Fixation Flashcards
`[2] Types of specimen samples obtain from surgical procedures.
Fresh samples
Fixed samples
For immediate diagnosis or evaluation.
[samples]
Fresh samples
Motion, mitosis and phagocytosis are to be observed.
[samples]
Fresh samples
Not permanent or its use is limited, are liable to develop changes that have been observed after death.
[samples]
Fresh samples
Detailed structure of cells because well preserved.
[samples]
Fixed samples
Avoid autolysis.
[samples]
Fixed samples
Often referred to as “cut – up”, involves a careful examination and description of specimen its- appearance, number of piece, and dimension.
Grossing
Patient information, Clinical History, Description of site of origin.
Request form
To reduce the risk of mislabeling, or mismatching.
Accessioned with a specific number (or barcode)
Specimen size for processing.
3X2 cm and 3-5 mm THICK
[6] Specimen types
- Excision specimens
- Incisional biopsy
- Punch biopsies
- Shave biopsies surface (usually skin)
- Curetting
- Core biopsies
[4] Methods of fresh tissue examination
- Teasing/Dissociation
- Crushing/ Squash preparation
- Smear preparation
- Frozen section
Normally used when a rapid diagnosis of a tissue is required.
[methods of fresh tissue examination]
Frozen section
Best for frozen section.
[freezing]
Unfixed tissue
Used to localize hydrolytic.
[freezing]
Fixed tissue
Without use of any chemical fixative.
Freeze drying
Rapid freezing (160°C)
Quenching
Removal of water in the form of ice (-40°C vacuum).
Sublimation
Frozen tissue is submerged to what formula?
Rossman’s formula
[5] Commonly used methods of freezing.
- Optimal cutting temperature
- Liquid nitrogen
- Isopentane
- Carbon dioxide gas
- Aerosol sprays
[2] Two methods of preparing frozen section
- Cold knife procedure
- Cryostat procedure
Almost any microtome can be used.
[methods of preparing frozen section]
Cold knife procedure
Cold microtome.
[methods of preparing frozen section]
Cryostat procedure
A refrigerated cabinet in which a modified
microtome is housed.
Cryostat
OPTIMUM WORKING TEMPERATURE = -18 ° to -20 ° C
[methods of preparing frozen section]
Cryostat procedure
Presently, the ROTARY MICROTOME is the type of choice.
[methods of preparing frozen section]
Cryostat procedure
[12] Tissue processing
- Accessioning
- Fixation
- Dehydration
- Decalcification
- Clearing/ Dealcoholization
- Infiltration/Impregnation
- Embedding
- Trimming
- Secretion/Microtomy
- Staining
- Mounting
- Labelling
[2] Mechanism of action of fixative
- Additive fixation
- Non-additive fixation
Becomes part of the tissue by formation of cross links or complexes. Ex. Formalin, Hg, osmium tetroxide.
[fixative]
Additive fixation
NOT incorporated in the tissue, stabilizes tissue by removing of the bound water.
Ex. Alcoholic fixatives
[fixative]
Non-additive fixation
[6] Factors involved in fixation
- pH
- Temperature
- Thickness
- Osmolality
- Concentration
- Time duration
Slightly hypertonic solution around 400-
450mOsm.
Osmolality
Rate of penetration:
[practical consideration]
Formalin 1mm/hour.
Volume.
[practical considerations]
10-25 times that of the tissue
maximum effectiveness.
[practical considerations]
20:1
Osmium tetroxide.
[practical considerations]
5-10:1
prolonged fixation (museum preparation)
[practical considerations]
50-100: 1
[2] Types of fixative according to composition.
- Simple fixative
- Compound fixative
Are made up of only one component substance.
[types of fixative acc to composition]
Simple fixtive
Are made up of two or more fixatives which have been added together.
[types of fixative acc to composition]
Compound fixative
[3] Types of fixative acc to ACTION
- Microanatomical fixative
- Cytological fixative
- Cytoplasmic fixative
[2] Cytological fixative
- Nuclear fixative
- Cytoplasmic fixative
Contains glacial acetic acid.
(ex.Bouin’s fluid, Flemming’s fluid, Newcomers fluid, Carnoy’s fluid, Heidenhain’s SuSa (BFNCH)
[cytololgical fixative]
Nuclear fixative
Helly’s fluid, Orth’s fluid, Regaud’s fluid, Flemming fluid without acetic acid, Formalin with post chroming (HORFF)
[cytololgical fixative]
Cytoplasmic fixative
[3] Histochemical fixative
- Lipid fixation
- Carbohydrate fixation
- Protein fixation
Fixatives containing mercuric chloride and potassium dichromate in cryostat section.
[histochemical fixation]
Lipid fixation
Alcoholic fixative for glycogen (Rossman’s fluid or cold absolute alcohol)
[histochemical fixation]
Carbohydrate fixation
Neutral buffered formalin.
Protein fixation
[8] Aldehyde fixatives
- Formaldehyde
- 10 % Formol saline
- 10% Neutral Buffered Formalin (NBF) or PO4 buffered formalin
- Formol corrosive
- Glutaraldehyde
- Karnovsky’s paraformaldehyde - glutaraldehyde
- Acrolein
- Formol - calcium
[3] Metallic fixative
- Mercuric chloride (BOSCHZZ)
- Chromate fixatives
- Lead fixative
[7] Mercuric chloride BOSCHZZ
- B5 fixative
- Ohlmacher’s
- Schaudinn’s
- Carnoy-Lebrun
- Heidenhain Susa
- Zenker
- Zenker’s formol
[4] Chromate fixatives (ROCP)
- Regaud’s (mollers) (molliflex)
- Orth’s fluid
- Chromic acid
- Potassium dichromate
HIGHLY EXPLOSIVE when dry.
Picric acid fixative
[2] Picric acid fixative
- Bouin’s
- Brasil’s alcoholic picroformol fixative
Recommended for fixation of embryos and pituitary biopsies.
[picric acid fixative]
Bouin’s
Excellent fixative for glycogen and less messy then Bouin’s solution (excellent).
[picric acid fixative]
Brasil’s alcoholic picroformol fixative
It is normally used in conjunction with other fixatives to form a compound solution.
Glacial acetic acid
Fixes & precipitates nucleoproteins, chromosomes, & chromatin material.
Glacial acetic acid
Solidifies at 17°C.
Glacial acetic acid
[6] Alcohol fixatives. (MEICAN)
- Methyl alcohol
- Ethanol
- Isopropyl alcohol
- Carnoy’s fluid
- Alcoholic formalin
- Newcomer’s
For fixing dry and wet smears (PBS and
BM tissues.
[alcohol fixatives]
Methyl alcohol
Simple fixative incorporated with compound fixatives for better results, preserves but does not fix glycogen (Disadvantage: polarization).
[alcohol fixatives]
Ethanol
Fixing touch preparation.
[alcohol fixatives]
Isopropyl alcohol
For fixing chromosomes, lymph glands and urgent biopsies (MOST RAPID;1-3 hours).
[alcohol fixatives]
Carnoy’s fluid
To preserve sputum.
[alcohol fixatives]
Alcoholic formalin
For fixing mucopolysaccharides and nuclear proteins. Give better reaction in Fuelgen stain than Carnoys.
[alcohol fixatives]
Newcomer’s
[2] Osmium tetroxide (FF)
- Flemmings solution
- Flemming’s solution without acetic acid
Most common chrome-osmium acetic acid fixative used (FIXATIVE & DECALCIFYING
AGENT), permanently fixes fat, for nuclear structures (excellent).
[osmium tetroxide]
Flemmings solution
(improve cytoplasmic details) – recommended for mitochondria.
[osmium tetroxide]
Flemming’s solution without acetic acid
[3] Fixation terminilogies (SPW)
- Secondary fixation
- Post - chromatization
- Washing out
Process of placing an already fixed tissue in a second fixative.
[fixation terminologies]
Secondary fixation
Fixation whereby a primarily fixed tissue is placed in Aqueos solution of 2.5-3% potassium dichromate.
[fixation terminologies]
Post - chromatization
Removing excess fixative.
[fixation terminologies]
Washing out
[3] Washing out (fixation terminologies)
- Tap water (chromates)
- 50-70% alcohol
- Alcoholic iodine
[3] Factors affect fixation of tissues. (SAM)
- size and thickness of tissue
- Agitation
- Moderate heat (37-56°)
Each specimen receives an what?
accession number
Each number is unique to that case and is.
NEVER reused.
SAC means
S (surgical)
A (autopsy)
C (cytology)
8o[4] Smear preparation
[methods of fresh tissue examination]
Streaking
Spreading
Pull apart
Touch preparation
pH:
[factors involved in fixation]
6-8
[5] Temperature (ATERF)
[factors involved in fixation]
- Autotech (40°C)
- Traditionally (RT)
- EM and histochem (0-4°C)
- Rapid examination (60°C)
- For tissue w/ TB: (100°C)
Formalin.
[concentration]
10%
Glutaraldehyde
[concentration]
3%
Glutaraldehyde (IEM)
[concentration]
0.25%
Primary fixation
[time duration]
2-6 hours
EM fixation
[time duration]
3 hours
Stock solution of Formaldehyde
[aldehyde fixatives]
37-40%
Working solution of Formaldehyde.
[aldehyde fixatives]
10%
For tumor biopsies esp of the skin.
FT 3-12 hrs
[mercuric chloride (BPSCHZZ)]
Heidenhain Susa
(fixing small pieces of liver,spleen, CT fibers and nuclei)
FT: 12-24 hrs
[mercuric chloride (BPSCHZZ)]
Zenker
Fixative for pituitary gland, BM and blood containing organs.
[mercuric chloride (BPSCHZZ)]
Zenker’s formol
Precipitates proteins.
[trichloroacetic, acetone, heat fixation]
Trichloroacetic acid
Swelling effect 🡪 counteract shrinkage by other fixatives.
[trichloroacetic, acetone, heat fixation]
Trichloroacetic acid
Weak decalcifying agent (softening effect)
[trichloroacetic, acetone, heat fixation]
Trichloroacetic acid
Used at ice cold temperature from -5°C to 4°C.
[trichloroacetic, acetone, heat fixation]
Acetone
For fixing BRAIN TISSUE (rabies diagnosis)
[trichloroacetic, acetone, heat fixation]
Acetone
For diffusible enzymes such as phosphatases and lipases.
[trichloroacetic, acetone, heat fixation]
Acetone
Microwave: 45-55°C
[trichloroacetic, acetone, heat fixation]
Heat fixation
Thermal coagulation of tissue proteins.
[trichloroacetic, acetone, heat fixation]
Heat fixation
For bacteriologic smears.
[trichloroacetic, acetone, heat fixation]
Heat fixation
Failure to arrest early autolysis of cells.
[cause]
Failure to fix immediately
Removal of substances soluble in fixing agent.
[cause]
Wrong choice of fixatives
Presence of artifact pigments.
[cause]
Incomplete fixation
Tissue are soft and feather like.
[cause]
Incomplete fixation
Loss or inactivation of enzymes.
[cause]
Wrong choice of fixative
Shrinkage and swelling of cells.
[cause]
Overfixation
Tissue blocks are brittle and hard.
[cause]
prolonged fixation
Best mounting media for cryostat.
[methods of freezing]
Optimal Cutting Temperature (OCT)
Most rapid.
[methods of freezing]
Liquid nitrogen
Cooled by liquid nitrogen.
[methods of freezing]
Isopentane
Adequate for freezing small pieces of tissue EXCEPT muscle.
[methods of freezing]
Aerosol sprays
For BM biopsies. FT: 1 ½ -2 hours.
[mercuric chloride (BOSCHZZ)]
B5 fixative
[5] Steps in Mercuric chloride.
Water
Iodine
Water
Sodium Thiosulfate
Water
[5] Pigments
- Acid formaldehyde hematin
- Mercuric chloride pigment
- Chromate pigment
- Osmium tetroxide pigment
- Crush artifact
Helly’s, Zenker’s, Flemming’s
[washing out]
Tap water (chromates)
picric acid (Bouin’s solution)
[washing out]
50 - 70 % alcoholic
mercuric fixatives.
[washing out]
Alcoholic fixatives
Fixes CT mucin and is recommended for acid mucopolysaccharides.
[metallic fixatives]
Lead fixatives
to demonstrate chromatin, mitochondria, mitotic figures, golgi bodies, RBC.
[chromate fixatives]
Regaud’s
To study early degenerative processes and tissue necrosis, preserves myelin better.
[chromate fixatives]
Orth’s fluid
preserves CHO.
[chromate fixatives]
Chromic acid
Preserves lipids and mitochondria (pH 4.5-5.2).
[chromate fixatives]
Potassium dichromate
[2] Paraformaldehyde in Aldehyde Fixatives.
- Paraformaldehyde
- Acid Formaldehyde hematin
[5] Steps in Picric Acid Fixatives.
- Picrates
- Protein
- Precipitate (water soluble)
- 70% alcohol
- Insoluble
Frozen section may lead to formation of?
Ice crystals
4% formalin or formol saline, acetone or formalin for cryostat section.
[fixative abs]
Fixative for enzyme histochemistry
Glutaraldehyde, PtCl3, PtCl3– formalin (Zamboni’s), AuCl, Osmium tetroxide, 10% NBF = acceptable but not recommended.
[fixative abc]
Fixatives for EM
KARNOVSKY’S PARAFORMALDEHYDE GLUTARALDEHYDE
[fixative abc]
Fixative for electron histochemistry and electron immunocytochemistry.
pH of Potassium dichromate.
4.5 - 5.2
Example of Additive Fixation.
Formalin
Example of Non- additive fixation.
Alcoholic fixatives
Most important reaction for maintaining tissue morphology.
[fixation/preservation]
Stabilization of proteins
To harden and protect the tissue from the trauma of further handling.
[fixation/reservation]
Secondary aim
To preserve the morphologic and chemical integrity of the cell in as life-like manner as possible.
[fixation/preservation]
Primary aim
Process of preserving cells and tissue constituents.
[fixation/preservation]
First and most critical step
The tissue is preserved by preventing degeneration, putrefaction, decomposition and distortion.
[fixation/preservation]
First and most critical step
Diluted in 10% NaCl.
[aldehyde fixatives]
10 % formol saline
For routine post mortem tissues.
[aldehyde fixatives]
Formol corrosive
w/ HgCl2.
[aldehyde fixatives]
Formol corrosive
Mixture w/ formaldehyde/formaldehyde.
[aldehyde fixtatives]
Acrolein
Lipids (frozen section]
[aldehyde fixatives]
Formol-calcium