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Processing fine needle aspiration biopsies for electron microscopic examination. Experience implementing a procedure

E Ravinsky1, G E Quinonez, M Paraskevas

  • 1Department of Pathology, University of Manitoba Health Sciences Centre, Winnipeg, Canada.

Acta Cytologica
|September 1, 1993
PubMed

Insights

Optimizing electron microscopy for fine needle aspiration biopsy requires proper glutaraldehyde fixation and careful sample handling. Improved methods significantly enhance preservation and diagnostic yield in ultrastructural evaluations.

Area of Science:

  • Pathology
  • Microscopy
  • Cell Biology

Background:

  • Fine needle aspiration (FNA) biopsy is crucial for diagnosis.
  • Electron microscopy (EM) provides detailed ultrastructural information.
  • Previous methods for processing FNA rinses for EM had preservation issues.

Purpose of the Study:

  • To identify and resolve preservation challenges in processing FNA rinses for EM.
  • To improve the quality and quantity of material available for ultrastructural analysis.
  • To assess the clinical diagnostic contribution of EM in FNA cases.

Main Methods:

  • Investigated factors affecting preservation: glutaraldehyde fixation time, transport medium tonicity, and sample handling.
  • Implemented solutions: prompt glutaraldehyde addition, adjusted transport medium, and gentler handling.
  • Developed a filtration method to concentrate tissue fragments from needle rinses.
  • Required multidisciplinary team collaboration and continuous quality monitoring.

Main Results:

  • Dramatic improvement in preservation after addressing fixation and handling issues.
  • Filtration effectively captured scarce tissue fragments for ultrastructural evaluation.
  • Ultrastructural evaluation contributed clinically valuable information in 48% of cases with adequate material.

Conclusions:

  • Optimized processing protocols significantly enhance the utility of EM for FNA biopsies.
  • Careful attention to sample handling and fixation is critical for diagnostic EM.
  • EM can provide valuable diagnostic insights in a substantial proportion of FNA cases.

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