signup and view all the flashcards
What is the most common tissue processing method?
What is the most common tissue processing method?
Signup and view all the flashcards
What are the main steps in tissue processing?
What are the main steps in tissue processing?
Signup and view all the flashcards
What is an aldehyde?
What is an aldehyde?
Signup and view all the flashcards
What is the role of a fixative?
What is the role of a fixative?
Signup and view all the flashcards
Why is tissue processing important?
Why is tissue processing important?
Signup and view all the flashcards
Why Dehydration is Needed?
Why Dehydration is Needed?
Signup and view all the flashcards
Dehydration Steps
Dehydration Steps
Signup and view all the flashcards
Dehydration Time
Dehydration Time
Signup and view all the flashcards
Why is Clearing Needed?
Why is Clearing Needed?
Signup and view all the flashcards
What is a Clearing Agent?
What is a Clearing Agent?
Signup and view all the flashcards
Xylene vs. Toluene
Xylene vs. Toluene
Signup and view all the flashcards
Alternatives to Xylene
Alternatives to Xylene
Signup and view all the flashcards
Clearing Agent Hazards
Clearing Agent Hazards
Signup and view all the flashcards
Tissue Size Limit
Tissue Size Limit
Signup and view all the flashcards
Specimen Thickness
Specimen Thickness
Signup and view all the flashcards
Calcification/Ossification
Calcification/Ossification
Signup and view all the flashcards
Fixative Mechanism
Fixative Mechanism
Signup and view all the flashcards
Microtome
Microtome
Signup and view all the flashcards
Deparaffinization
Deparaffinization
Signup and view all the flashcards
EDTA (Decalcification)
EDTA (Decalcification)
Signup and view all the flashcards
Dimethoxypropane (DMP)
Dimethoxypropane (DMP)
Signup and view all the flashcards
Paraffin Embedding
Paraffin Embedding
Signup and view all the flashcards
Embedding Medium
Embedding Medium
Signup and view all the flashcards
Collagen Shrinkage
Collagen Shrinkage
Signup and view all the flashcards
Paraffin Shrinkage
Paraffin Shrinkage
Signup and view all the flashcards
Tissue Alignment in Embedding
Tissue Alignment in Embedding
Signup and view all the flashcards
Biopsy Size and Number
Biopsy Size and Number
Signup and view all the flashcards
Biopsy from Ulcerated Tumours
Biopsy from Ulcerated Tumours
Signup and view all the flashcards
Minimize Tissue Damage
Minimize Tissue Damage
Signup and view all the flashcards
Study Notes
Tissue Processing
- Tissues for disease diagnosis are processed in a histology lab to create microscope slides
- Tissue samples come from biopsies or surgery or autopsies
- Three main techniques for preparing tissue sections: paraffin, celloidin, and freezing
- Specimens are accompanied by a request form including patient info and site of origin
- Specimens are accessioned by assigning a unique number
- Tissue processing involves fixing tissue in paraffin, via dehydration and clearing steps
Specimen Assessment
- Tissue samples sent to the pathology lab are accompanied by a request form
- This form includes patient information, history, and site of origin
- The specimens are accessioned, given a unique identifier for each individual patient
Tissue Processing Steps
- The process of fixing tissue in paraffin is called tissue processing
- The main steps are dehydration and clearing procedures
Fixation
- Fixation is preserving tissues in a lifelike state as much as possible
- Fixation should be carried out as soon as possible to prevent autolysis
- No perfect fixative exists, but formaldehyde is a good option
- Various fixatives are available, depending on the tissue type
Types of Fixatives
- Major groups: aldehydes, mercurials, alcohols, oxidizing agents, picrates
- Aldehydes: Formaldehyde (formalin), glutaraldehyde; good for immuno-histochemistry; formalin penetrates tissue well but is relatively slow
- Mercurials: Contain mercuric chloride (e.g., Zenker's); penetrate poorly but rapidly; causes tissue hardness
- Alcohols: Methyl alcohol (methanol), ethyl alcohol (ethanol); good for cytologic smears, act quickly
- Oxidizing Agents: Potassium permanganate, potassium dichromate, osmium tetroxide
- Picrates: Picric acid (e.g., Bouin's solution)
Factors Affecting Fixation
- Buffering: Fixation at a neutral pH (range of 6-8) is ideal
- Penetration: The fixative's ability to diffuse into tissue depends on its diffusability
- Volume: Fixative volume should be approximately 10:1 in relation to tissue volume
- Temperature: Higher temperature increases the speed of fixation
- Concentration: The concentration needs to be adjusted to the lowest possible level
- Time Interval: The time between tissue removal and fixation
Gross Examination
- Tissues for diagnosis are examined in the pathology department
- Examination involves describing the specimen and placing it in a small plastic cassette
- The cassettes are stored in a fixative for further processing into a paraffin block
Tissue Processing Steps (Continued)
- Tissues are held firmly to allow for cutting thin sections with a sharp knife
- Firmness achieved through embedding or freezing
- The tissue, after fixation, must be processed into a format that can be sectioned into microscopic slides
Clearing
- The alcohol is replaced with paraffin wax
- Materials used includes xylene, benzene, acetone, chloroform, carbon tetrachloride, toluene.
- Xylene is a routine clearing agent
- Smaller tissue cleared in 0.5-1 hour, larger in 2-4 hours
- Chloroform is no longer a preferred clearing agent due to potential health hazards
- Removing the dehydrant with a substance, similar to paraffin (embedding medium), is called clearing
Impregnation in Paraffin
- Tissues are put in hot, soft paraffin at 50°C for a period varying from 6-24 hours
- Tissues are transferred to hot hard paraffin at 55°C for further impregnation in an oven
- Paraffin penetrates the tissue and hardens it, a necessary step prior to embedding
Wax:
- The volume of paraffin should be approximately 25-30 times the tissue volume
- The impregnation duration depends on tissue size, type, and clearing agent usage
- Impregnation takes about 4 hours for a routine process
Embedding
- Paraffin, a derivative of crude petroleum, is the typical embedding agent
- Paraffin melts between 52° and 58°C, infiltrating the cells while hot
- Impregnation should be performed few degrees above the melting point of paraffin
- Firmness is achieved using a supporting medium
Cutting (Sectioning)
- Embedded tissues are cut into thin sections (4-6 microns) using a microtome with a very sharp knife
- This method allows for the preparation of thinly sliced samples that can be examined under a microscope
Frozen Sections
- Frozen sections are performed using a cryostat
- The cryostat is a refrigerated box containing a microtome
- Frozen sections are used at temperatures ranging from -20 to -30°C
- Tissue sections are cut and mounted on glass slides
Staining
- The embedding process is reversed to allow water-soluble dyes to penetrate
- Slides are depraffinized using xylene, then alcohols, finally water
- There are no stains applicable to tissues containing paraffin.
Coverslipping
- A thin piece of glass is placed over the stained section, protecting the tissue from scratches and preserving the tissue section for years
Decalcification
- Bone samples, as well as other calcified tissues, must be decalcified before embedding and sectioning
- Mineral acids, organic acids, EDTA, and electrolysis are among the decalcifying reagents used
- Strong mineral acids remove calcium rapidly, but may damage tissue morphology
- Organic acids are slower but may be better for dense cortical bone
- EDTA removes calcium safely, but is slow, penetrates poorly, and is costly
Sampling for Histopathological Examination
- Tissue specimens should not exceed 3mm in thickness nor be larger than the slides
- Pieces from solid tissues are typically 10-15mm in surface area and 2-3mm in thickness
- Discrete calcified areas should be removed and decalcified separately
- Tissue samples should be wrapped in paper or gauze
General Rules for Biopsy Procedure
- The number of biopsies increases with the size of the lesion
- Ulcerated tumors should be biopsied to include the periphery of the tumor, which includes normal tissue.
- Tissues should not be crushed or squeezed too hard.
Specimen Handling
- Specimens should be transported in a container of suitable material, like glass, plastic or metal, along with 10% formalin
- If formalin isn't immediately available, it can be placed in the refrigerator at 4°C to slow down autolysis
- The container opening should have an adequate size for easy tissue removal after fixation
Examination
- Proper identification and orientation of the specimen
- Unlabeled specimens should not be processed
- Complete histopathology requisition forms include patient name, age, sex, relevant clinical data, surgical findings, operation type, and specific tissue name
- The examination should be done in an orderly manner, searching all the submitted tissue and placing them in a proper anatomic position, recording specimen type, shape, dimensions, weight, color, surgical margins, consistency and pertinent information
Automated Tissue Processor
- The whole process is automated for efficiency
- An instrument moves the tissue through the agents at controlled speeds
Blocking
- Impregnated tissues are placed in a mold and covered with fresh wax
- After cooling, it is immersed in cold water for rapid cooling, then cut into individual blocks and each is trimmed.
- Labels are adhered on the surface of the block.
Histological Technique
- Deals with tissue preparation for microscopic study
- The aim is to retain microscopic tissue structures
Fixation (Continued)
- The process fixes the constituents of cells and tissues in a physical and chemical state to resist subsequent treatment
- This is achieved by exposing tissues to chemical compounds known as fixatives
- Solutions for dealing with thick specimens include cutting slices and soaking wool in fixative solution, or injecting fixatives along blood vessels.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Explore the essential techniques of tissue processing used in pathology labs for disease diagnosis. This quiz covers the steps involved, including fixation, dehydration, and accessioning specimens, as well as the importance of accompanying request forms. Test your knowledge on the preparation of microscope slides and the methods used for tissue sample processing.