The document discusses tissue fixation, which is the first step in preparing tissue for microscopic examination. It aims to prevent decomposition of tissues after removal from the body through chemical and physical processes. This involves using fixatives to preserve tissues in a lifelike state. Several types of fixatives are described including aldehydes, oxidizing agents, and mercurials. The effects of fixation on different cell components and factors affecting fixation are also outlined. A variety of fixatives commonly used in histopathology are then classified and their formulations and uses explained.
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Fixatives
1. By – Dr. Snigdha Das
Moderator–Dr.Veena Vidya Shankar
2. 1. Introduction
2. Aim
3. Purpose
4. Effects of fixation
5. Reaction
6. Factors involved in fixation & methods
7. Classification of fixatives
8. Agents used in fixation
9. Secondary fixation
10. Post chromatization
11. Summary & References
3. Preparation of tissues for microscopic examination,
through a series of processes namely fixation,
dehydration, clearing, embedding, cutting and
staining.
Tissues decompose when removed from the
body or it is cut off from the blood supply –
Autolysis and Putrefaction
4. ï‚ž Process by which the constituents of the cells
and therefore of the tissues are fixed in a
physical, partly also in a chemical state so that
they will withstand the subsequent treatment with
various reagents with minimum of loss ,
distortion or decomposition.
Fixation is the foundation for the subsequent
stages in the preparation of the sections
5. ï‚ž Complex series of chemical events which differs
for different groups of substances found in
tissues.
6. ï‚ž Dissecting table made up of hard wood with a working
surface area of 45 35 cm
ï‚ž Wood- actual cutting surface
ï‚ž Rubber pads of various dimensions- suitable
ï‚ž Instrument- thin bladed knives 20-30 cm in length,
scissors, probes, scalpels, stainless-steel rule,
forceps, sponges
ï‚ž First-aid box & eye-wash bottle
ï‚ž Cutting board & instruments should be cleaned before
procedures
ï‚ž Powdering of the gloves & washing of the gloved
hands before dissection
7. ï‚ž Fixation of tissue- as soon as possible after death or
removal from the body
ï‚ž Screw capped specimen jars containing appropriate
fixatives – in OT, post-mortem room, animal house
ï‚ž Amount of fluid in the jars- 15-20 times
ï‚ž Early dispatch of the specimens to histology laboratory
ï‚ž Tissues should be washed in physiological saline
ï‚ž Excessive blood & mucous should not be there
ï‚ž Tissues selected for sectioning should be sufficiently
thin to be adequately fixed throughout a reasonable
time
ï‚ž Best thickness- 3-5mm
8. ï‚— Preservation of cells &
tissue constituents in a
condition identical to that
existing during life.
ï‚— To do this in a manner that
will allow preparation of
thin, stained sections.
9. 1. To prevent autolysis,
bacterial decomposition &
putrefaction.
2. To coagulate the tissue as
to prevent loss of easily
diffusible substances.
3. To fortify the tissue against
deleterious effects of further
stages.
4. To facilitate differential
staining with dyes & other
reagents.
10. 1. Inhibition of autolysis &
putrefaction
2. Preservation
3. Hardening
4. Solidification of colloid
material
5. Optical differentiation
6. Effect on staining
11. ï‚ž Produces immediate death of cells (life like
appearances)
ï‚ž Prevents autolysis & putrefaction
ï‚ž Reacts rapidly & completely with the tissue
ï‚ž Fixes all the constituents of the tissue
ï‚ž Neither shrinks nor swells
ï‚ž Makes the specimen hard enough
ï‚ž Raises refractive indices
ï‚ž Provides full range of staining methods with great
selectivity
12. ï‚ž No rigid upper limit of fixing time
ï‚ž No tendency to deteriorate
ï‚ž Easily prepared
ï‚ž Cheap, safe to handle
ï‚ž Non-toxic, stable
ï‚ž Non-inflammable & non-irritant
ï‚ž Should penetrate a tissue quickly
ï‚ž Cause minimum physical and chemical
alteration of the tissue and its components.
13. ï‚ž As such no ideal fixative.
ï‚ž Choice depends on the cell or tissue
constituent to be demonstrated
14. 1. Proteins:
ï‚— Cross links are formed
between proteins.
ï‚— Soluble proteins are fixed to
structural proteins- insoluble-
mechanical strength-allowing
subsequent maneuvers.
ï‚— Formaldehyde -reversible.
ï‚— Gluteraldehyde -rapid &
irreversible.
ï‚— React with basic amino-acid
residues
15. 2. Nucleic acid:
ï‚— Fixation brings a change in the physical &
chemical state of RNA & DNA.
ï‚— Uncoiling of DNA & RNA occurs with formalin
when heated to 45ËšC & 65ËšC respectively.
16. 3. Lipids:
ï‚— Phospholipids are fixed by aldehydes.
ï‚— Formaldehyde reacts with unsaturated fatty acids
hence less lipid can be demonstrated in tissue stored in
it for a long time.
ï‚— Mercuric chloride reacts with lipids to form complexes.
 Ultrastructural demonstration of lipids – post fixing in
imidazole-osmium tetroxide.
17. ï‚ž Carbohydrates are more water soluble- difficulty
in total preservation
ï‚ž They bind with fixed protein
ï‚ž So the fixatives which are used for proteins, can
be used for carbohydrate preservation.
ï‚ž Fixed protein traps carbohydrates.
ï‚ž Glycogen not bound to protein- fixed protein
form lattice around glycogen to preserve it
ï‚ž Glycogen are more demonstrable in liver cells
18. 1. Buffers & hydrogen ion
concentration:
ï‚— Best fixation occurs between pH
6-8
 Buffers used – phosphate, s-
collidine, bicarbonate,
2. Temperature:
 Most tissues fixed– room temp
ï‚— Electron microscopy &
histochemistry – 0-4˚C
3. Penetration of tissues:
ï‚— Blocks should be small or thin to
ensure adequate penetration.
19. 4. Volume changes:
ï‚— Due to inhibition of respiration, membrane
permeability changes, changes in ion transport
through membrane.
ï‚— Tissues fixed in formaldehyde & embedded in
paraffin shrink by 33%
5. Osmolality of fixative:
 Hypertonic solutions – cell shrinkage
 hypotonic solutions – swelling of cells & poor
fixation.
 Best – slightly hypertonic solutions.
20. 6. Substances to vehicle:
ï‚— Adding substances to fulfill certain functions.
ï‚— Denaturing effects, some stabilize proteins.
ï‚— Eg. Sodium chloride & sodium sulphate
used with mercuric chloride.
ï‚— Tannic acid enhances fixation of lipids &
proteins in EM
7. Concentration of fixatives:
ï‚— Different concentrations have different
effects on morphology.
ï‚— Effects subsequent staining
21. 8. Duration of fixation:
 Formalin – 2-6hours
 Electron microscopy – 3 hours
 Formaldehyde – prolonged fixation – shrinkage &
hardening of tissue.
 Gluteraldehyde – prolonged fixation – advantageous.
ï‚— Long fixation in aldehydes - inhibits enzyme activity.
 Long fixation in oxidizing fixatives – degrade the
tissue.
22. ï‚ž Immersion/ in vitro fixation
ï‚ž Perfusion/ in vivo fixation
ï‚ž Perfusion-immersion
ï‚ž Heat fixation
23. 1. Aldehydes: formaldehyde, gluteraldehyde, acrolein
2. Oxidizing agents: osmium tetroxide, potassium
permanganate, potassium dichromate
3. Protein denaturing agents: acetic acid, methyl
alcohol, ethyl alcohol
4. Other cross linking agents: carbodiimides
5. Physical: heat, microwave
6. Unknown mechanism: mercuric chloride, picric
acid
7. HOPE fixatives: formalin like morphology, good
protein antigenicity for enzyme histochemistry, good
for RNA & DNA yeilds
General classification
24. ï‚ž Aldehydes (cross linking agents)- act by creating
covalent chemical bonds between proteins of tissues-
anchor the insoluble compound to cytoskeleton-protect
secondary as well as tertiary structure of protein-
provide mechanical strength/ additional rigidity to
tissue structure.
ï‚ž Oxidizing agents- joins with various side chains of
protein molecules & other biomolecules- allow
formation of cross link- stabilizes tissue structure
25. ï‚ž Protein denaturing agents: reduce the solubility of
protein without combining with it & disrupts the
hydrophobic bonds which is needed for its tertiary
structure to form.
ï‚ž Mercurials (B5 fixatives): it increases the staining
brightness & give good nuclear detail. Good for
reticulo-endothelial tissue & haemo-poetic tissue.
ï‚ž Picrates:binds with histone & basic proteins to form
crystalline picrates with amino acid & precipitates
protein.
26. ï‚— Gas soluble in water up to
40% by wt.
ï‚— Available as 40%
formaldehyde or formalin.
 Stabilizer – 10-14%
methanol
ï‚— 10% formalin
ï‚— Acidic solution.
ï‚— On storage becomes
acidic by formation of
formic acid.
ï‚— Colourless.
ï‚— Turbid on keeping -
paraformaldehyde.
27.  Yellow – contaminated
with ferric iron from metal
containers. Positive
prussian blue reaction.
ï‚— fixes protein, lipids well
preserved.
ï‚— Favors staining of acidic
structures like nuclei with
basic dyes
ï‚— Diminishes effect of acid
dyes on basic structures
like cytoplasm.
28. ï‚ž Formalin is cheap
ï‚ž Easy to prepare
ï‚ž Relatively stable
ï‚ž Frozen sections can be prepared with ease.
ï‚ž Staining of fat and tissue enzymes.
ï‚ž Penetrates tissues well.
ï‚ž Beneficial hardening with little shrinkage
29. ï‚ž Natural tissue colors are retained.
ï‚ž Does not require washing before processing.
ï‚ž Best fixative for nervous system
31. ï‚— Brown, granular material,
extracellular, birefringent
ï‚— Progressive in deposition
ï‚— Often seen after several
days
ï‚— Action of acid formalin on
blood
ï‚— Avoided by using
buffered formalin.
 Removed – treatment
with saturated alcoholic
solution of picric acid for
20mins
32. ï‚— Peculiar artifact seen in sections fixed in formal saline &
stained with H&E.
ï‚— Complete or partial failure of nuclei to stain with
haematoxylin – take up eosin – loss of nuclear margin
distinction.
 Lymphoid & epithelial tissue – most distinct
ï‚— Patchy distribution
ï‚— Avoided by using - 2% acetic acid in 10% formalin
 When present – treat with 1% hydrochloric acid in
absolute alcohol for 1 hour before staining with H&E.
33. ï‚— Used for Electron
Microscopy with osmium
tetroxide
ï‚— Advantage:
ï‚— Most efficient cross linking
agent for collagen
ï‚— More rapid fixation than
formalin.
ï‚— Disadvantage:
ï‚— Poorer penetration
ï‚— False positivity with PAS
ï‚— More costly
34. ï‚— White crystalline substance.
ï‚— Powerful protein precipitant,
fixes both nucleus &
cytoplasm well favoring its
staining.
ï‚— Conjunction with other
fixatives.
ï‚— Adv: rapidly penetrates &
hardens tissue, radio-opaque
ï‚— Disadv: Extremely
poisonous & corrosive to
metals.
ï‚— Intolerant fixative.
ï‚— Pollution to environment.
35.  Mercury pigment –
brown to black granular
deposit.
ï‚— Treatment-
1. Place section in 0.5%
iodine in 80% alcohol for
3mins
2. Rinse in water
3. Place in 3% aqueous
sodium thiosulphate for
3mins
4. Wash in running water
for 1-2mins
36. ï‚ž Bright yellow
crystalline
substance.
ï‚ž Damped with water
because of
explosive
properties.
ï‚ž Enhances
cytoplasmic
staining.
ï‚ž Acts as mordant
ï‚ž Much shrinkage but
little hardening.
37. ï‚— Orange crystalline
substance
 Less acidic pH – fixes
cytoplasm &
mitochondria
 More acidic pH – fixes
nucleus & cytoplasm
ï‚— Mordant
ï‚— Wash in running water
after to prevent formation
of insoluble precipitate.
ï‚— Prolonged exposure
causes tissue to become
brittle.
38. ï‚ž Dark red crystals of
anhydride.
ï‚ž Powerful oxidizing agent,
ï‚ž Requires washing with
running water.
39. ï‚ž Pale yellow.
ï‚ž Demonstrates lipid like
myelin.
ï‚ž Excellent preservation of
detail of single cells hence
used for EM.
ï‚ž Uneven penetration for
pieces more than 2-3mm
ï‚ž Storage in dark, cool place
ï‚ž Vapour is irritating, causes
conjunctivitis
ï‚ž Uneven fixation
40. ï‚ž Colour-less liquid with
pungent odour.
ï‚ž Used in compound fixatives
ï‚ž Swells collagen fibres
ï‚ž Precipitates nucleoproteins
ï‚ž Solvent action on
cytoplasmic granules.
41. ï‚— Colour-less.
ï‚— Powerful dehydrating
agent.
ï‚— Causes shrinkage &
hardening
ï‚— Coagulates protein but not
nucleoprotein.
ï‚— Precipitates glycogen.
ï‚— Used in histochemical
method for enzymes.
43. 1. Micro-anatomical fixatives:
When anatomy of tissues with correct relationship of
tissue layers & large aggregate of cells is to be
preserved.
2. Cytological fixatives:
To preserve constituent elements of cells.
Elements being preserved at the expense of
penetration, ease of cutting & loss of other cell
structures.
3. Histochemical fixatives:
When histochemical tests are to be applied.
44. I. Routine formalin fixatives:
1. 10% Formol-Saline:
ï‚— 10% formalin in 0.9% sodium chloride.
ï‚— Layer of marble chips/calcium carbonate added to
neutralize formic acid production.
2. Buffered Formalin:
 Formalin – 10ml
ï‚— Acid sodium phosphate monohydrate 0.4g
ï‚— Anhydrous disodium phosphate 0.65g
ï‚— Water to 100ml
45. 3. Formol Calcium(Baker)
 Formalin – 10ml
 Calcium chloride – 2g
 Water – 100ml
ï‚— Chloride preserves
phospholipids
4. Formol Calcium(Lillie)
ï‚— Acetate instead of chloride
ï‚— Easily prepared
ï‚— Widely used for routine
fixation.
46. II. FORMALIN FIXATIVES FOR CARBOHYDRATES:
1. Buffered Gluteraldehyde
2. Heidenhain’s Susa:
 Mercuric chloride – 4.5g
 Sodium chloride – 0.5g
 Trichloroacetic acid – 2g
 Acetic acid – 4ml
 Formalin – 20ml
ï‚— Distilled water to 100ml
 Adv – Excellent fixative for routine biopsy work.
ï‚— Brilliant staining with good cytological detail.
ï‚— Rapid penetration, minimum shrinkage
 Disadv – intolerant fixative
ï‚— Transfer to absolute alcohol is required
47. 3. Zenker’s fluid:
 Mercuric chloride – 5g
 Potassium dichromate – 2.5g
 Sodium sulphate – 1g
ï‚— Distilled water to 100ml
 Glacial acetic acid immediately before use – 5ml
 Adv – rapid & even penetration
beneficial effect on cytologic, nuclear
chromatin & fibre stain
ï‚— Wash in running water.
ï‚— Fixation complete in 12hours
48. ï‚ž Distilled water 100 ml
ï‚ž Potassium dichromate 2.5g
ï‚ž Sodium sulphate 1g
ï‚ž Mercuric chloride 5g
ï‚ž 5ml of 40% formaldehyde before use
ï‚— Formalin instead of acetic acid.
ï‚— Excellent fixative for bone marrow, spleen
 Aka Spuler’s or Maximow’s fluid
49. 7. Bouin’s fluid:
 Picric acid – 75ml
 Formalin – 25ml
 Glacial acetic acid – 5ml
ï‚— Rapid & even peneration
ï‚— Fixed tissue gives brilliant
staining with trichome
methods
ï‚— Used to demonstrate
glycogen.
ï‚— Good for GIT biopsies
52. 2. Flemming fluid:
ï‚— Only 5-10 times of tissue bulk is required.
ï‚— Used as secondary fixative for myelin following
primary formalin fixation.
3. Newcomer’s fluid:
ï‚— Fixation of chromosomes
 Preserves chromatin better than Carnoy’s.
53. II. CYTOPLASMIC FIXATIVES:
1. Champy’s fluid:
ï‚— Should be freshly prepared.
ï‚— Poor & uneven penetration
ï‚— Preserves mitochondria, fat, yolk, lipids
ï‚— Preferred for mitochondria
2. Regaud’s fluid – mitochondria & chromaffin
tissue
3. Muller’s fluid – bone specimens
4. Zenker Formol
5. Schaudinn’s fluid – For wet smears
54. ï‚— Preserve the constituent to be demonstrated & its
morphological relationships.
ï‚— Without affecting the reactive groups & reagent to be
used in its visualization.
 Best – cryostat cut sections of rapidly frozen tissue.
ï‚— Formol saline
 Cold acetone – where enzymes are to be studied
especially phosphatases
ï‚— Absolute alcohol
ï‚— Vapour fixatives like formaldehyde, acetaldehyde,
gluteraldehyde, acrolein to fix cryostat cut sections of
fresh tissue & blocks of frozen dried tissue
55. ï‚ž Urgent paraffin section
Thin slices are fixed in alcohol containing
fixatives Carnoy’s , formol alcohol
ï‚ž Enzyme Histochemistry-
Fix in cold formol calcium
ï‚ž Transmission Electron Microscopy
Osmium tetroxide, glutaraldehyde.
ï‚ž Electron microscopy - 2% glutaraldehyde
 Immunoflourescence – unfixed cryostat
56. tissue Time interval fixative
Adrenal gland 1 or 2 hr Formaldehyde
eye Immediately after
death or within 2
hrs
Formol saline
Alimentary tract Immediately after
death
Susa fixative
Blood forming organ -do- Zenker’s fluid
Testis/ovary -do- Susa fixative
Lung/kidney/bone Fairly resistant to
postmortem
changes
Susa fixative
Renal biopsy Neutral buffer
formalin
58. ï‚ž Tissues fixed with 2 fixatives in succession.
ï‚ž Improved preservation & staining.
 Tissues fixed in buffered formalin – fixed with mercuric
chloride.
ï‚ž Tissues fixed with gluteraldehyde is post fixed with
osmium tetroxide for electron microscopy.
59. ï‚ž Treatment of tissues with 3% potassium dichromate
following normal fixation.
 Before processing – tissue in dichromate solution for 6-
8days
 After processing – for 12- 24 hrs
ï‚ž Both followed by washing in running water
ï‚ž Employed to mordant tissues.
ï‚ž Mitochondria & myelin demonstrated.
ï‚ž Improved preservation and staining of elements.
62. ï‚ž Formalin is used for all routine surgical
pathology and autopsy tissues when an
H & E slide is to be produced.
ï‚ž Formalin is the most forgiving of all
fixatives when conditions are not ideal.
ï‚ž B5 fixatives are recommended for reticulo-
endothelial tissues including lymph
nodes, spleen, thymus, and bone marrow.
63. ï‚ž Bouin's solution is recommended for fixation
of testis, general fixative for connective
tissue stains.
ï‚ž Glutaraldehyde is recommended for fixation of
tissues for electron microscopy.
ï‚ž Alcohols, specifically ethanol, are used primarily
for cytologic smears.
64.  Bouin’s fluid- embryo fixation
ï‚ž Commercially 40% by volume
ï‚ž 37% by weight
ï‚ž Dessication- to study inorganic components
ï‚ž Post fixation- softening by 4% phenol for 3-4
days- for better cut sections of tumours
ï‚ž Secondary fixation- to prevent hardening effect
ï‚ž Phenoxitol- ideal fixative, but very costly