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In surgical pathology more than ever, the laboratories are expected to do more with less. Taking on more specimens with less technical staff, or getting more stains out of tiny biopsies or fine needle aspirations have become the norm. The College of American Pathology (CAP) checklist item ANP.22300 Specimen Modification, asks the lab to have written procedures that address any modifications that are in place on how specimens other than formalin fixed paraffin embedded tissues are handled. These specimens can be air dried smears, cytological preparations or decalcified tissues. The Principles of Analytic Validation of Immunohistochemical Assays published by the CAP in 2014, have two specific guidelines on what labs should do to properly validate these types of specimens. Most antibodies issued by manufacturers are tested and optimized using formalin fixed paraffin embedded tissues, and not on these “other” specimens. Most labs place a disclaimer on their report to indicate that the test results should be used with caution as the specimen did not fall into the category of formalin fixed paraffin embedded. But is putting a disclaimer on the report the best thing for the patient? During this presentation I will addressing these concerns and offer alternatives in dealing with those “other” types of specimens.
- Learn alternative ways to handle decalcified specimens when dealing with IHC and FISH/ISH.
- Review ways to validate IHC staining of cytological preparations.
- Overview of disclaimers for different types of specimens.