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Despite the best efforts of histotechnologists to be as precise as possible when handling tissue samples, contamination happens—and when it does, the fallout can be serious. From devastating misdiagnoses to hefty lawsuits, tissue contamination can come at a cost.
In the NSH Tissue Contaminants in the Histology Lab webinar, Valerie Cortright, BA, HT, HTL, QIHC, of the University of Vermont Medical Center walks through the points where tissue contamination, particularly floaters, can occur.
Procedure rooms
The beginning of tissue contamination often takes place in a procedure room, long before histologists have the opportunity to handle a sample. In the clinics Cortright works with, she has observed errors that ensue because of many factors, including mistakes with container labeling, instrumentation reuse, and high patient volume.
“I went to a colonoscopy to shadow and was just amazed at how many biopsies they would take and then put them into the jars. I thought, ‘How do they know which ones are which?’ There are some things as a histotech we look at and say, ‘Oh my goodness, that's a little bit scary,’” she said. “So the clinic is definitely a place that can have some errors.”
Gross rooms
The gross rooms can have a lot of traffic coming in and out, and if a lab has multiple people using the same bench for different cases, there is a high possibility that contamination can happen—especially since histotechnologists may share the same instrumentation and don’t have time to clean it after each use.
“Using the benches for different types of cases is a concern. One of the things I've seen at gross benches that’s always scary is when someone will gross a really bloody placenta and then put all of those cassettes into a rack that has all of these other specimens in it, and you can see the blood and you can see contaminants on the outside of the cassette,” Cortright explained. “I know I do a lot of preaching to my residents about making sure that they rinse things off, they wrap things up and just keep everything as clean as possible.”
Processors
The processor can be considered the washing machine of pathology, and like a washing machine, there can be debris found inside of it. The filters at the bottom of processors can be filled with specimens and solutions that have been accumulating for a long time, which can be a reminder of how many opportunities there are for contamination to arise.
“It's amazing the amount of contaminants and bits and pieces of different things you'll find on those filters,” said Cortright. “If they're ending up in that filter, they're probably ending up in other tissues too.”
Tissue contamination is an ever-present challenge in histology labs, with potential risks arising at multiple points in the process—from procedure rooms to grossing benches and tissue processors. While complete elimination of floaters may not be possible, awareness and proactive measures can significantly reduce their occurrence. By understanding where contamination happens most and implementing best practices, histotechnologists can help safeguard diagnostic accuracy and patient outcomes. To explore real-world examples and expert insights on preventing contamination, watch the Tissue Contaminants in the Histology Lab webinar.
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