To the editor: The recent manuscript by Murakata et al studying acrylic polyamide plastic embolization materials nicely illustrates the struggle and histological maneuvers pathologists employ for identification of foreign material in tissue sections.1 Interventional intravascular procedures are becoming more common and it is not unusual to find such material in routine surgicals and autopsies. Often, as the authors point out, little useful clinical history accompanies the patient or surgical specimen to help us.
I wish to bring attention to the readership an article that has proved invaluable for assessment of such material. Dr Walley and co-workers have published an atlas like article depicting the histology and special stain appearances of 130 foreign materials.2 New devices and materials are introduced everyday, but many of these are still composed of prior materials. Nature and the environment also provide us with many inadvertent pick ups and foreign material introduction into our sections despite our care.
Most of us do not have easy access to infrared microspectroscopy or even scanning electron microscopy. Judicious routine and special stains with reference to such an article may prove of use.
References
Murkata LA, Lewin-Smith MR, Specht CS, et al. Characterization of acrylic polyamide plastic embolization particles in vitro and in human tissue sections by light microscopy, infrared microspectroscopy and scanning electron microscopy with energy dispersive X-ray analysis. Mod Pathol 2006;19:922–930.
Walley VM, Stinson WA, Upton C, et al. Foreign materials found in the cardiovascular system after instrumentation or surgery (Including a guide to their light microscopic identification). Cardiovasc Pathol 1993;2:157–185.
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Veinot, J. Foreign material identification. Mod Pathol 19, 1519 (2006). https://doi.org/10.1038/modpathol.3800703
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DOI: https://doi.org/10.1038/modpathol.3800703