Standard techniques for formalin-fixed paraffin-embedded tissue: A Pathologist’s perspective

Abstract

Histopathology considered as an essential keystone to understanding diseases on a cellular level, without examining affected tissues and cells; will lack the accurate diagnosis. The most common protocol that used worldwide for histopathology is termed as formalin-fixed paraffin-embedded techniques; this protocol is the oldest protocol and still used, this technique not invented once, but it is started with a simple process of tissue fixation then undergo several successful steps as it's known today. This protocol depends on formalin to induce tissue fixation and preservation simultaneously, followed by a series of steps to facilitate infiltration of hot paraffin wax in the cells to adjust the density of tissue similar to that of paraffin wax to support tissue during sectioning process at few micrometers of thickness. Many protocols have been invented and modified subsequently to increase the accuracy of tissue processing and facilitate their study under light microscopy. Additionally, the formalin-fixed and paraffin-embedded samples can be considered the most durable process till now. In this review, we are trying to view all fundamental aspects of classical tissue processing that was depended since 1850s, starting from tissue examination, sampling, accessory, labelling, fixation, dehydration, clearance, infiltration, and embedding with hot paraffin wax. Additionally, explain the routine sectioning and staining with classical Hari’s hematoxylin and alcoholic eosin staining protocol.

Keywords

• histopathology
• formalin
• paraffin
• hematoxylin
• eosin