Tissue Processing

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The key takeaways are the various steps involved in tissue processing such as fixation, dehydration, clearing, impregnation, embedding, section cutting, staining and mounting to enable microscopic examination of tissues.

The main steps involved in tissue processing are fixation, dehydration, clearing, impregnation, embedding, section cutting, staining and mounting.

Some common fixatives used are 10% formalin, glutaraldehyde, osmium tetraoxide, potassium dichromate, mercuric chloride, picric acid and Bouin's fluid.

Tissue Processing

Introduction
• Histopathology – microscopic study of diseased tissue
• Tissue source
• Biopsy
• Necropsy
• The techniques for processing the tissues, whether biopsies or tissues
from necropsy so as to enable the pathologist to study them under
the microscope
Protocols
1. Receipt & Identification
2. Labeling of the specimen with numbering
3. Fixation
4. Dehydration
5. Clearing
6. Impregnation
7. Embedding
8. Section cutting
9. Staining
10. Mounting
Specimen identification
• Patient information
• History
• Laboratory code (numbers that will identify each specimen for each
patient)
Fixation
• Preserve tissues permanently in as life-like a state as possible
• The fixative should be 15 – 20 times more in volume then the
specimen
Ideal Fixative
Aims
• Should not cause shrinkage or swelling
• Prevent autolysis
of cells
• Penetrate evenly and rapidly
• Must not interfere with staining
• Harden specimen
• Cheap and easily available
• Antisepsis of the sample
• Should be good antiseptic
• Increase optical density
• Safe to use
Fixation
• The bits should of the size of approximately 2 x 2 cm & 4-6
micrometer in thickness
• These bits are then placed in metal cassettes or capsules which are
then placed in the fixative
Fixatives
• 10% Formalin
• 10 ml formalin in 90 ml distilled water
• MOA – forms cross links between amino acids of proteins thereby making
them insoluble
• Advantages – rapid penetration, available & cheap, does not over harden
tissue, ideal for mailing
• Disadvantages – irritant, forms paraformaldehyde precipitates, formation of
black formalin pigment , acid formaldehyde hematin
Fixatives
• Other fixatives
1. Glutaraldehyde
2. Osmium tetraoxide
3. Potassium dichromate
4. Mercuric chloride
5. Picric acid
6. Zenker’s fluid
7. Zenker’s Formal (Helly’s fluid)
8. Bouin’s fluid
* Why we prefer formaline over all these?S
Fixatives
• Microanatomical fixatives:
• These are used to preserve the anatomy of the tissue.
• E.g. 10% formal saline (brain), buffered formalin
• Cytological fixatives:
• These are used to fix intracellular structures.
• E.g. nuclear fixatives (Carnoy’s fluid, Clarke’s fluid), cytoplasmic fixatives
(Champy’s fluid, Regaud’s fluid)
• Histochemical fixatives:
• These are used to demonstrate the chemical constituents of the cell.
• E.g. formal saline, cold acetone, absolute alcohol
Decalcification
• Removal of the calcium salts from the specimen
• Nitric acid, formic acid, picric acid, acetic acid, citric acid, hydrochloric
acid
Dehydration
• Process in which the water content in the tissue to be processed is
completely reduced by passing the tissue through increasing
concentrations of dehydrating agents
• E.g. Ethyl alcohol, Acetone, Isopropyl alcohol, Dioxane
• Dehydration is done so that the wax i.e. Paraffin wax, which is used
for impregnation, can be easily miscible as it is immiscible with water
Clearing
• The procedure where in the alcohol in the tissue is replaced by a fluid
which will dissolve the wax used for impregnating the tissues
• Cedar wood oil : The best agent but is expensive.
• Benzene : It is carcinogenic.
• Xylene : It is most commonly used.
• Chloroform: Toxic and expensive
Impregnation
• In this the tissue is kept in a wax bath containing molten paraffin wax
for 6 – 8 hours.
• The wax is infiltrated in the interices of the tissue which increases the
optical differentiation & hardens the tissue & helps in easy sectioning
of the tissue.
• Paraffin wax
• Paraplast
• Paraplast plus
• Gelatin
• Celloidin
Embedding
• It is done by transferring the tissue which has been cleared of the
alcohol to a mould filled with molten wax & is allowed to cool &
solidify.
• After solidification, a wax block is obtained which is then sectioned to
obtain ribbons.
Section cutting
• The procedure in which the blocks which have been prepared are cut
or sectioned and thin strips of varying thickness are prepared
• The instrument by which this is done is called as a Microtome
• Types of microtomes:
• Sliding
• Rotary
• Rocking
• Freezing
• Base sledge
Section cutting
• It is the most commonly used.
• Also known as Minnot’s Rotary microtome.
• In this the Block holder moves up and down while the knife remains
fixed.
• It is suitable for cutting of small tissues & serial sections can be taken
on it.
Parts of a Microtome (Rotary)
• Block holder
• Knife clamp screws
• Knife clamps
• Block adjustment
• Thickness gauge
• Angle of tilt adjustment
• Operating handle.
Tissue flotation bath
• It is a thermostatically controlled water bath with the inside colored
black.
• It is maintained at a temperature maintained 5 – 6 degree below the
melting point of paraffin wax.
Staining
• Staining of the section is done to bring out the particular details in the
tissue under study
• The most commonly used stain in routine practice is Haematoxylin &
eosin stain
• Nucleus – blue, cytoplasm – pink
Mounting
• Adhesives used for fixing the sections on the slides :
• Albumin solution (Mayor’s egg albumin)
• Starch paste
• Gelatin
• Mountants :
• DPX ( Distrene Dibutyl phthalate Xylene ).
• Canada Balsam
• Colophonium resin
• Terpene resin

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