Microscopic Slide Review
Tissues are not necessarily examined microscopically in every autopsy – this is a determination made by the original pathologist. Representative portions of all organs are typically retained in a fixative (usually formalin) to preserve the tissue. Even if microscopic sections were not prepared at the outset, the tissues placed into formalin can potentially be used to generate microscopic slides, if indicated.
If a review of microscopic slides is deemed necessary, there are three possible ways to accomplish this: request that the original pathologist/agency forward the original microscopic slides for review; have our pathologist travel to the location of the original microscopic slides and view them at that facility; or have a set of “recut” slides prepared and sent to our pathologist for review at our lab.
Obviously it is best to have our pathologist review the identical material seen by the original pathologist upon which their opinion was based. However, it is extremely rare, and rightfully so, that the original pathologist/agency would part with their original slides. More often traveling to the original slides or the viewing of “recuts” occurs – which opinion is preferable is case dependent and each option has its advantages and disadvantages.
While there are obvious expenses associated with travel, the production of “recuts” also is associated with a charge (which varies by agency). “Recuts” (a near duplicate of the original section) is made by utilizing the portion of tissue submitted by the pathologist and stored in a paraffin (wax) block. The histologist can make another very thin section of that tissue, mount it to a slide and stain it. Now this section will be very close (within microns) to the original section but it is not an exact duplicate. There can be very localized abnormalities in tissue that can no longer be present a mere few microns away. However, sometimes the production of “recuts” is the only option available.