Gastrointestinal biopsies: more action and less ‘chatter’?

‘Chatter’ is a histologic artifact which can obscure morphology, sometimes precluding histopathologic diagnosis. Chatter in gastrointestinal (GI) biopsies is a particular challenge in many laboratories. This departmental quality assurance initiative sought to determine (1) the prevalence of chatter in GI biopsies, (2) its relationship to histotechnologist, section level and anatomic site, and (3) the effectiveness of education and technical adjustments in reducing its rate. A gastrointestinal pathologist evaluated 660 randomly selected slides for chatter artifact. Biopsy site, level (slide 1,2 or 3) and sectioning histotechnologist were recorded. Histotechnologists completed a questionaire on block handling and sectioning technique. The study was repeated 6 months following feedback and implementation of technical measures to reduce chatter. Moderate-to-severe chatter was present in 9.2% of slides (61/660), with wide variation between the 11 histotechnologists (range 0-19%). All four histotechnolo...