Rapid, Automated Tissue Processing Techniques for Small Biopsies Can be used to Produce Quality Sections for Diagnostic Reporting in Histopathology

Abstract

Surgical histopathologists are currently working in a context of high demand and requirement for fast turnaround times to report small diagnostic biopsies. Use of automated rapid cycle processing could improve turnaround times for reporting small biopsies. There are few papers in the medical literature describing detailed assessment of staining quality in verification of automated rapid cycle processing methods. This study assessed quality of immunohistochemical and haematoxylin and eosin staining of 62 paired endometrial biopsy samples processed using standard overnight cycles compared with rapid cycles of either 2, 3 or 4 hours duration. We found that small biopsies adequately fixed in 10% neutral buffered formalin were of sufficient staining quality for use in diagnostic reporting if they were processed for 3 or 4 hours. Five samples in our 2-hour group were of insufficient staining quality for full microscopic evaluation and histopathological diagnosis. As such, the 2-hour method was rejected. Rapid cycles of three hours duration will be adopted in our laboratory for processing small samples. Prospective monitoring of report turnaround times will be needed to assess impact on future outcomes for patients.