Abstract
Tissue contamination is a common occurrence in pathology, but surgeons are relatively unaware of this. We present the case of a 45-year-old man with Barrett's oesophagus, in which the histology of routine biopsies of an asymptomatic patient, were reported as 'carcinoma in situ'. Further biopsies were taken over a three month period but showed no evidence of malignancy. Tissue contamination or 'cross over' was identified as the likely cause of the abnormal result. This case report highlights the importance of the correlation of the clinical and histopathological findings and tissue contamination should be considered when both of these findings are not consistent.
Highlights
We present the case of a 45-year-old man with Barrett’s oesophagus, in which the histology of routine biopsies of an asymptomatic patient, were reported as ‘carcinoma in situ’
Tissue contamination or ‘cross over’ was identified as the likely cause of the abnormal result. This case report highlights the importance of the correlation of the clinical and histopathological findings and tissue contamination should be considered when both of these findings are not consistent
It was thought by histopathology that the focus of tumour could be a contaminant from another specimen
Summary
The recognition of the discrepancy between the clinical history, endoscopic and histopathological findings was imperative in this case, otherwise this may have resulted in unnecessary major surgery for the patient. Specimens should undergo DNA-based PCR techniques when there is suspected crossover involving similar tissue types and no obvious source of contamination. It has been shown to determine whether tissue contamination with another specimen has occurred [6] This technique is expensive and there are limitations, as shown by this case, due to the small amount of tissue available from which DNA can be isolated or from degradation due to the fixation agent (formalin) [8]. Mitochondrial genetic typing is recommended for tissue samples with low DNA content and high degradation [3]. This was not performed on any of the specimens. EM is the patient’s consultant, and senior author of this article
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