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A simple and rapid approach to the problem of tissue contamination and patient identity in histopathologic specimens
Lesley J Christie1, Fiona J McKay, Colin A Purdie
1Department of Pathology and Neuroscience, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland. l.y.christie@dundee.ac.uk
Abstract:
Individual pathologists deal with thousands of diagnostic biopsy and excision specimens annually. At each stage, procedures are in place to limit the possibility of human error, which could result in specimen transposition or contamination. One specimen contaminating another is usually easily identified and rarely causes diagnostic difficulty; however, when it does, the consequences can be very serious. We discuss 5 cases in which concerns over specimen identity and tissue contamination arose and the methodology by which we resolved those concerns. Polymerase chain reaction analysis of each case was carried out using a panel of 12 polymorphic microsatellite markers, specific for chromosomes 13, 18, and 21. These markers are routinely used in the molecular genetics diagnostic laboratory for rapid trisomy screening. In each case, the question of error was satisfactorily resolved. Using this approach, we prevented the real possibility of patients undergoing second invasive procedures. We suggest that this or a similar methodology become a routine part of pathology practice.
Insights
Pathologists can ensure accurate specimen identification using molecular genetic techniques. Polymerase chain reaction (PCR) analysis of microsatellite markers resolves concerns about tissue contamination, preventing unnecessary patient procedures.
Area of Science:
- Forensic Pathology
- Molecular Genetics
- Diagnostic Pathology
Background:
- Pathologists handle numerous specimens, necessitating robust error-prevention protocols.
- Specimen transposition or contamination can lead to serious diagnostic errors.
- Identifying cross-contamination is crucial for patient safety and accurate diagnosis.
Purpose of the Study:
- To present a methodology for resolving concerns regarding specimen identity and tissue contamination.
- To demonstrate the utility of molecular genetic analysis in pathology practice.
- To prevent potential misdiagnoses and avoid unnecessary invasive procedures for patients.
Main Methods:
- Utilized polymerase chain reaction (PCR) analysis.
- Employed a panel of 12 polymorphic microsatellite markers targeting chromosomes 13, 18, and 21.
- Applied established molecular genetics techniques for rapid trisomy screening.
Main Results:
- Successfully resolved specimen identity and contamination concerns in 5 challenging cases.
- PCR analysis provided definitive answers regarding specimen origin.
- Prevented patients from undergoing potentially unnecessary second invasive procedures.
Conclusions:
- Molecular genetic analysis, specifically PCR with microsatellite markers, is effective in confirming specimen identity.
- This methodology offers a reliable solution for addressing specimen transposition and contamination issues.
- Routine implementation of this approach in pathology practice is recommended to enhance diagnostic accuracy and patient care.
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