Inking in surgical pathology: does the method matter? a procedural analysis of a spectrum of colours

Abstract

Objective: Proper identification of surgical margins along with margin status holds utmost importance in histopathology. inking margins is one way. india ink has long been used but it can ink only one margin. On other hand acrylic colours, available in variety of colours can be used for inking multiple margins along with many more advantages. The present study was undertaken to analyse acrylic colours and indian ink for inking surgical margins via three different methods for optimum results. Material and Method:Thirteen acrylic colours along with india ink were evaluated via three different methods on radical specimens of breast and colon after preliminary requisites of grossing were completed. in Method 1, coloured inks were applied to an overnight formalin fixed specimen and representative sections were taken. in Method 2, the specimen was inked and kept for overnight fixation. The specimen was sampled following day. in Method 3, the specimen was inked and kept for overnight fixation. The following day, it was re-coloured with the same colours as of the previous day and subsequently sections were taken. Coloured inks were assessed on different parameters for their performance as surgical ink and given scores.Results: acrylic shades #04, #22, #06, #01, #02 and india ink had very good to excellent score on microscopy in all three methods. Shades #64, #18, #09, #23 had poor microscopic visibility in all three methods. Shade #09 showed loss of colour and the shade #23 showed penetration into deeper tissues on microscopy. results were best with Method 3 followed by Method 1 and 2, respectively. Conclusion: acrylic colours have more advantages compared to india ink. Method 3 is recommended for inking. Few acrylic shades meet the criteria of surgical inks in all three methods.

Alteration of Tissue Marking Dyes Depends on Used Chromogen during Immunohistochemistry

“…The aim of this study was to examine the fastness and fidelity of commercially available TMD during routine tissue processing and immunohistochemical analyses. There are a few studies in the literature, which already analysed the properties of TMD [2][3][4][5]14]. All of these studies investigated TMD in H&E stained histological slides.…”

“…A distinct determination of surgical resection margin is essential for pathological diagnoses, particularly regarding oncological specimens [1][2][3][4]. For instance, in breast cancer, resection margin status and use of adjuvant chemotherapy are the most important factors associated with local recurrence and patient survival [5].…”

Surgical Inking and Double Embedding Technique for Routine Histopathology to Save Time and Effort

“…In view of these benefits of acrylic colours, we have chosen them over others for this study. [1][2][3][4][5][6] Inking of the specimens is being widely practiced in routine processing of the tumours for margin clearance in oncology service laboratories. Various authors have used it to improve the diagnostic yield and identification of margin involvement.…”

“…The application of inking in the form of India ink, surgical inks and recent application of economical & easily available hobby colours like Fevicryl® are in use now. [1,2] Inking of the specimens in the form of India ink has been used widely since fourth century B.C. [6] This ink is made of carbon black molecules in colloidal suspension which after drying forms a waterproof layer.…”

“…[1][2][3] Inking also helps in identifying a specimen, its orientation and this process can be colour coded for uniformity. There are many traditionally used marking inks available in the market like India ink, alcian blue, plain gelatine, gelatine with added colours, tissue marking dye and acrylic colours.…”