3D Histology Evaluation of Dermatologic Surgery

144 Pages·2013·4.674 MB·English

by  Helmut Breuninger, Patrick Adam (auth.)

Helmut Breuninger
Patrick Adam
3D Histology
Evaluation of
Dermatologic Surgery
123
3D Histology Evaluation
of Dermatologic Surgery

Helmut Breuninger Patrick Adam
(cid:129)
3D Histology
Evaluation
of Dermatologic Surgery
Helmut Breuninger Patrick Adam
Universitätsklinikum Tübingen Universitätsklinikum Tübingen
Hautklinik Pathologie und Pathologische
Tübingen Anatomie
Germany Tübingen
Germany
ISBN 978-1-4471-4437-3 ISBN 978-1-4471-4438-0 (eBook)
DOI 10.1007/978-1-4471-4438-0
Springer London Heidelberg New York Dordrecht
Library of Congress Control Number: 2013938491
© Springer-Verlag London 2013
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About the Authors
Helmut Breuninger, MD, is a specialist for surgery and derma-
tology as well and worked since 32 years as dermatosurgeon at
the Department of Dermatology of the University of Tübingen.
In this time, more than 50,000 malignant skin tumors have been
treated in his Department of Dermatosurgery, which is special-
ized for 3D histological procedures, and a high number of
respective international publications with very high case num-
bers have been published. Here the collaboration with the histo-
pathology was crucial.
Patrick Adam, MD, is a specialist for pathology in the
Department of Pathology working tight together with the
Department of Dermatology and has more than 12 years of
experience in histopathologic diagnosis of skin tumors.
During this time, he has established schemes of sectioning for
the histopathologic workup.
v

Acknowledgements
First of all, we thank Mr. Grant Weston, Senior Editor from
Springer Medicine, London, who had the idea to this book
and who supported the authors during the work on this book.
Special thanks to Dr. Holger Breuninger of the University of
Oxford for reading and editing this book.
We would like to thank the following colleagues who all had
given a lot of very important suggestions (in alphabetic order):
Franziska Eberle, MD; Hans-Martin Häfner, MD; Malte
Hübner, MD; Matin Röcken, MD; Camillo Roldan, MD;
Saskia Schnabl, MD; Ugur Uslu; and Daniel Wilder, MD.
Last but not least, we will thank the Springer publishing
team for having done a superb job with the publication.
vii

Contents

1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
About This Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
What Is 3D Histology? . . . . . . . . . . . . . . . . . . . . . . . . . 2
A Few Historical Details. . . . . . . . . . . . . . . . . . . . . . . . 6
Why Do We Need 3D Histology? . . . . . . . . . . . . . . . . 8
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2 The Basics for Excision and Flattening . . . . . . . . . . . 11
Excising the Tumor and Conversion of 3D
Margins to a 2D Plane. . . . . . . . . . . . . . . . . . . . . . . . . . 11
Oblique Excision of the Tumor . . . . . . . . . . . . . . . 12
Vertical Excision of the Tumor. . . . . . . . . . . . . . . . 15
3 Embedding and Sectioning. . . . . . . . . . . . . . . . . . . . . . 27
Paraffin- or Cryo-sections?. . . . . . . . . . . . . . . . . . . . . . 27
Comparison of Embedding Cassettes . . . . . . . . . . 28
Paraffin Sectioning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Fresh Tissue Prepared for Formalin Fixation. . . . 30
Embedding in a Mold with Paraffin. . . . . . . . . . . . 31
Preparation of Paraffin Sectioning. . . . . . . . . . . . . 32
Paraffin Sectioning. . . . . . . . . . . . . . . . . . . . . . . . . . 33
Division and Flattening of a Formalin-Fixed
Tumor Specimen. . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Cryo-sectioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Embedding for Cryo-procedure. . . . . . . . . . . . . . . 37
Preparations for Cryo-sectioning. . . . . . . . . . . . . . 37
Cryo-sectioning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
ix