MP19-18 THE USE OF FORMALIN AS A FIXATIVE FOR TESTICULAR BIOPSIES

Abstract

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation II1 Apr 2018MP19-18 THE USE OF FORMALIN AS A FIXATIVE FOR TESTICULAR BIOPSIES James Ellenburg, Joseph Drwiega, Anna Posey, Matthew Goldberg, Jennifer Gordetsky, and Peter Kolettis James EllenburgJames Ellenburg More articles by this author , Joseph DrwiegaJoseph Drwiega More articles by this author , Anna PoseyAnna Posey More articles by this author , Matthew GoldbergMatthew Goldberg More articles by this author , Jennifer GordetskyJennifer Gordetsky More articles by this author , and Peter KolettisPeter Kolettis More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.667AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testicular biopsy (TB) is important in the management of the infertile man. Bouin solution (BS) has traditionally been the recommended fixative for TB specimens. While buffered formalin (BF) is the most common fixative used in pathology, its use for a testicular fixative has been discouraged due to concern that it may cause histologic artifact that could hamper assessment of spermatogenesis. We evaluated TB fixed in BF and those fixed in BS to assess any difference in histology quality. METHODS 103 patients who underwent TB from January 2000 through December 2016 were identified. Representative slides from 12 patients, 6 fixed with BF and 6 fixed with BS, were evaluated by a genitourinary (GU) pathologist blinded to the fixative used. Nuclear, cytoplasmic, and basement membrane (NM, CM, BM) detail, and nuclear and cytoplasmic granularity (NG, CG), were graded as crisp (high quality) or blurred (low quality). In an attempt to minimize aging artifact in specimens, an additional two pairs of rat testicles were harvested. Each testis was sectioned in half; one half was fixed in BF and one half in BS to yield a total of 8 slides. These were evaluated by a GU pathologist blinded to the fixative used for each case using criteria above. RESULTS Of 71 patients, 56 (78.8%) specimens were fixed in BF, 8 (11.3%) in Zinc formalin, and 7 (9.86%) in BS. 22 slides from 6 specimens fixed in BS and 12 slides from 6 specimens fixed in BF were graded based on above quality metrics. NM detail was crisp in all slides fixed in BF (12/12) and in 10 of 22 slides fixed in BS. NG was crisp in all slides fixed in BF (12/12) and in BS (22/22). CG was crisp in 10 of 12 BF slides and in 16 of 22 BS slides. CM detail was crisp in all BF fixed slides and in 20 of 22 BS fixed slides. BM detail was crisp in all BF slides (12/12) and in 12 of 22 BS slides. For the rat testes, the BF fixed tissue was described as crisp for each metric in all four slides (4/4). The BS fixed tissue had crisp CM detail (4/4), crisp CG (4/4), and BM detail (4/4). However, the NM detail was blurred in half of the tissue (2/4), and the NG was blurred in 3 of 4 slides. CONCLUSIONS Slides from BF fixed specimens were found to be high quality in the evaluated metrics. CG was the only metric that was found to be low quality in one specimen fixed in BF. BS slides demonstrated more variability in quality across all metrics, with each specimen having at least one metric that was found to be blurred, or low quality. These findings were demonstrated in the rat testes as well. We conclude that spermatogenesis and testicular histology can be adequately evaluated with formalin fixation. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e250-e251 Advertisement Copyright & Permissions© 2018MetricsAuthor Information James Ellenburg More articles by this author Joseph Drwiega More articles by this author Anna Posey More articles by this author Matthew Goldberg More articles by this author Jennifer Gordetsky More articles by this author Peter Kolettis More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...