Artefacts produced by normal saline when used as a holding solution for biopsy tissues in transit

Oral surgeons, surgeons and dentists carrying out small biopsy procedures on an out-patient basis have been frequently sending poorly stored biopsy tissues to the Departments of Oral Pathology of various dental colleges, wherein the tissues were being stored in normal saline and then transferred to formalin. Such tissues often show abnormal cellular and architectural changes, which pose a challenge to diagnosis, especially when the histopathologist is not aware that the tissue was stored in normal saline for some time. We wanted to know the extent of artefactually induced cellular and architectural changes in tissues that were transported in normal saline and received by us, based on the duration for which they were held in normal saline. Normal oral soft tissue was subjected to storage in normal saline for periods varying from 1 to 36 h, before being fixed in 10 % formalin. Soft tissue specimens were collected during routine surgical extractions and each was cut into six parts. One was transferred immediately to formalin as control and other bits kept in normal saline for intervals of 1, 3, 12, 24, and 36 h before fixing in formalin. A comparative photographic analysis was carried out to analyze the histopathological changes. The tissues kept in normal saline before fixation underwent various changes. In no way should normal saline be used, even for a short time, to store and transport excised tissue; it is imperative that such tissues be placed immediately in a proper fixative like 10 % formalin.