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 immersion, lymph nodes will be visibly grayish in color, standing out from surrounding tissues and readily identifiable.

METHOD:

Fixation Recommendations:

Larger Biopsies: A minimum of 10-12 hours.
Small Biopsies:  A minimum of 4 to 6 hours.

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 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 smaller area with suspected lymph nodes.  Bread loaf tissue to increase surface area and promote fixative penetration.
         2. Colon tissue: cut open, rinse, pin-out and work with either a segment of colon or entire specimen.
         3. Other specimens: gross to increase tissue surface area and promote 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 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 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.
      1. 1. After fixation, transfer Lymph Node Grossing Aid fixed tissue to Formalin 10%, Phosphate Buffered for long-term storage purposes.

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 Pathology 21.11 (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.