Ed. Adickes et al., USE OF PERFUSION FIXATION FOR IMPROVED NEUROPATHOLOGIC EXAMINATION, Archives of pathology and laboratory medicine, 121(11), 1997, pp. 1199-1206
Citations number
17
Categorie Soggetti
Pathology,"Medical Laboratory Technology","Medicine, Research & Experimental
Objective.-To assess the efficacy of 10% formalin perfusion fixation a
s a method of rapid fixation to examine the human brain immediately fo
llowing autopsy.Design.-Compare the histology and immunohistochemistry
from human brains in which one hemisphere undergoes perfusion fixatio
n using 10% buffered formalin, and the contralateral nonperfused hemis
phere undergoes standard 14-day immersion fixation in 8 L of 10% buffe
red formalin. Setting.-Autopsy material in a general medical-surgical
university hospital. Participants.-Pathologists, neuropathologists, re
sident pathologists, and pathology assistants. Intervention.-Immediate
ly following brain removal, a single hemisphere was perfused with 1 L
10% buffered formalin over a 15- to 20-minute period. The contralatera
l nonperfused hemisphere served as a control, undergoing standard imme
rsion fixation for 2 weeks in 10% formalin. The perfusion-fixation hem
isphere was immediately available for neuropathologic examination, and
histologic sections of the brain were processed immediately with the
other necropsy tissue sections. This allows completion of a final auto
psy neuropathology report within 3 to 5 days in concert with the syste
mic section of the report. Main Outcome Measure.-Perfusion-fixation br
ain sections were compared with immersion-fixation brain sections from
the same brain. The effects on hematoxylin-eosin, Bielschowsky's silv
er, and immunohistochemical staining were evaluated by an experienced
neuropathologist and a general pathologist with no prior knowledge of
the fixation technique. Results.-Perfusion fixation revealed equal and
occasionally superior histologic sections compared with traditional i
mmersion fixation in terms of (1) technical preparation of section, (2
) quality and intensity of staining with both hematoxylin-eosin and si
lver, and (3) immunoreactivity localization with a variety of immunohi
stochemical reactions. Conclusions.-Immediate perfusion of the brain i
s an easily performed fixation technique that yields comparable or sup
erior fixation to prolonged immersion fixation and allows an immediate
complete neuropathologic examination and report within 3 to 5 days of
performance of the autopsy.