Difference between revisions of "Tissue floater"

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A '''tissue floater''', also '''floater''', is a (biologic) contaminant that is transferred to the slide some time during [[tissue processing]].<ref name=pmid19492892>{{Cite journal  | last1 = Platt | first1 = E. | last2 = Sommer | first2 = P. | last3 = McDonald | first3 = L. | last4 = Bennett | first4 = A. | last5 = Hunt | first5 = J. | title = Tissue floaters and contaminants in the histology laboratory. | journal = Arch Pathol Lab Med | volume = 133 | issue = 6 | pages = 973-8 | month = Jun | year = 2009 | doi = 10.1043/1543-2165-133.6.973 | PMID = 19492892 | URL = http://www.archivesofpathology.org/doi/full/10.1043/1543-2165-133.6.973}}</ref>  
A '''tissue floater''', also '''floater''', is a (biologic) contaminant that is transferred to the slide some time during [[tissue processing]].<ref name=pmid19492892>{{Cite journal  | last1 = Platt | first1 = E. | last2 = Sommer | first2 = P. | last3 = McDonald | first3 = L. | last4 = Bennett | first4 = A. | last5 = Hunt | first5 = J. | title = Tissue floaters and contaminants in the histology laboratory. | journal = Arch Pathol Lab Med | volume = 133 | issue = 6 | pages = 973-8 | month = Jun | year = 2009 | doi = 10.1043/1543-2165-133.6.973 | PMID = 19492892 | URL = http://www.archivesofpathology.org/doi/full/10.1043/1543-2165-133.6.973}}</ref>  


A tissue floater is a type of ''extraneous tissue''; tissue that is foreign to the case.<ref name=pmid22031316>{{Cite journal  | last1 = Layfield | first1 = LJ. | last2 = Witt | first2 = BL. | last3 = Metzger | first3 = KG. | last4 = Anderson | first4 = GM. | title = Extraneous tissue: a potential source for diagnostic error in surgical pathology. | journal = Am J Clin Pathol | volume = 136 | issue = 5 | pages = 767-72 | month = Nov | year = 2011 | doi = 10.1309/AJCP4FFSBPHAU8IU | PMID = 22031316 | URL = http://ajcp.ascpjournals.org/content/136/5/767.long }}</ref>
A floater is a type of ''extraneous tissue'' and foreign to the case.<ref name=pmid22031316>{{Cite journal  | last1 = Layfield | first1 = LJ. | last2 = Witt | first2 = BL. | last3 = Metzger | first3 = KG. | last4 = Anderson | first4 = GM. | title = Extraneous tissue: a potential source for diagnostic error in surgical pathology. | journal = Am J Clin Pathol | volume = 136 | issue = 5 | pages = 767-72 | month = Nov | year = 2011 | doi = 10.1309/AJCP4FFSBPHAU8IU | PMID = 22031316 | URL = http://ajcp.ascpjournals.org/content/136/5/767.long }}</ref><ref name=pmid12049100>{{Cite journal  | last1 = Gephardt | first1 = GN. | last2 = Zarbo | first2 = RJ. | title = Extraneous tissue in surgical pathology: a College of American Pathologists Q-Probes study of 275 laboratories. | journal = Arch Pathol Lab Med | volume = 120 | issue = 11 | pages = 1009-14 | month = Nov | year = 1996 | doi =  | PMID = 12049100 }}</ref> They are ''not'' found in the tissue block.<ref name=pmid22031316/> Contaminants in the tissue block, i.e. paraffin block, are known as "pick-up" and, generally, are assumed to result from conditions at the [[cut-up|grossing]] bench.


==Quality==
==Quality==
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==Management==
==Management==
*Floaters are not found in the tissue block.<ref name=pmid22031316/>
*Tissue that is confidently identified as a floater and benign is typically identified as such on the slide and otherwise ignored.
**Contaminants in the tissue block, i.e. paraffin, are known as "pick-up" and generally result conditions at the grossing bench.  
**Example: a fragment of benign colon on an endometrial biopsy seen only on one level.
*Tissue that cannot be definitely identified as a floater may require identity testing, using short tanden repeat (STR) DNA testing.<ref name=pmid19745614>{{Cite journal  | last1 = Mosse | first1 = CA. | last2 = Stumph | first2 = JR. | last3 = Best | first3 = DH. | last4 = Vnencak-Jones | first4 = CL. | title = A B-cell lymphoma diagnosed in floater tissue: implications of the diagnosis and resolution of a laboratory error. | journal = Am J Med Sci | volume = 338 | issue = 3 | pages = 248-51 | month = Sep | year = 2009 | doi = 10.1097/MAJ.0b013e3181a88dc0 | PMID = 19745614 }}</ref>
*Tissue that cannot be definitely identified as a floater may require [[identity testing]], using short tanden repeat (STR) DNA testing.<ref name=pmid19745614>{{Cite journal  | last1 = Mosse | first1 = CA. | last2 = Stumph | first2 = JR. | last3 = Best | first3 = DH. | last4 = Vnencak-Jones | first4 = CL. | title = A B-cell lymphoma diagnosed in floater tissue: implications of the diagnosis and resolution of a laboratory error. | journal = Am J Med Sci | volume = 338 | issue = 3 | pages = 248-51 | month = Sep | year = 2009 | doi = 10.1097/MAJ.0b013e3181a88dc0 | PMID = 19745614 }}</ref>
*Malignant tissue that is apparently foreign to the case should be worked-up and reported.


==See also==
==See also==
*[[Molecular pathology tests]].
*[[Molecular pathology tests]].
*[[Quality]].
*[[Quality]].
*[[Lost tissue]].


==References==
==References==

Latest revision as of 18:34, 15 January 2015

A tissue floater, also floater, is a (biologic) contaminant that is transferred to the slide some time during tissue processing.[1]

A floater is a type of extraneous tissue and foreign to the case.[2][3] They are not found in the tissue block.[2] Contaminants in the tissue block, i.e. paraffin block, are known as "pick-up" and, generally, are assumed to result from conditions at the grossing bench.

Quality

Floaters are considered to be near-misses, as they can lead to misdiagnoses if not identified as such.[4] They are considered to be an indicator of (poor) quality.

Management

  • Tissue that is confidently identified as a floater and benign is typically identified as such on the slide and otherwise ignored.
    • Example: a fragment of benign colon on an endometrial biopsy seen only on one level.
  • Tissue that cannot be definitely identified as a floater may require identity testing, using short tanden repeat (STR) DNA testing.[5]
  • Malignant tissue that is apparently foreign to the case should be worked-up and reported.

See also

References

  1. Platt, E.; Sommer, P.; McDonald, L.; Bennett, A.; Hunt, J. (Jun 2009). "Tissue floaters and contaminants in the histology laboratory.". Arch Pathol Lab Med 133 (6): 973-8. doi:10.1043/1543-2165-133.6.973. PMID 19492892.
  2. 2.0 2.1 Layfield, LJ.; Witt, BL.; Metzger, KG.; Anderson, GM. (Nov 2011). "Extraneous tissue: a potential source for diagnostic error in surgical pathology.". Am J Clin Pathol 136 (5): 767-72. doi:10.1309/AJCP4FFSBPHAU8IU. PMID 22031316.
  3. Gephardt, GN.; Zarbo, RJ. (Nov 1996). "Extraneous tissue in surgical pathology: a College of American Pathologists Q-Probes study of 275 laboratories.". Arch Pathol Lab Med 120 (11): 1009-14. PMID 12049100.
  4. Smith, ML.; Raab, SS. (Nov 2011). "Assessment of latent factors contributing to error: addressing surgical pathology error wisely.". Arch Pathol Lab Med 135 (11): 1436-40. doi:10.5858/arpa.2011-0334-OA. PMID 22032570.
  5. Mosse, CA.; Stumph, JR.; Best, DH.; Vnencak-Jones, CL. (Sep 2009). "A B-cell lymphoma diagnosed in floater tissue: implications of the diagnosis and resolution of a laboratory error.". Am J Med Sci 338 (3): 248-51. doi:10.1097/MAJ.0b013e3181a88dc0. PMID 19745614.