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Title: |
Tissue Concentration and Preservation of Morphology in Bloody Aspirates | |||||||||||||||||||
| Authors: | Neeta Kumar, M.D., and Shyama Jain, M.D. | |||||||||||||||||||
| To the Editors: The approaches to bloody aspirates described by Drs. Giri and Vazquez1 and Tong and Chan2 are of practical value. We wish to draw attention to some drawbacks and suggest some modifications. We agree with Giri et al1 that the "pick and smear" technique is very useful for large tissue fragments and can be used to make cell blocks. However, squirting the bloody aspirate on a watch glass leads to the loss of small, invisible tissue fragments; therefore we recommend the use of glass slides for this purpose, concurring with Tong et al.2 The use of an aspiration needle for sucking the blood back from the glass slide involves 2 drawbacks: (1) the aspiration needle is usually thin and may already be blocked due to partial clotting; therefore, quick resuction may not be possible; and (2) invisible, small tissue fragments may also be sucked back along with blood and lost. We suggest a modified method (draining technique) practiced successfully routinely at our center (Figure 1): 1. The bloody aspirate is quickly squirted on 1 to 2 glass slides, the "primary" slides. 2. The primary slides are tilted at an angle of 45? on other slides, the "secondary" slides, to drain the extra blood. 3. After removing large, visible fragments for a cell block, the residual tissue material is spread on primary slides using another glass slide. Coverslips can also be used for smearing, but they are liable to break easily while spreading the thick, hemorrhagic aspirate. Also, they may not be available readily, especially in a radiology clinic, where bloody aspirates are frequent from guided aspiration. 4. Drained blood on the secondary slides is also smeared. After staining, the secondary slides are rapidly screened for any useful cellular material and discarded if not needed. In our experience, this technique helps to avoid loss of small, invisible but useful tissue particles. The primary slides contain abundant cellular material with well-preserved morphologic detail not obscured by blood and are sufficient for a meaningful interpretation. The secondary slides usually contain an insignificant quantity of cellular material, which may or may not be obscured by blood. The whole procedure needs to be completed quickly to avoid clotting on the primary slides. This can be achieved with some practice. | ||||||||||||||||||||
| Keywords: | aspiration biopsy, blood, clinical laboratory techniques | |||||||||||||||||||
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