coroner

Peace Sells...but who's buying?
10+ Year Member
Aug 3, 2007
673
282
22 Acacia Avenue
Status
Attending Physician
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?
 

AZpath

5+ Year Member
Nov 1, 2012
449
118
Status
Attending Physician
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

Member
15+ Year Member
Jul 14, 2002
233
24
Status
Attending Physician
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

7+ Year Member
Sep 17, 2009
525
85
Status
Attending Physician
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.
 
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