Lymph Node Grossing Aid

SOLUTION:

For storage requirements and expiration date refer to individual bottle labels.

APPLICATION:

Newcomer Supply Lymph Node Grossing Aid is a ready-to-use fixative that serves as either a primary or secondary fixative to enhance the visibility and yield of lymph nodes in specimens in which lymph node examination is critical, such as; breast, colon, lung, radical neck dissection, small intestine and omentum.

The combination of formaldehyde, ethanol and acetic acid in the Lymph Node Grossing Aid solution allows for rapid tissue penetration.  Following sufficient fixation/immersion lymph nodes will be visibly grayish in color, noticeably standing out from surrounding tissues and readily identifiable.

METHOD:

Fixation:

Larger Biopsies: A minimum of 10-12 hours is recommended.

Small Biopsies:  A minimum of 4 to 6 hours is recommended.

Solutions:  All solutions are manufactured by Newcomer Supply, Inc.

FIXATION PROCEDURE:

1. 1. Place fresh tissue in an adequate amount of Lymph Node Grossing Aid solution as soon as possible after surgical excision.
      1. 1. See Procedure Note #1.
   2. Gross tissue specimen in a manner to allow Lymph Node Grossing Aid to adequately penetrate.
      1. 1. Breast tissue: work with entire specimen or remove a smaller area with suspected lymph nodes. Bread loaf tissue to increase surface area and promote efficient fixative penetration.
         2. Colon tissue: cut open, rinse and pin-out, work with either a segment(s) of colon or entire specimen.
         3. Other specimens: gross to increase tissue surface area and promote efficient fixative penetration.
   3. Return specimens to Lymph Node Grossing Aid solution and fix for a sufficient amount of time, depending upon size and type of tissue.
   4. After adequate immersion in Lymph Node Grossing Aid, remove specimen and re-gross.
      1. 1. Remove adipose and palpate for lymph nodes and/or identify nodes by their visibly grayish color.
   5. Hold tissues in either Lymph Node Grossing Aid or Formalin 10%, Phosphate Buffered (Part 1090) until ready to process.
      1. 1. See Procedure Note #2.

PROCEDURE NOTES:

1. 1. A specimen initially received in Formalin 10%, Phosphate Buffered can remain in fixative until initial grossing occurs, then transferred to Lymph Node Grossing Aid solution as a secondary fixative.
   2. Extended storage in Lymph Node Grossing Aid is not recommended. After fixation, transfer Lymph Node Grossing Aid wet tissue to Formalin 10%, Phosphate Buffered for long-term storage.

REFERENCES:

1. 1. Koren, Rumelia, Shlomo Kyzer, Adrian Paz, Vladimir Veltman, Baruch Klein, and Rivka Gal. “Lymph Node Revealing Solution: A New Method for Detection of Minute Axillary Lymph Nodes in Breast Cancer Specimens.” The American Journal of Surgical Pathology11 (1997): 1387-1390.
   2. Luna, Lee G. Manual of Histologic Staining Methods of the Armed Forces Institute of Pathology. 3rd ed. New York: Blakiston Division, McGraw-Hill, 1968. 4.
   3. Newell, Ken, Barry Sawka, and Brian Rudrick. “An Inexpensive, Simple and Effective Aid for the Retrieval of Lymph Nodes From Colorectal Cancer Resections.” Archives of Pathology Laboratory Medicine 125 (2001): 642-45.
   4. Modifications developed by Newcomer Supply Laboratory.