Goldberg Matthew S, Wetherington Sarah J, Susa Joseph S, Wickless Scott C, Cockerell Clay J
*Department of Dermatology, University of Texas Southwestern Medical Center, Cockerell Dermatopathology, Dallas, TX; and †Medical College of Georgia, Augusta, GA.
Am J Dermatopathol. 2015 Nov;37(11):846-9. doi: 10.1097/DAD.0000000000000338.
With recent technological advances and cost reductions, automated embedding systems are rapidly becoming routine in the processing of skin biopsy specimens. The efficiency advantages of this technique are due in part to the use of patented sectionable cassettes that hold formalin-fixed tissue from the time of grossing through tissue sectioning. In this process, the final paraffin block contains both the tissue and the cassette, which are sectioned and stained in unison. Here, we report the multiple tissue and slide artifacts commonly seen with automated embedding systems that are unique to this method of tissue processing. The most frequently observed tissue changes are patterned molding of the biopsy specimen around the cassette material. The most common slide artifacts are due to the presence of geometrically shaped polarizable cassette material adjacent to or overlying the stained tissue. As many of these artifacts strongly resemble the shapes seen in the classic 1980s video game, Tetris, we propose the term of Tetris-like artifacts for these findings. Although we remain confident that use of an automated embedding system does not decrease diagnostic reliability, increased familiarity with the standard appearance of slides processed using this technique will help avoid confusion when evaluating these cases.
随着近期技术的进步和成本的降低，自动包埋系统在皮肤活检标本处理中迅速成为常规操作。这项技术的效率优势部分归因于使用了专利的可切片盒，该盒从大体标本处理到组织切片阶段都能保存福尔马林固定的组织。在这个过程中，最终的石蜡块包含组织和包埋盒，它们一起进行切片和染色。在此，我们报告了自动包埋系统常见的多种组织和玻片伪像，这些伪像是这种组织处理方法所特有的。最常观察到的组织变化是活检标本围绕包埋盒材料出现规则的塑形。最常见的玻片伪像是由于在染色组织附近或上方存在几何形状的可极化包埋盒材料。由于这些伪像中的许多形状与20世纪80年代经典电子游戏《俄罗斯方块》中的形状非常相似，我们将这些发现称为类俄罗斯方块伪像。尽管我们仍然相信使用自动包埋系统不会降低诊断可靠性，但增加对使用该技术处理的玻片标准外观的熟悉程度将有助于在评估这些病例时避免混淆。
