By The University of Chicago Department of Pathology
Bone & Soft Tissue Biopsies
Auto Text: “Insert Core Biopsy” or “Insert Bone Curettings”
Submit one intact core per cassette. Use multiple cassettes if needed. Always fix thoroughly prior to decalcification.
If decalcification is needed, NEVER decalcify entirely in standard Hydrochloric Acid (HCl). It is preferred to decalcify entirely in EDTA (in order to preserve nucleic acids for molecular testing and better preserve proteins for IHC).
If multiple cassettes are needed and you are unsure about the extent of HCl versus EDTA, please CALL an attending. The PAs can provide assistance in using the EDTA.
When submitting biopsies that are hybrids of soft and hard pieces, examine which pieces (if any) need decalcification and submit these in a separate cassette.
Be sure to state “after EDTA decalcification” in your cassette summary and add a Decal stain (appears as “Decalcification process” NOT “H&E Decalcificaton”) in CoPath. One “stain” per container will suffice, as the only result of ordering the “stain” is to drop a billing charge.
For known molecular cases, make sure histology protocol is for 1 H&E only.
For other cases, make sure histology protocol is for a 10 Level FNB biopsy (i.e. Levels 1 and 10 should be H&E-stained slides, Levels 2 through 9 should be unstained slides).
Ask the front desk to change the protocol if you need help. Ask an attending if you are unsure of the proper protocol.