The discipline of Anatomic Pathology is understandably one of the greatest hoarders in the medical profession. While so many other fields of medicine have transitioned to electronic data retention for historical records, in anatomic pathology there still exists the necessity for a tremendous volume of ‘hard’ storage. Hard storage constitutes the physical elements that are the subject of diagnostic decisions in surgical pathology and research. Every element involved such as grossed wet tissue in preservative (fixative), paraffin embedded tissue blocks, and microscopic tissue glass slides; all of these are traditionally retained for weeks, months, and even decades. The anxiety and insecurity in the possibility that a past diagnoses might one day be questioned, and the legal liability of not retaining the element of the actual diagnosis, has caused a great reluctance to dispose of these items. Thus, there is an endless and growing need for storage. With this in mind, storage must be viewed as a broad general concept that has options to accommodate each element within. In this 2-Part series we will discuss a plethora of storage options from simple, cost-effective systems that are light-weight, mobile and transitional, to the high-end, large volume, permanent placement systems.

In anatomic pathology, particularly research, there is oftentimes the need for the archival of large, whole organ specimens such as kidney, liver, brain, etc. During and after proper fixation of tissue, these specimens are stored in the fixative solutions sometimes for years.  

This requires some form of durable leak-proof large specimen container that will not denature with long-term storage in fixative, and one that is resistant to breakage or shattering such as glass. In the top image to the right, we see such an item in polypropylene buckets of various sizes ranging from 2-liter volumes to over 10 liters. In Histology, particularly hospital or reference labs, there is a daily need for smaller specimen containers small enough to accommodate biopsy and other particulate tissue. In the bottom image to the right there are small vial or jar-type containers for transport and/or specimen retention. These examples are also made of a durable polypropylene material but in a clear container for better utility in visualizing and extracting the tissue. Both of these two examples are durable enough to store tissues for years after the gross pathology is performed.
After fixation, typically a small representative portion is dissected away during the grossing, processed, and embedded in a paraffin wax block. In surgical pathology as well as in research, after these blocks have been sectioned and viewed, the paraffin blocks are retained and stored in diagnostic labs, (hospital and reference). These patient specimens become so voluminous that even off-site storage becomes an option. Storage systems designed to accommodate paraffin blocks need to be versatile enough to use as a light-weight, cost-effective container kept on a counter-top with an organized system able to file blocks in a numerical sequence that is easy to retrieve. The paraffin block filing system shown here demonstrates these necessary features.

Each individual unit has corrugated drawers along with removable plastic insert trays. Because of the light-weight design of this storage system, the individual trays can be taken out and used to store the most recent and active cases for that day or week, then filed back into the drawers. As the unit volumes continue to expand, special outer cartons can be utilized for long-term storage.

These same requirements needed for the paraffin blocks are also needed for the subsequent glass microscopic slides that are produced from the blocks. After diagnostic review, short term and long-term storage is needed, and this same type of organized system can be employed as a cost-effective solution. You will note in the final image to the right that the slide storage system is designed differently from the block storage system with deeper drawers and plastic trays to accommodate the height of the microscope slides.

In any event, these are examples of highly efficient, durable, cost-effective storage solutions that can address the daily increasing need for hard storage retention. Hoarding is an unavoidable consequence of anatomic pathology, but within these and other options we will discuss in part 2, we can eleviate the anxiety of disorganization and clutter in the lab environment. Every lab must look at their internal space restrictions, investigate the options in the market, and make the informed decision as to what type of system is best for their lab. Hoarding can be done with professionalism and pride through optimal storage systems.

Reference:

  • Brown, S., ‘Histology Block & Slide Storage Options’, LabStore Highlights, 2020.
  • www.labstore.com
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