CC BY-NC-ND 4.0 · J Lab Physicians 2020; 12(04): 271-275
DOI: 10.1055/s-0040-1722546
Original Article

Histomorphological Assessment of Formalin versus Nonformalin Fixatives in Diagnostic Surgical Pathology

Jayaprakash Kubalady Shetty
1   Department of Pathology, K. S. Hegde Medical Academy, Nitte (Deemed to be University), Mangaluru, Karnataka, India
,
Hannah Fathima Babu
1   Department of Pathology, K. S. Hegde Medical Academy, Nitte (Deemed to be University), Mangaluru, Karnataka, India
,
Kishan Prasad Hosapatna Laxminarayana
1   Department of Pathology, K. S. Hegde Medical Academy, Nitte (Deemed to be University), Mangaluru, Karnataka, India
› Author Affiliations
Funding This study was funded by ICMR for Short Term Studentship project.

Abstract

Introduction Fixation is the critical step in the preservation of tissues in diagnostic pathology. The formalin is an economical and excellent fixative with the inherent property of adequate fixation. The well-established side effects of formalin include mucosal irritation, upper respiratory diseases, and corrosive injury to the gastrointestinal tract. In addition, substantial evidence exists regarding the potential role of formaldehyde as a human carcinogen. The carcinogenic and toxic effects of formalin encourage searching for alternative fixatives for tissue fixation. However, “the formalin dogma” has severely hampered the search for alternative fixatives for many years.

Material and Methods Ninety tissues of liver and skeletal muscle obtained during autopsies were immersed in adequate amounts of the following fixatives: formalin (10%), methyl alcohol (70%), and acetone (100%). The comparison among the three was made based on time for fixation, preservation of tissue architecture, cell borders, cytoplasm, nuclear contours, chromatin texture, and uniformity of staining.

Results The tissue preserved in formalin undergoes rapid fixation compared with alcohol and acetone. The tissue architecture, cell border characteristics of alcohol and acetone was found satisfactory compared with formalin. The cytoplasm and nuclear contour were superior with the formalin. The chromatin texture and uniformity of staining were similar with all the three fixatives.

Conclusion The formalin is considered superior to most of the parameters, whereas both methyl alcohol and acetone showed nearly equivalent scores. Hence, owing to the potential human health hazards and carcinogenicity of formalin, no rational reasons hamper the complete substitution of formalin with alternative fixatives such as alcohol and acetone in diagnostic pathology and medical research.



Publication History

Article published online:
30 December 2020

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  • References

  • 1 Bardana Jr EJ, Montanaro A. Formaldehyde: an analysis of its respiratory, cutaneous, and immunologic effects. Ann Allergy 1991; 66 (06) 441-452
  • 2 Bostwick DG, al Annouf N, Choi C. Establishment of the formalin-free surgical pathology laboratory. Utility of an alcohol-based fixative. Arch Pathol Lab Med 1994; 118 (03) 298-302
  • 3 Carleton HM, Drury RAB, Wallington EA. Carleton's Histological Technique. 5th ed. Oxford; New York: Oxford University Press; 1980: 520 p
  • 4 Cogliano VJ, Grosse Y, Baan RA, Straif K, Secretan MB, El Ghissassi F. Working Group for Volume 88. Meeting report: summary of IARC monographs on formaldehyde, 2-butoxyethanol, and 1-tert-butoxy-2-propanol. Environ Health Perspect 2005; 113 (09) 1205-1208
  • 5 Eltoum I, Fredenburgh J, Myers RB, Grizzle WE. Introduction to the theory and practice of fixation of tissues. J Histotechnol 2001; 24 (03) 173-190
  • 6 Lillie RD, Fullmer HM. Histopathologic Technic and Practical Histochemistry. 4th ed. New York: McGraw-Hill; 1976: 942 p
  • 7 Loomis TA. Formaldehyde toxicity. Arch Pathol Lab Med 1979; 103 (07) 321-324
  • 8 Santovito A, Schilirò T, Castellano S. et al. Combined analysis of chromosomal aberrations and glutathione S-transferase M1 and T1 polymorphisms in pathologists occupationally exposed to formaldehyde. Arch Toxicol 2011; 85 (10) 1295-1302
  • 9 Tbakhi A, Totos G, Hauser-Kronberger C. et al. Fixation conditions for DNA and RNA in situ hybridization: a reassessment of molecular morphology dogma. Am J Pathol 1998; 152 (01) 35-41
  • 10 Thavarajah R, Mudimbaimannar VK, Elizabeth J, Rao UK, Ranganathan K. Chemical and physical basics of routine formaldehyde fixation. J Oral Maxillofac Pathol 2012; 16 (03) 400-405
  • 11 van Essen HF, Verdaasdonk MA, Elshof SM, de Weger RA, van Diest PJ. Alcohol based tissue fixation as an alternative for formaldehyde: influence on immunohistochemistry. J Clin Pathol 2010; 63 (12) 1090-1094
  • 12 Zanini C, Gerbaudo E, Ercole E, Vendramin A, Forni M. Evaluation of two commercial and three home-made fixatives for the substitution of formalin: a formaldehyde-free laboratory is possible. Environ Health 2012; 11 (01) 59 [Internet]