[506] Skin Punch Biopsy Sectioning: Before or after Tissue Processing?

Nuran Sungu, Sibel Orhun, Seda Marali, Serdar Balci, Aydan Kilicarslan, Canan Altunkaya, Gulnur Guler. Yildirim Beyazit University, Ankara, Turkey

Background: Punch biopsies (PB) are frequently used in inflammatory dermatoses. For macroscopic sampling, while the PBs larger than 4mm are recommended to be cut into two or three equal parts, those smaller than 4mm are either not cut or cut into two equal parts. We intended to study whether there is a meaningful difference at microscopic examination between dividing section into two equal parts before tissue processing or after.
Design: 400 cases included in the study. Punch biopsies were cut into two pieces before tissue processing (first method) in 200 and after tissue processing just before paraffin embedding (second method) in other 200 cases. We microscopically evaluated the appearance of epidermal mesh view (EMV), the presence of cross-cut hair follicle (CCHF) and bow shape (BS) due to epidermal angling, presence of two pieces(TP) on the slide and if there was a distance greater than 2mm(DG) between the parts, the number of new sections(NNS), new slides(NNL), and diameter(D) of biopsies.
Results: We determined that the values for CCHFs (p=0.018), EMV(p=0.036), DG (p=0.008), NNS(p<0.001), and NNL(p<0.001) were considerably higher in first method than second one but the presence of TP was low(p<0.001) in first method.

Comparison of 2 methods
 1st method2nd methodp
CCHF1230.018
EMV24120.036
BS1790.105
TP1011840.001
DG830.008
Mean NNS1.530.440.001
Mean NNL0.580.150.001
2 pieces per 3mm33/8098/1090.001
2 pieces per 4mm68/12086/910.001
Total200200 


Figure 1: The presence of cross-cut hair follicle, bow shape due to epidermal angling, H&Ex40

Figure 2: Epidermal mesh view,H&Ex100


Conclusions: As macroscopic inspection, proper division, appropriate paraffin embedding and sectioning of biopsies are critical for pinpointing small lesions, we noted a meaningful difference in quality of microscopic evaluation between first and second methods. Better sections were obtained when PBs sectioned after tissue processing. In addition, decrease in the number of new slides will reduce workload, archive work, and cost.
Category: Dermatopathology

Wednesday, March 6, 2013 9:30 AM

Poster Session V # 78, Wednesday Morning

 

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