Abstract
Proper tissue fixation is essential to ensure the highest level of specimen evaluation. Pathologists and laboratory staff are frequently consulted by clinical counterparts regarding what fixative should be used for different tissues or to enable a diagnosis of a specific condition. It is vital for the patient that the pathologist provides accurate information to ensure proper fixation. Frequently, once a tissue has been fixed inadequately or inappropriately, remedial changes may no longer be possible. Most often formalin is an adequate choice, if not the optimal one; however, there are certain situations when placing the tissue in formalin may limit the ability to reach a definitive diagnosis. It is imperative for pathologists to have the knowledge to communicate which fixative is optimal. Furthermore, as we move into a world of personalized medicine, where ancillary testing has both diagnostic and specific therapeutic implications, knowledge about how different fixatives affect immunohistochemistry, cytogenetics, and molecular studies becomes even more significant. This chapter provides practical information regarding common fixatives, their mechanism of action and optimal uses.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Rolls G (2012) Fixation and fixatives (1) – the process of fixation and the nature of fixatives. Leica Biosystems. http://www.leicabiosystems.com/pathologyleaders/fixation-and-fixatives-1-the-process-of-fixation-and-the-nature-of-fixatives/ Accessed 20 Aug 2013
Carson F, Hladik C (2009) Histotechnology: a Self-instructional text, 3rd edn. American Society for Clinical Pathology Press.
Rolls G (2012) Fixation and fixatives (5) – practical procedures to optimize quality, the effects of heat and microwaves. Leica Biosyst. http://www.leicabiosystems.com/pathologyleaders/fixation-and-fixatives-5-practical-procedures-to-optimise-quality-the-effects-of-heat-and-microwaves/. Accessed 20 Aug 2013
Rolls G (2012) Fixation and fixatives (2) – factors influenceing chemical fixation, formaldehyde and glutaraldehyde. Leica Biosyst. http://www.leicabiosystems.com/pathologyleaders/fixation-and-fixatives-2-factors-influencing-chemical-fixation-formaldehyde-and-glutaraldehyde/. Accessed 20 Aug 2013
Tampa Pathology Laboratories – School of Histotechnology 2012–2013. Introduction to tissue fixation. http://histologycourse.com/Tissue%20Fixation-Lecture%2012.pdf. Accessed 20 Aug 2013
Rolls G (2012) Fixation and fixatives (4) – popular fixative solutions. Leica Biosyst. http://www.leicabiosystems.com/pathologyleaders/fixation-and-fixatives-4-popular-fixative-solutions/ Accessed 20 Aug 2013
Bultitude MF, Ghani KR, Horsfield C et al (2011) Improving the interpretation of ureteroscopic biopsies: use of Bouin’s fixative. BJU Int 108(9):1373–1375
Wolff AC, Hammond EH, Schwartz JN et al (2007) American society of clinical oncology/college of American pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. Arch Pathol Lab Med 25(1):118–145
Neat MJ, Moonim MT, Dunn RG et al (2013) Fluorescence in situ hybridization analysis of bone marrow trephine biopsy specimens; an additional tool in the diagnostic armoury. J Clin Pathol 66:54–57
Wu HH, Jones KJ, Cramer MH (2013) Immunohistochemistry performed on cell-transferred direct smears of the fine-needle aspirates. Am J Clin Pathol 139:754–758
Grizzle WE (2009) Special symposium: fixation and tissue processing models. Biotech Histochem 84(5):185–193
Kissel HD, Paulson TG, Liu K et al (2013) Feasibility of RNA and DNA extraction from fresh pipelle and archival endometrial tissues for use in gene expression an SNP arrays. Obstet Gynecol Int 2013:1–9
Wang J, Gouda-Vossos A, Dzamko N et al (2013) DNA extraction from fresh-frozen and formalin-fixed, paraffin-embedded human brain tissue. Neurosci Bull 29(5):649–654
Liu J, Johcon RM, Traweek ST (1993) Rearrangement of the BCL-2 gene in follicular lymphoma: detection by PCR in both fresh and fixed tissue samples. Diagn Mol Pathol 2:241–247
Limpens J, Beelen M, Stad R et al (1993) Detection of the t(14;18) translocation in frozen and formalin-fixed tissue. Diagn Mol Pathol 2:99–107
Goelz SE, Hamilton SR, Vogelstein B (1985) Purification of DNA from formaldehyde fixed and paraffin embedded human tissue. Biochem Biophys Res Commun 130:118–126
Carson FL. Fixation and processing. College of American Pathologists. www.cap.org/apps/docs/cap_press/Fixation_and_Processing.pdf. Accessed 27 Jan 2013
Kilburn KH, Warshaw RH (1992) Neurobehavioral effects of formaldehyde and solvents on histology technicians: repeated testing across time. Environ Res 58:134–146
Set R, Shastri J (2011) Laboratory aspects of clinically significant rapidly growing mycobacteria. Indian J Med Microbiol 29:343–352
Strauss WM (1995) Preparation of genomic DNA from mammalian tissue, In: Ausubel FM, Brent R, Kingston RE, et al., eds. Current protocols in molecular biology. Wiley, New York, pp 2.2.1–2.2.3
Yildiz-Aktas IZ, Dabbs DJ, Cooper KL et al (2012) The effect of 96-hour formalin fixation on the immunohistochemical evaluation of estrogen receptor, progesterone receptor, and HER2 expression in invasive breast carcinoma. Am J Clin Pathol 137:691–698
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science+Business Media, New York
About this protocol
Cite this protocol
Qidwai, K., Afkhami, M., Day, C.E. (2014). The Pathologist’s Guide to Fixatives. In: Day, C. (eds) Histopathology. Methods in Molecular Biology, vol 1180. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-1050-2_2
Download citation
DOI: https://doi.org/10.1007/978-1-4939-1050-2_2
Published:
Publisher Name: Humana Press, New York, NY
Print ISBN: 978-1-4939-1049-6
Online ISBN: 978-1-4939-1050-2
eBook Packages: Springer Protocols