Levels per slide

[coroner]

I was talking to a colleague the other day and he mentioned that their protocol is to only cut two levels on two slides for GI bx's. He suggested that I do the same where I'm at. I've always been used to three levels x three slides, but he said it's overkill. What do you think and what do your institutions do?

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[AZpath]

I have worked at many labs over the years( I did locums for a while). Usually GI gets two slides each with a ribbon containing 2-3 adjacent cuts.
I am sure you are picking up a few extra polyps etc.

However, you are spending 33% more time reading and cutting. The clinical impact is small IMO.

 

[univlad]

We do two slides on GI biopsies with two ribbons on each slide, except if the case is marked as r/o Barrett's and then we do 4 slides. I generally order 3 additional levels if they call someting a polyp and I don't see a polyp on the initial levels.

 

[icpshootyz]

We do 3 levels on 1 slide (if possible) which works for most small biopsies (GI, skin). Endometrium and endocervical bx's get 2 levels, 1 slide if possible. If the tissues are larger, we'll use more slides. But putting different levels on different slides often just wastes slides. We can usually get 2-3 profiles per ribbon on each section of the slide, as well. Levels are up to individual discretion beyond that.

 

[coroner]

Ok, thanks for the input. Sounds like our lab can be a little more conservative.