A rapid manual processing technique for resource-limited small laboratories

BACKGROUND: Surgical pathology is an integral part of diagnosis and management planning in patient care. In the absence of widespread automation, many small laboratories are unable to provide this service due to lack of time. Currently, the shortest processing schedule for formalin-fixed paraffin-embedded tissues is 16 working hours; most small laboratories cannot complete the rapid schedules within the average 8–9 working hours. Thus, the availability of an 8–9 h processing schedule that provide satisfactory results can help many small laboratories in routinely providing surgical pathology services. OBJECTIVES: To evaluate the effectiveness of a new rapid processing schedule and compare it with two existing rapid processing schedules. MATERIALS AND METHODS: This animal study tested a new rapid processing schedule suggested by authors with overnight preprocessing in 60% isopropyl alcohol followed by an 8 h processing schedule. This was tested and compared with the rapid processing schedules described by Godkar's (11 h) and Bancroft's (2 working days). A routinely used automatic tissue processor long cycle (17 h) was the control. Each schedule was used on 20 tongue specimens. The prepared slides were evaluated for surface area and linear tissue shrinkage, ease of sectioning, quality of hematoxylin and eosin staining, histological appearance and artifacts. RESULTS: No statistical differences were found between schedules. Overall total average performance ranking placed Bancroft's schedule as the best with only 27.9% of the sections processed and stained showing any shortcomings, followed closely by the test schedule suggested by authors (28.7%), Godkar's (31.8%) and the automatic processor schedule/control (33.3%). CONCLUSION: The test results indicated that the schedule devised by authors is an effective rapid processing cycle that produces diagnostic quality histological results when compared with other conventional processing schedules for small tissue blocks (average 6 mm × 8 mm).