Fixation: Difference between revisions

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{{Top

<noinclude>{{Top

|author1=~~[[User:Mikael Häggström|Mikael Häggström]]~~

|author1={{MH top}}

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==Immersion==

<!-- Also in Pathology for medical students article

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[[File:Adipose tissue with crumpling artifact due to insufficient fixation.jpg|thumb|Adipose tissue with crumpling artifact due to insufficient fixation.]]

Within an hour after removal from the body,<ref>{{cite web|url=https://www.uclahealth.org/pathology/workfiles/Education/Residency%20Program/Gross%20Manual/Mastectomy%2006.03.20.pdf|title=Breast pathology grossing guidelines|website=UCLA Health|accessdate=2021-09-09}}</ref> tissue samples should generally be placed in vessels with enough fixative to allow them to lie freely in the solution.<ref name=kvast>{{cite web|url=http://www.svfp.se/foreningar/uploads/L15178/kvast/hud/Handlaggning%20av%20hudprover%20%20provtagningsanvisningar%20utskarningsprinciper%20och%20snittning%2020150325.pdf|title=Handläggning av hudprover – provtagningsanvisningar, utskärningsprinciper och snittning (Handling of skin samples - Instructions for sampling, cutting and incision|author=Katarzyna Lundmark, Krynitz, Ismini Vassilaki, Lena Mölne, Annika Ternesten Bratel|accessdate=2019-09-09|website=KVAST (Swedish Society of Pathology)}}</ref> The standard fixation fluid is generally 10% neutral buffered '''formalin''', which is roughly equivalent to 4% formaldehyde.<ref>{{cite web|url=https://microscopy.duke.edu/guides/paraformaldehyde-formaldehyde-formalin|title=Paraformaldehyde, Formadehyde and Formalin|website=Duke University|accessdate=2019-12-17}}</ref> The ratio of tissue:formalin should be 1:5<ref>{{cite web|url=https://www.rcpa.edu.au/getattachment/d6f7f095-e8b7-45eb-8dcb-6a9d9bd5a88a/Fixation-of-Tissues.aspx|title=Fixation of Tissues}} Approval Date: August 2016, August 2020. Review Date: August 2024|website=Royal College of Pathologists of Australia</ref> to 1:10<ref name="pmid22483550">{{cite journal| author=Buesa RJ, Peshkov MV| title=How much formalin is enough to fix tissues? | journal=Ann Diagn Pathol | year= 2012 | volume= 16 | issue= 3 | pages= 202-9 | pmid=22483550 | doi=10.1016/j.anndiagpath.2011.12.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22483550 }} </ref>.<ref name="pmid22483550">{{cite journal| author=Buesa RJ, Peshkov MV| title=How much formalin is enough to fix tissues? | journal=Ann Diagn Pathol | year= 2012 | volume= 16 | issue= 3 | pages= 202-9 | pmid=22483550 | doi=10.1016/j.anndiagpath.2011.12.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22483550 }} </ref>

==Duration==

The duration depends on tissue thickness, where formalin will penetrate and fix the tissue at ~1 mm/hour.<ref>{{cite web|url=https://rhslab.pitt.edu/drop-info/how-submit-tissues-embedding|title=How to Submit Tissues for Embedding|website=University of Pittsburgh, Starzl Transplantation Institute}} Revised 04/19/21</ref>

==When not to use formalin==

Within an hour after removal from the body,<ref>{{cite web|url=https://www.uclahealth.org/pathology/workfiles/Education/Residency%20Program/Gross%20Manual/Mastectomy%2006.03.20.pdf|title=Breast pathology grossing guidelines|website=UCLA Health|accessdate=2021-09-09}}</ref> tissue samples should generally be placed in vessels with the correct fixing solution, with a volume that allows them to lie freely in the solution.<ref name=kvast>{{cite web|url=http://www.svfp.se/foreningar/uploads/L15178/kvast/hud/Handlaggning%20av%20hudprover%20%20provtagningsanvisningar%20utskarningsprinciper%20och%20snittning%2020150325.pdf|title=Handläggning av hudprover – provtagningsanvisningar, utskärningsprinciper och snittning (Handling of skin samples - Instructions for sampling, cutting and incision|author=Katarzyna Lundmark, Krynitz, Ismini Vassilaki, Lena Mölne, Annika Ternesten Bratel|accessdate=2019-09-09|website=KVAST (Swedish Society of Pathology)}}</ref> The standard fixation fluid is generally 10% neutral buffered '''formalin''', which is roughly equivalent to 4% formaldehyde.<ref>{{cite web|url=https://microscopy.duke.edu/guides/paraformaldehyde-formaldehyde-formalin|title=Paraformaldehyde, Formadehyde and Formalin|website=Duke University|accessdate=2019-12-17}}</ref>

~~The main exception to using formalin are mainly:~~

*A '''[[tophus]]''' or other specimen suspicious for gout versus pseudogout should be sent in alcohol or dry, since formalin will dissolve the crystals.

*[[Lymph node]]s (or other lymphoid aggregates) with a suspicion of '''lymphoma''', where samples are generally put in a special solution for flow cytometry.

*[[Products of conception]] with a need to take samples for '''genetic testing'''.

</noinclude>

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-{{Top
+<noinclude>{{Top
-|author1=[[User:Mikael Häggström|Mikael Häggström]]
+|author1={{MH top}}
 |author2=
-}}
+}}</noinclude>
+==Immersion==
+<!--  Also in Pathology for medical students article
+-->
+[[File:Adipose tissue with crumpling artifact due to insufficient fixation.jpg|thumb|Adipose tissue with crumpling artifact due to insufficient fixation.]]
+Within an hour after removal from the body,<ref>{{cite web|url=https://www.uclahealth.org/pathology/workfiles/Education/Residency%20Program/Gross%20Manual/Mastectomy%2006.03.20.pdf|title=Breast pathology grossing guidelines|website=UCLA Health|accessdate=2021-09-09}}</ref> tissue samples should generally be placed in vessels with enough fixative to allow them to lie freely in the solution.<ref name=kvast>{{cite web|url=http://www.svfp.se/foreningar/uploads/L15178/kvast/hud/Handlaggning%20av%20hudprover%20%20provtagningsanvisningar%20utskarningsprinciper%20och%20snittning%2020150325.pdf|title=Handläggning av hudprover – provtagningsanvisningar, utskärningsprinciper och snittning (Handling of skin samples - Instructions for sampling, cutting and incision|author=Katarzyna Lundmark, Krynitz, Ismini Vassilaki, Lena Mölne, Annika Ternesten Bratel|accessdate=2019-09-09|website=KVAST (Swedish Society of Pathology)}}</ref> The standard fixation fluid is generally 10% neutral buffered '''formalin''', which is roughly equivalent to 4% formaldehyde.<ref>{{cite web|url=https://microscopy.duke.edu/guides/paraformaldehyde-formaldehyde-formalin|title=Paraformaldehyde, Formadehyde and Formalin|website=Duke University|accessdate=2019-12-17}}</ref> The ratio of tissue:formalin should be 1:5<ref>{{cite web|url=https://www.rcpa.edu.au/getattachment/d6f7f095-e8b7-45eb-8dcb-6a9d9bd5a88a/Fixation-of-Tissues.aspx|title=Fixation of Tissues}} Approval Date: August 2016, August 2020. Review Date: August 2024|website=Royal College of Pathologists of Australia</ref> to 1:10<ref name="pmid22483550">{{cite journal| author=Buesa RJ, Peshkov MV| title=How much formalin is enough to fix tissues? | journal=Ann Diagn Pathol | year= 2012 | volume= 16 | issue= 3 | pages= 202-9 | pmid=22483550 | doi=10.1016/j.anndiagpath.2011.12.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22483550  }} </ref>.<ref name="pmid22483550">{{cite journal| author=Buesa RJ, Peshkov MV| title=How much formalin is enough to fix tissues? | journal=Ann Diagn Pathol | year= 2012 | volume= 16 | issue= 3 | pages= 202-9 | pmid=22483550 | doi=10.1016/j.anndiagpath.2011.12.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22483550  }} </ref>
+==Duration==
+The duration depends on tissue thickness, where formalin will penetrate and fix the tissue at ~1 mm/hour.<ref>{{cite web|url=https://rhslab.pitt.edu/drop-info/how-submit-tissues-embedding|title=How to Submit Tissues for Embedding|website=University of Pittsburgh, Starzl Transplantation Institute}} Revised 04/19/21</ref>
+==When not to use formalin==
+{{Formalin exceptions}}
+<noinclude>
 {{General notes}}
-Within an hour after removal from the body,<ref>{{cite web|url=https://www.uclahealth.org/pathology/workfiles/Education/Residency%20Program/Gross%20Manual/Mastectomy%2006.03.20.pdf|title=Breast pathology grossing guidelines|website=UCLA Health|accessdate=2021-09-09}}</ref> tissue samples should generally be placed in vessels with the correct fixing solution, with a volume that allows them to lie freely in the solution.<ref name=kvast>{{cite web|url=http://www.svfp.se/foreningar/uploads/L15178/kvast/hud/Handlaggning%20av%20hudprover%20%20provtagningsanvisningar%20utskarningsprinciper%20och%20snittning%2020150325.pdf|title=Handläggning av hudprover – provtagningsanvisningar, utskärningsprinciper och snittning (Handling of skin samples - Instructions for sampling, cutting and incision|author=Katarzyna Lundmark, Krynitz, Ismini Vassilaki, Lena Mölne, Annika Ternesten Bratel|accessdate=2019-09-09|website=KVAST (Swedish Society of Pathology)}}</ref> The standard fixation fluid is generally 10% neutral buffered '''formalin''', which is roughly equivalent to 4% formaldehyde.<ref>{{cite web|url=https://microscopy.duke.edu/guides/paraformaldehyde-formaldehyde-formalin|title=Paraformaldehyde, Formadehyde and Formalin|website=Duke University|accessdate=2019-12-17}}</ref>
-The main exception to using formalin are mainly:
-*A '''[[tophus]]''' or other specimen suspicious for gout versus pseudogout should be sent in alcohol or dry, since formalin will dissolve the crystals.
-*[[Lymph node]]s (or other lymphoid aggregates) with a suspicion of '''lymphoma''', where samples are generally put in a special solution for flow cytometry.
-*[[Products of conception]] with a need to take samples for '''genetic testing'''.
 {{Bottom}}
+</noinclude>

Fixation: Difference between revisions

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