That Mohs Tech

Mohs histotechnologist sharing some slides with you

[thatmohstech]

Right lower eyelid first stage at 2x with toluidine blue and hematoxylin and eosin

[thatmohstech]

Changed my H&E stain from a progressive stain to a regressive stain by adding clarifier to the lineup (Using a Linistat stainer), and we got better contrast on the slides.

I already was diluting the eosin heavily with 100% alcohol, and I still am, and tried more water rinses and little tweaks in the protocol, and so the very best we had achieved was the progressive slide on the left, and after adding clarifier to the mix, you can see there's a slightly better contrast.

It's more obvious when you look in more closely, and in the depth, more so than in the epidermis.

[thatmohstech]

Basal cell carcinoma, nice and obvious!

This is a first stage Mohs layer

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Basal cell carcinoma with H&E and toluidine blue

[thatmohstech]

Piece of a right helix with cartilage stained with toluidine blue, 8 microns 4x objective

I've had the best luck using SlideMate Plus Slides particularly in the Mohs lab both for cartilage and for IHC. I've tried other brands of charged slides that didn't work as well.

When I have cartilage, I put the slides on a hot plate on its lowest setting for 1-2 minutes (not much more!!! Or else the Oct bakes), then put them in 100% for 1 minute, a quick dip in water, and then I continue the H&E stain from the hematoxylin (or go into T. Blue)

[thatmohstech]

Heart shaped first layer lol

Valentine's day themed mohs surgery

[thatmohstech]

Infiltrative basal cell carcinoma in a first stage Mohs layer stained with H&E and toluidine blue at 2X

Notice the epidermal layer in the top right corner

[thatmohstech]

A section of cartilage (second stage Mohs layer) stained with both toluidine blue and hematoxylin and eosin

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Nodular basal cell carcinoma in a first stage Mohs layer

[thatmohstech]

Nodular basal cell carcinoma stained with toluidine blue

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BCC in a first stage Mohs layer

[thatmohstech]

We had a big one today!

[thatmohstech]

Showing off a nine stage Mohs case. Yes one case at one site that went on for 9 stages. Basal cell carcinoma

[thatmohstech]

Your cryostat after doing 12 Mohs in one day lol.

Just kidding, it is not normal for my cryostat to cry for help. I submitted a service ticket. Hopefully it's not serious.

[thatmohstech]

Basal cell carcinoma in a first stage Mohs layer processed whole mount. The cancer is close to the bottom, on the right side of the separation/the 'nick' in the tissue

[thatmohstech]

Slow Mohs specimen during grossing - I already split it into four pieces and inked it the way I usually ink them at this hospital.

I put red ink on the face of the margin, then tell the pathology lab to place the red ink facing down. I also do them an extra, and after the specimen gets accessioned, i draw a map of how i grossed it, and how the inks are, and tell them to put the red ink facing down during embedding, and I write the accession number on it, and leave it by the embedding centers, so that way the embedders see it right away.

[thatmohstech]

Inflammation in a first stage mohs layer whole mount with toluidine blue and H&E

2x view