CONTEXT: In 1987, the Formaldehyde Standard became law in the United States, alerting laboratory workers to the potential carcinogenicity of formaldehyde. As a result, a variety of proprietary fixatives were developed for use in surgical pathology. OBJECTIVE: To assess histomorphology with different formalin substitute fixatives. DESIGN: Four experienced board-certified surgical pathologists examined 7 specimens (hepatocellular carcinoma, ovarian sex cord/stromal tumor, myxoid liposarcoma, uterine endometrioid adenocarcinoma, splenic follicular hyperplasia, infiltrating mammary carcinoma, and cecal signet ring carcinoma) fixed with formalin and 5 proprietary fixatives advertised as formalin replacements. In a blind study, the pathologists rated cellular outlines, cytoplasmic detail, nuclear detail, erythrocyte integrity, lymphocyte integrity, overall morphology, and overall staining in each case. RESULTS: Formalin received the highest overall morphology and staining scores, followed by Glyo-Fixx, STF-Streck, Omnifix, Histochoice, and Histofix. Formalin also received the highest scores in cellular outline and erythrocyte integrity. Individually, some fixatives performed better in different areas than others. Glyo-Fixx performed as well as formalin for overall morphology and provided highest nuclear detail and lymphocyte appearance scores. Omnifix II gave best results for cytoplasmic detail. CONCLUSION: In this blind study, formalin fixation provided the highest histomorphologic quality for tissue stained with hematoxylin-eosin and examined for diagnostic surgical pathology. Should the use of formalin be discontinued, pathologists will have to familiarize themselves with a different set of microscopic details associated with the replacement fixatives.
CONTEXT: In 1987, the Formaldehyde Standard became law in the United States, alerting laboratory workers to the potential carcinogenicity of formaldehyde. As a result, a variety of proprietary fixatives were developed for use in surgical pathology. OBJECTIVE: To assess histomorphology with different formalin substitute fixatives. DESIGN: Four experienced board-certified surgical pathologists examined 7 specimens (hepatocellular carcinoma, ovarian sex cord/stromal tumor, myxoid liposarcoma, uterine endometrioid adenocarcinoma, splenic follicular hyperplasia, infiltrating mammary carcinoma, and cecal signet ring carcinoma) fixed with formalin and 5 proprietary fixatives advertised as formalin replacements. In a blind study, the pathologists rated cellular outlines, cytoplasmic detail, nuclear detail, erythrocyte integrity, lymphocyte integrity, overall morphology, and overall staining in each case. RESULTS:Formalin received the highest overall morphology and staining scores, followed by Glyo-Fixx, STF-Streck, Omnifix, Histochoice, and Histofix. Formalin also received the highest scores in cellular outline and erythrocyte integrity. Individually, some fixatives performed better in different areas than others. Glyo-Fixx performed as well as formalin for overall morphology and provided highest nuclear detail and lymphocyte appearance scores. Omnifix II gave best results for cytoplasmic detail. CONCLUSION: In this blind study, formalin fixation provided the highest histomorphologic quality for tissue stained with hematoxylin-eosin and examined for diagnostic surgical pathology. Should the use of formalin be discontinued, pathologists will have to familiarize themselves with a different set of microscopic details associated with the replacement fixatives.
Authors: Virginia Espina; Kirsten H Edmiston; Michael Heiby; Mariaelena Pierobon; Manuela Sciro; Barbara Merritt; Stacey Banks; Jianghong Deng; Amy J VanMeter; David H Geho; Lucia Pastore; Joel Sennesh; Emanuel F Petricoin; Lance A Liotta Journal: Mol Cell Proteomics Date: 2008-07-30 Impact factor: 5.911
Authors: Fengting Yan; Xin Wu; Melissa Crawford; Wenrui Duan; Emily E Wilding; Li Gao; S Patrick Nana-Sinkam; Miguel A Villalona-Calero; Robert A Baiocchi; Gregory A Otterson Journal: Methods Date: 2010-10-01 Impact factor: 3.608
Authors: Megan M Garrity; Simon J Gibbons; Thomas C Smyrk; Jean Marie Vanderwinden; Pedro Julian Gomez-Pinilla; Anoop Nehra; Matthew Borg; Gianrico Farrugia Journal: Histopathology Date: 2009-02 Impact factor: 5.087
Authors: Jerry J Lou; Leili Mirsadraei; Desiree E Sanchez; Ryan W Wilson; Maryam Shabihkhani; Gregory M Lucey; Bowen Wei; Elyse J Singer; Sergey Mareninov; William H Yong Journal: Clin Biochem Date: 2013-12-18 Impact factor: 3.281
Authors: Robert D Cardiff; Neil E Hubbard; Jesse A Engelberg; Robert J Munn; Claramae H Miller; Judith E Walls; Jane Q Chen; Héctor A Velásquez-García; Jose J Galvez; Katie J Bell; Laurel A Beckett; Yue-Ju Li; Alexander D Borowsky Journal: Lab Invest Date: 2013-02-11 Impact factor: 5.662