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Agar pre-embedding of small skin biopsies: real-life benefits and challenges in high throughput pathology laboratories
  1. Mara Ridolfi1,
  2. Michele Paudice1,
  3. Sandra Salvi2,
  4. Luca Valle3,
  5. Marina Gualco2,
  6. Antonio Perasole4,
  7. Luca Anselmi5,
  8. Roberto Fiocca3,6,
  9. Luca Mastracci3,
  10. Federica Grillo3
  1. 1 Department of Surgical Sciences and Integrated Diagnostics (DISC), Univeristy of Genoa, Genoa, Italy
  2. 2 Anatomic Pathology, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
  3. 3 Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), Univeristy of Genoa, Genoa, Italy
  4. 4 Anatomic and Cytopathology, Az. ULSS 8 Berica, Regione Veneto, Ospedale San Bortolo, Vicenza, Italy
  5. 5 Anatomic Pathology, ASL 3, Ospedale Villa Scassi, Genoa, Italy
  6. 6 Ospedale Policlinico San Martino IRCCS, Genoa, Italy
  1. Correspondence to Dr Federica Grillo, Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa and Ospedale Policlinico San Martino IRCCS, Genoa 16132, Italy; federica.grillo{at}


Paraffin embedding of small, thin tissue samples requires specific expertise for optimal orientation before tissue sectioning. This study evaluates the real-life utility of the agar pre-embedding technique for small skin biopsies with regards to lengthening of work times, problems in orientation (re-embedding) and ancillary techniques (immunohistochemistry and in situ hybridisation) between two high work flow pathology laboratories, one of which routinely uses the agar pre-embedding technique and one which does not. The mean time required for pre-embedding in agar was 30.4 s, but time for paraffin embedding for agar pre-embedded samples was shorter than the traditional method (177 vs 296 s; p<0.005). The number of skin samples requiring re-embedding was significantly higher with the traditional embedding method (p<0.005). No problems in immunoreactivity were observed in all 1900 reactions performed with 17 different antibodies. Fluorescence in situ hybridisation analysis was optimised with a prolonged protease K incubation time (21 vs 18 min).

  • dermatopathology
  • histopathology
  • immunohistochemistry
  • in situ hybridisation
  • laboratory management

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  • MR, MP, LM and FG contributed equally.

  • Handling editor Dhirendra Govender.

  • Contributors MR, MP, LV: collected the data. SS: performed the FISH analysis. MG, AP, LA: performed the agar pre-embedding at cut up. RF: critically revised the manuscript. FG, LM: wrote the manuscript and devised the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.