Due to the presence of mineralized matrix within resection and biopsy specimens, routine processing techniques, utilized in soft-tissue specimens, cannot be performed. Bony tissue received within the laboratory is customarily fixed in 10% formalin. If a hematologic, lymphop-roliferative process or other small round blue cell tumor is clinically suspected, the specimen should be sent fresh (without fixative). Tissue can then be harvested for flow cytometric analysis, molecular diagnostics, or cytogenetic studies. Additionally, microbiologic cultures can be performed. A tissue imprint (smear) can provide preliminary information as to adequacy of sample or aid in the diagnosis. A frozen section may be attempted if tissue is deemed adequate and without significant osseous matrix. After formalin fixation, a decalcification step must be performed prior to further processing. This may involve a commercially available acid-based solution (Decal) or an ethylenediaminetetraacetic acid-containing reagent if dealing with small biopsies. A delay in diagnosis may occur if the specimen is large or involves dense cortical bone, thus prolonging the decalcification step. Most needle core biopsies require less than 24 hours. Another alternative is to use a methyl methacrylate-based embedding technique in which the decalcification step is unnecessary. This option allows for excellent cytologic and histologic preservation of tissue. However, it is both time consuming and requires specialized equipment, which may be too expensive for most surgical pathology laboratories.
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