Background

In definitive pull through and/or re-sectioned cases in the operating room, the surgeon may send full thickness colorectal wall biopsies to establish the level of aganglionosis. The initial specimens are usually for frozen section diagnosis.

Tissue Processing

The tissue fragments are usually C-shaped. Embed them in OCT so that you cut through the “C” in your sections.  If there is more than one piece, embed and freeze on separate chucks.

Ganglion cells are best identified with thicker sections, so please cut them at 5-6 microns, and cut two slices per slide.

When staining, add an extra 30 seconds to the Hematoxylin to bring out the Nissl substance.

If gangion cells are NOT identified on the first round, you may be asked to cut deepers.

Gross

When frozens are complete, place remainder of tissue in mesh bag and cassette for permanent sections.