[{"id":10403,"date":"2023-12-11T08:38:09","date_gmt":"2023-12-11T08:38:09","guid":{"rendered":"https:\/\/vospan.com\/?p=10403"},"modified":"2023-12-11T08:38:09","modified_gmt":"2023-12-11T08:38:09","slug":"mot-so-van-de-thuong-gap-khi-nhuom-hematoxylin-eosin-he","status":"publish","type":"post","link":"https:\/\/vospan.com\/mot-so-van-de-thuong-gap-khi-nhuom-hematoxylin-eosin-he\/","title":{"rendered":"M\u1ed9t s\u1ed1 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p khi nhu\u1ed9m Hematoxylin & Eosin (H&E)"},"content":{"rendered":"
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Nhu\u1ed9m H&E<\/a> l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p t\u01b0\u01a1ng \u0111\u1ed1i \u0111\u01a1n gi\u1ea3n \u0111\u1ec3 th\u1ef1c hi\u1ec7n, nh\u01b0ng c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 c\u00f3 th\u1ec3 g\u1eb7p ph\u1ea3i v\u00e0 t\u1ea1o ra c\u00e1t l\u00e1t m\u00f4 kh\u00f4ng \u0111\u1ea1t ch\u1ea5t l\u01b0\u1ee3ng.<\/p>\n

M\u1ed9t s\u1ed1 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p khi nhu\u1ed9m H&E<\/a><\/strong><\/h2>\n

C\u1eaft l\u00e1t m\u00f4 \u0111\u00f3ng vai tr\u00f2 thi\u1ebft y\u1ebfu \u0111\u1ec3 c\u00f3 \u0111\u01b0\u1ee3c m\u00f4 nhu\u1ed9m ch\u1ea5t l\u01b0\u1ee3ng. Hi\u1ec7n nay, nhi\u1ec1u ph\u00f2ng th\u00ed nghi\u1ec7m \u0111\u00e3 th\u1ef1c hi\u1ec7n c\u1eaft m\u00f4 tr\u00ean m\u00e1y c\u1eaft l\u00e1t ti\u00eau b\u1ea3n t\u1ef1 \u0111\u1ed9ng, \u0111i\u1ec1u n\u00e0y kh\u00f4ng ch\u1ec9 mang \u0111\u1ebfn nh\u1eefng l\u00e1t m\u00f4 \u0111\u1ec1u, nh\u1ea5t qu\u00e1n m\u00e0 c\u00f2n an to\u00e0n cho ng\u01b0\u1eddi s\u1eed d\u1ee5ng.<\/p>\n

\"Figure
H\u00ecnh 1.<\/strong> S\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 m\u00e0u s\u1eb5n gi\u1eefa hai ph\u1ea7n m\u00f4 gi\u1ed1ng nhau<\/figcaption><\/figure>\n<\/div>\n
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\"H\u00ecnh
H\u00ecnh 2.<\/strong> C\u00e1c ph\u1ea7n d\u00e0y v\u00e0 m\u1ecfng \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y trong c\u00f9ng m\u1ed9t ph\u1ea7n m\u00f4<\/figcaption><\/figure>\n<\/div>\n
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\"H\u00ecnh
H\u00ecnh 3.<\/strong> V\u1ebft n\u1ee9t nh\u1ecf trong ph\u1ea7n ru\u1ed9t k\u1ebft<\/figcaption><\/figure>\n<\/div>\n
C\u00e1c ph\u1ea7n m\u00f4 n\u1ee9t li\u00ean quan \u0111\u1ebfn qu\u00e1 tr\u00ecnh x\u1eed l\u00fd m\u00f4<\/a> k\u00e9m. C\u00f3 th\u1ec3 d\u1ec5 d\u00e0ng nh\u1eadn th\u1ea5y m\u1ed9t d\u1ea5u hi\u1ec7u kh\u00e1c v\u1ec1 c\u00e1c m\u00f4 \u0111\u01b0\u1ee3c x\u1eed l\u00fd qu\u00e1 m\u1ee9c khi nh\u00ecn v\u00e0o c\u00e1c t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u (RBC) trong m\u1ea1ch.<\/div>\n
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\"H\u00ecnh
H\u00ecnh 4.<\/strong> V\u1ebft n\u1ee9t c\u1ee7a h\u1ed3ng c\u1ea7u \u1edf \u0111\u1ed9 ph\u00f3ng \u0111\u1ea1i th\u1ea5p h\u01a1n<\/figcaption><\/figure>\n<\/div>\n
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N\u01b0\u1edbc th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0m ch\u1ea5t ph\u00e2n bi\u1ec7t eosin v\u00ec n\u00f3 c\u00f3 th\u1ec3 lo\u1ea1i b\u1ecf eosin th\u1eeba ra kh\u1ecfi ti\u00eau b\u1ea3n. C\u1ed3n kh\u1eed n\u01b0\u1edbc v\u00e0 c\u1ed3n 100% \u0111\u1ea7u ti\u00ean c\u00f3 th\u1ec3 ch\u1ee9a \u0111\u1ee7 n\u01b0\u1edbc \u0111\u1ec3 l\u00e0m nh\u1ea1t eosin v\u00e0 ph\u00e2n bi\u1ec7t r\u00f5 h\u01a1n eosin. Qu\u00e1 nhi\u1ec1u b\u01b0\u1edbc s\u1ebd l\u00e0m m\u00e0u c\u1ee7a eosin nh\u1ea1t h\u01a1n v\u00e0 l\u00e0m m\u1edd c\u1ea5u tr\u00fac t\u1ebf b\u00e0o ch\u1ea5t.<\/p>\n

Trong khi nhu\u1ed9m, n\u01b0\u1edbc c\u00f3 th\u1ec3 th\u1ea5m v\u00e0o r\u01b0\u1ee3u (theo eosin) do s\u1ef1 chuy\u1ec3n m\u00e0u gi\u1eefa c\u00e1c b\u01b0\u1edbc. Khi thu\u1ed1c th\u1eed kh\u00f4ng \u0111\u01b0\u1ee3c thay th\u01b0\u1eddng xuy\u00ean, h\u00e0m l\u01b0\u1ee3ng n\u01b0\u1edbc s\u1ebd ti\u1ebfp t\u1ee5c t\u0103ng v\u00e0 s\u1ebd \u0111\u01b0\u1ee3c chuy\u1ec3n sang c\u00e1c xylen ti\u1ebfp theo tr\u01b0\u1edbc khi ph\u1ee7 l\u00ean. L\u01b0\u1ee3ng n\u01b0\u1edbc th\u1eeba trong xylen n\u00e0y theo th\u1eddi gian c\u00f3 th\u1ec3 g\u00e2y ra hi\u1ec7n t\u01b0\u1ee3ng eosin th\u1ea5m ra kh\u1ecfi m\u00f4. N\u00f3 \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y tr\u00ean ti\u00eau b\u1ea3n nh\u01b0 h\u00ecnh d\u01b0\u1edbi \u0111\u00e2y. Hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y c\u00f3 th\u1ec3 x\u1ea3y ra ngay c\u1ea3 khi xylene kh\u00f4ng b\u1ecb nhi\u1ec5m n\u01b0\u1edbc.<\/p>\n

\"H\u00ecnh
H\u00ecnh 5.<\/strong> N\u01b0\u1edbc \u1edf khu v\u1ef1c n\u00e0y \u0111\u00e3 lo\u1ea1i b\u1ecf g\u1ea7n nh\u01b0 to\u00e0n b\u1ed9 ch\u1ea5t c\u1ea3n quang c\u1ee7a t\u1ebf b\u00e0o ch\u1ea5t.<\/figcaption><\/figure>\n

T\u00f9y thu\u1ed9c v\u00e0o v\u1ecb tr\u00ed, ch\u1ea5t l\u01b0\u1ee3ng n\u01b0\u1edbc c\u00f3 th\u1ec3 kh\u00e1 kh\u00e1c nhau. Fluor h\u00f3a, \u0111\u1ed9 pH ho\u1eb7c c\u00e1c kho\u00e1ng ch\u1ea5t kh\u00e1c c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng kh\u00f4ng ch\u1ec9 \u0111\u1ebfn c\u00e1ch m\u00f4 ti\u1ebfp nh\u1eadn thu\u1ed1c nhu\u1ed9m m\u00e0 c\u00f2n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn tu\u1ed5i th\u1ecd c\u1ee7a thu\u1ed1c nhu\u1ed9m. V\u00ed d\u1ee5, v\u00ec hematoxylin c\u00f3 t\u00ednh axit nh\u1eb9 n\u00ean n\u01b0\u1edbc c\u00f3 \u0111\u1ed9 pH c\u01a1 b\u1ea3n c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u0111\u1ed9 pH c\u1ee7a hematoxylin, khi\u1ebfn n\u00f3 k\u00e9m hi\u1ec7u qu\u1ea3 h\u01a1n. N\u1ebfu ch\u1ea5t l\u01b0\u1ee3ng n\u01b0\u1edbc k\u00e9m ho\u1eb7c thay \u0111\u1ed5i th\u00ec vi\u1ec7c s\u1eed d\u1ee5ng n\u01b0\u1edbc kh\u1eed ion (DI) l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn t\u1ed1t nh\u1ea5t. Ch\u1ec9 c\u1ea7n nh\u1edb \u0111\u1ea3m b\u1ea3o \u00e1p l\u1ef1c n\u01b0\u1edbc DI \u0111\u1ee7 cho thu\u1ed1c nhu\u1ed9m.<\/p>\n

M\u00f4 \u0111\u00f4ng l\u1ea1nh c\u00f3 th\u1ec3 l\u00e0 m\u1eabu r\u1ea5t kh\u00f3 nhu\u1ed9m. Th\u1eddi gian r\u1ea5t quan tr\u1ecdng n\u00ean vi\u1ec7c r\u00fat ng\u1eafn th\u1eddi gian nhu\u1ed9m m\u00e0u cho ph\u00e9p nh\u00e0 nghi\u00ean c\u1ee9u b\u1ec7nh h\u1ecdc ph\u1ea3n h\u1ed3i nhanh ch\u00f3ng v\u1edbi nh\u00e2n vi\u00ean ph\u1eabu thu\u1eadt.<\/p>\n

Tuy nhi\u00ean, m\u1ed9t trong nh\u1eefng v\u1ea5n \u0111\u1ec1 l\u1edbn nh\u1ea5t l\u00e0 s\u1ef1 nhu\u1ed9m m\u00e0u kh\u00f4ng \u0111\u1ed3ng \u0111\u1ec1u, kh\u00f4ng li\u00ean quan \u0111\u1ebfn vi\u1ec7c c\u1eaft m\u00f4 \u0111\u00f4ng l\u1ea1nh. Nguy\u00ean nh\u00e2n \u0111\u1ea7u ti\u00ean c\u00f3 th\u1ec3 k\u1ec3 \u0111\u1ebfn \u1edf quy tr\u00ecnh c\u1ed1 \u0111\u1ecbnh m\u00f4 v\u00e0 r\u1eeda ti\u00eau b\u1ea3n tr\u01b0\u1edbc khi nhu\u1ed9m. H\u00e3y nh\u1edb r\u1eb1ng m\u00f4i tr\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 h\u1ed7 tr\u1ee3 c\u00e1c m\u00f4 \u0111\u00f4ng l\u1ea1nh trong qu\u00e1 tr\u00ecnh c\u1eaft c\u00f3 th\u1ec3 h\u00f2a tan trong n\u01b0\u1edbc v\u00e0 PH\u1ea2I \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf kh\u1ecfi m\u1eabu, kh\u00f4ng kh\u00e1c g\u00ec lo\u1ea1i b\u1ecf parafin kh\u1ecfi c\u00e1c m\u1eabu th\u00f4ng th\u01b0\u1eddng tr\u01b0\u1edbc khi nhu\u1ed9m. Ch\u1ea5t n\u00e0y th\u1eadm ch\u00ed c\u00f3 th\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a thu\u1ed1c nhu\u1ed9m gi\u1ed1ng nh\u01b0 s\u00e1p parafin. V\u00e0, kh\u00f4ng gi\u1ed1ng nh\u01b0 s\u00e1p, b\u1ea1n c\u00f3 th\u1ec3 s\u1ebd kh\u00f4ng th\u1ea5y b\u1ea5t k\u1ef3 v\u1ebft n\u00e0o c\u00f2n s\u00f3t l\u1ea1i n\u00e0o tr\u00ean ti\u00eau b\u1ea3n khi k\u1ebft th\u00fac qu\u00e1 tr\u00ecnh nhu\u1ed9m, b\u1edfi v\u00ec n\u00f3 \u0111\u00e3 b\u1ecb lo\u1ea1i b\u1ecf trong qu\u00e1 tr\u00ecnh nhu\u1ed9m.<\/p>\n

\"H\u00ecnh
H\u00ecnh 6.<\/strong> S\u1ef1 nhu\u1ed9m m\u00e0u kh\u00f4ng \u0111\u1ed3ng \u0111\u1ec1u v\u00ec parafin c\u00f2n s\u00f3t l\u1ea1i tr\u00ean m\u00f4.<\/figcaption><\/figure>\n

C\u00e1c m\u1eabu th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c nh\u00e2n vi\u00ean ph\u00f2ng th\u00ed nghi\u1ec7m thu th\u1eadp, v\u00ec v\u1eady vi\u1ec7c \u0111\u00e0o t\u1ea1o nh\u00e2n vi\u00ean l\u1ea5y m\u1eabu l\u00e0 \u0111i\u1ec1u c\u1ea7n thi\u1ebft. Thu th\u1eadp m\u1eabu b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng mi\u1ebfng g\u1ea1c, d\u1ee5ng c\u1ee5 c\u00f3 \u0111\u1ea7u b\u00f4ng ho\u1eb7c c\u00e1c thi\u1ebft b\u1ecb trung gian kh\u00e1c c\u00f3 th\u1ec3 l\u00e0m kh\u00f4 m\u1eabu. Hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y th\u01b0\u1eddng th\u1ea5y nh\u1ea5t khi sinh thi\u1ebft, \u0111\u1eb7c bi\u1ec7t khi nhi\u1ec1u m\u1eabu \u0111\u01b0\u1ee3c thu th\u1eadp t\u1eeb c\u00f9ng m\u1ed9t b\u1ec7nh nh\u00e2n b\u1eb1ng c\u00f9ng m\u1ed9t thi\u1ebft b\u1ecb thu th\u1eadp. \u0110\u1ed1i v\u1edbi nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y, vi\u1ec7c r\u1eeda thi\u1ebft b\u1ecb thu th\u1eadp b\u1eb1ng formalin c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i cho b\u1ec7nh nh\u00e2n, n\u00ean s\u1eed d\u1ee5ng v\u1eadt li\u1ec7u kh\u00f4ng x\u1ed1p \u0111\u1ec3 l\u1ea5y m\u00f4 ra kh\u1ecfi thi\u1ebft b\u1ecb. N\u01b0\u1edbc mu\u1ed1i c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 r\u1eeda m\u00f4 t\u1eeb thi\u1ebft b\u1ecb sang v\u1eadt ch\u1ee9a kh\u00e1c v\u00ec n\u00f3 s\u1ebd kh\u00f4ng l\u00e0m m\u1ea5t n\u01b0\u1edbc kh\u1ecfi m\u1eabu \u0111\u00e3 thu th\u1eadp.<\/p>\n

\"H\u00ecnh
H\u00ecnh 7.<\/strong> C\u00e1c m\u1eabu \u0111\u01b0\u1ee3c \u0111\u1eb7t tr\u1ef1c ti\u1ebfp l\u00ean g\u1ea1c kh\u00f4ng th\u1ea5m formalin<\/figcaption><\/figure>\n

M\u1eabu ph\u1ea3i \u0111\u01b0\u1ee3c thu th\u1eadp v\u00e0 ngay l\u1eadp t\u1ee9c \u0111\u01b0\u1ee3c ng\u1ea5m v\u00e0o ch\u1ea5t c\u1ed1 \u0111\u1ecbnh \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o s\u1ef1 c\u1ed1 \u0111\u1ecbnh th\u00edch h\u1ee3p.\u00a0Formalin l\u00e0 ch\u1ea5t c\u1ed1 \u0111\u1ecbnh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn nh\u1ea5t trong ph\u00f2ng th\u00ed nghi\u1ec7m. Tuy nhi\u00ean, formalin ph\u1ea3i \u0111\u01b0\u1ee3c x\u1eed l\u00fd nh\u01b0 b\u1ea5t k\u1ef3 thu\u1ed1c th\u1eed n\u00e0o kh\u00e1c, \u0111\u1eb7c bi\u1ec7t l\u00e0 v\u1ec1 ng\u00e0y b\u1ea3o qu\u1ea3n v\u00e0 h\u1ebft h\u1ea1n. \u0110\u1ec3 formalin d\u01b0\u1edbi \u00e1nh n\u1eafng tr\u1ef1c ti\u1ebfp c\u00f3 th\u1ec3 l\u00e0m thay \u0111\u1ed5i \u0111\u1ed9 pH c\u1ee7a dung d\u1ecbch, g\u00e2y ra m\u00f4i tr\u01b0\u1eddng axit cho c\u00e1c m\u00f4. T\u00ednh axit trong ch\u1ea5t c\u1ed1 \u0111\u1ecbnh c\u00f3 xu h\u01b0\u1edbng c\u00f3 hai t\u00e1c \u0111\u1ed9ng ch\u00ednh l\u00ean m\u00f4:<\/p>\n

    \n
  1. L\u00e0m kh\u00f4 c\u00e1c c\u1ea1nh b\u00ean ngo\u00e0i c\u1ee7a c\u00e1c m\u00f4<\/li>\n
  2. L\u00e0m kh\u00f4 m\u00f4 qu\u00e1 m\u1ee9c<\/li>\n<\/ol>\n
    \"H\u00ecnh
    H\u00ecnh 8.<\/strong> S\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a c\u00e1c h\u1ea1t nuclei c\u00f3 th\u1ec3 c\u1ea3n tr\u1edf vi\u1ec7c ch\u1ea9n \u0111o\u00e1n.<\/figcaption><\/figure>\n

    Khi b\u1ed9 x\u1eed l\u00fd m\u00f4<\/a> ph\u00e1t tri\u1ec3n, k\u1ef9 thu\u1eadt x\u1eed l\u00fd c\u1ee7a ch\u00fang ta c\u0169ng ph\u00e1t tri\u1ec3n. T\u1eeb \u0111\u00f3, th\u1eddi gian c\u1ee7a quy tr\u00ecnh x\u1eed l\u00fd ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c s\u1eafp x\u1ebfp h\u1ee3p l\u00fd h\u01a1n \u0111\u1ec3 \u0111\u00e1p \u1ee9ng nhu c\u1ea7u c\u1ee7a b\u1ec7nh nh\u00e2n b\u1eb1ng c\u00e1ch t\u1ea1o ra hi\u1ec7u qu\u1ea3 trong qu\u00e1 tr\u00ecnh x\u1eed l\u00fd. V\u00ec l\u00fd do n\u00e0y, vi\u1ec7c \u0111\u1eb7t t\u1ea5t c\u1ea3 c\u00e1c m\u1eabu l\u1ea1i v\u1edbi nhau tr\u00ean c\u00f9ng m\u1ed9t giao th\u1ee9c l\u00e0 kh\u00f4ng c\u00f2n h\u1ee3p l\u00fd n\u1eefa. C\u00e1c m\u1eabu nh\u1ecf \u0111\u01b0\u1ee3c \u0111\u1eb7t qua quy tr\u00ecnh qua \u0111\u00eam s\u1ebd b\u1ecb m\u1ea5t n\u01b0\u1edbc qu\u00e1 m\u1ee9c, khi\u1ebfn vi\u1ec7c ph\u00e2n chia tr\u1edf n\u00ean kh\u00f3 kh\u0103n. Ng\u00e2m c\u00f3 th\u1ec3 gi\u00fap \u00edch, nh\u01b0ng th\u01b0\u1eddng s\u1ebd khi\u1ebfn m\u00f4 b\u1ecb n\u1ee9t. C\u00e1c m\u1eabu l\u1edbn \u0111\u01b0\u1ee3c \u0111\u1eb7t theo quy tr\u00ecnh th\u00edch h\u1ee3p h\u01a1n cho sinh thi\u1ebft s\u1ebd b\u1ecb kh\u1eed n\u01b0\u1edbc v\u00e0 kh\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u1eaft ra cho \u0111\u1ebfn khi ho\u00e0n t\u1ea5t qu\u00e1 tr\u00ecnh x\u1eed l\u00fd th\u00edch h\u1ee3p.<\/p>\n

    \"H\u00ecnh
    H\u00ecnh 9.<\/strong> H\u00ecnh \u1ea3nh cho th\u1ea5y s\u1ef1 n\u00e9n c\u1ee7a c\u00e1c m\u00f4 \u0111\u01b0\u1ee3c x\u1eed l\u00fd. Ti\u00eau b\u1ea3n b\u00ean ph\u1ea3i b\u1ecb h\u1ecfng v\u00e0 c\u00e1c chi ti\u1ebft c\u1ee7a t\u1ebf b\u00e0o m\u1ee1 k\u00e9m ch\u1ea5t l\u01b0\u1ee3ng, cho th\u1ea5y m\u1eabu kh\u00f4ng \u0111\u01b0\u1ee3c th\u1ea5m \u0111\u00fang c\u00e1ch<\/figcaption><\/figure>\n

    Bong b\u00f3ng h\u1ea1t nh\u00e2n x\u1ea3y ra khi c\u00e1c protein trong nh\u00e2n \u0111\u00f4ng l\u1ea1i. Hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y th\u01b0\u1eddng l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a c\u00e1c m\u1eabu \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh k\u00e9m v\u00e0 g\u1eb7p ph\u1ea3i nhi\u1ec7t \u0111\u1ed9 cao. Ch\u1ea5t c\u1ed1 \u0111\u1ecbnh c\u00f3 \u0111\u1ed9 pH cao c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y. M\u00f4i tr\u01b0\u1eddng kh\u1eafc nghi\u1ec7t khi\u1ebfn protein \u0111\u00f4ng t\u1ee5 xung quanh nh\u1eefng gi\u1ecdt ch\u1ea5t l\u1ecfng nh\u1ecf, khi\u1ebfn ch\u00fang c\u00f3 h\u00ecnh d\u1ea1ng bong b\u00f3ng.<\/p>\n

    \n
    \n
    \"H\u00ecnh
    H\u00ecnh 10.<\/strong> Hi\u1ec7n t\u01b0\u1ee3ng bong b\u00f3ng h\u1ea1t nh\u00e2n, do nhi\u1ec7t \u0111\u1ed9 cao v\u00e0 formalin c\u00f3 t\u00ednh axit c\u00f3 th\u1ec3 g\u00e2y \u0111\u00f4ng t\u1ee5 protein, l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ea9n \u0111o\u00e1n.<\/figcaption><\/figure>\n<\/div>\n<\/div>\n
    \n
    \n
    \n
    \n
    \n

    Sau khi c\u1eaft xong, c\u00e1c lam k\u00ednh \u01b0\u1edbt th\u01b0\u1eddng \u0111\u01b0\u1ee3c cho v\u00e0o t\u1ee7 s\u1ea5y \u0111\u1ec3 l\u00e0m kh\u00f4. Nhi\u1ec7t \u0111\u1ed9 cao (v\u00ed d\u1ee5 70\u00b0C) c\u00f3 th\u1ec3 l\u00e0m cho n\u01b0\u1edbc b\u00ean d\u01b0\u1edbi l\u00e1t c\u1eaft bay h\u01a1i nhanh qua m\u00f4. S\u1ef1 bay h\u01a1i c\u00f3 th\u1ec3 l\u00e0m cho protein \u0111\u00f4ng l\u1ea1i, t\u1ea1o ra hi\u1ec7n t\u01b0\u1ee3ng bong b\u00f3ng h\u1ea1t nh\u00e2n. C\u00e1ch t\u1ed1t nh\u1ea5t \u0111\u1ec3 tr\u00e1nh tr\u01b0\u1eddng h\u1ee3p n\u00e0y l\u00e0 gi\u1ea3m nhi\u1ec7t \u0111\u1ed9 l\u00f2 ho\u1eb7c \u0111\u1ec3 c\u00e1c lam k\u00ednh kh\u00f4 m\u1ed9t ch\u00fat tr\u01b0\u1edbc khi \u0111\u1eb7t ch\u00fang v\u00e0o t\u1ee7 s\u1ea5y.<\/p>\n

    \n
    \n
    \n

    C\u00e1ch \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh ngu\u1ed3n g\u1ed1c c\u1ee7a c\u00e1c h\u1ea1t n\u1ed5i l\u00e0 xem ch\u00fang \u1edf \u0111\u00e2u tr\u00ean ti\u00eau b\u1ea3n so v\u1edbi m\u00f4. N\u1ebfu ch\u00fang n\u1eb1m trong c\u00f9ng m\u1eb7t ph\u1eb3ng ti\u00eau \u0111i\u1ec3m v\u1edbi m\u1eabu m\u00f4 th\u00ec r\u1ea5t c\u00f3 th\u1ec3 ch\u00fang l\u00e0 ch\u1ea5t g\u00e2y \u00f4 nhi\u1ec5m trong kh\u1ed1i (trong qu\u00e1 tr\u00ecnh v\u00f9i m\u00f4)<\/p>\n<\/div>\n<\/div>\n<\/div>\n

    \"H\u00ecnh
    H\u00ecnh 11.<\/strong> Ph\u1ea7n m\u00f4 n\u00e3o n\u00e0y c\u00f3 m\u1ed9t m\u1ea3nh m\u00f4 ru\u1ed9t ngo\u1ea1i lai. C\u00f3 th\u1ec3 x\u1ea3y ra trong qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p m\u1eabu v\u1eadt, ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c ngu\u1ed3n g\u1ed1c c\u1ee7a n\u00f3.<\/figcaption><\/figure>\n

    \u00d4 nhi\u1ec5m b\u00ean ngo\u00e0i th\u01b0\u1eddng s\u1ebd xu\u1ea5t hi\u1ec7n c\u00e1c h\u1ea1t n\u1ed5i ph\u00eda tr\u00ean m\u00f4 ho\u1eb7c ra kh\u1ecfi m\u1eb7t ph\u1eb3ng m\u00f4. Vi\u1ec7c th\u01b0\u1eddng xuy\u00ean thay \u0111\u1ed5i v\u00e0 l\u1ecdc thu\u1ed1c th\u1eed l\u00e0 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p t\u1ed1t nh\u1ea5t \u0111\u1ec3 tr\u00e1nh hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y.<\/p>\n

    \"H\u00ecnh
    H\u00ecnh 12.<\/strong> Ph\u1ea7n th\u1eadn n\u00e0y c\u00f3 c\u00e1c t\u1ebf b\u00e0o v\u1ea3y ngo\u1ea1i lai ph\u00eda tr\u00ean m\u1eb7t ph\u1eb3ng m\u00f4.<\/figcaption><\/figure>\n

    Vi khu\u1ea9n v\u00e0 n\u1ea5m c\u00f3 th\u1ec3 ph\u00e1t tri\u1ec3n trong m\u00e1y nhu\u1ed9m v\u00e0 b\u00ecnh thu\u1ed1c th\u1eed n\u1ebfu nh\u1eefng khu v\u1ef1c n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c l\u00e0m s\u1ea1ch th\u01b0\u1eddng xuy\u00ean. Th\u1ef1c hi\u1ec7n theo h\u01b0\u1edbng d\u1eabn c\u1ee7a nh\u00e0 s\u1ea3n xu\u1ea5t \u0111\u1ec3 b\u1ea3o tr\u00ec thi\u1ebft b\u1ecb.<\/p>\n

    \"H\u00ecnh
    H\u00ecnh 13.<\/strong> Alternaria, m\u1ed9t lo\u1ea1i n\u1ea5m trong kh\u00f4ng kh\u00ed, \u0111\u01b0\u1ee3c th\u1ea5y tr\u00ean ph\u1ebft t\u1ebf b\u00e0o Pap<\/figcaption><\/figure>\n
    \"H\u00ecnh
    H\u00ecnh 14.<\/strong> C\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y c\u00e1c s\u1ee3i t\u1eeb ti\u00eau b\u1ea3n ho\u1eb7c thi\u1ebft b\u1ecb thu th\u1eadp \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho b\u1ec7nh nh\u00e2n tr\u00ean ph\u1ebft t\u1ebf b\u00e0o Pap<\/figcaption><\/figure>\n

    Melanin, hemosiderin v\u00e0 c\u00e1c ph\u1ea7n ngo\u1ea1i lai c\u00f3 th\u1ec3 g\u00e2y m\u1ea5t t\u1eadp trung. Ngay c\u1ea3 c\u00e1c ch\u1ea5t c\u1ed1 \u0111\u1ecbnh c\u0169ng c\u00f3 th\u1ec3 t\u1ea1o ra c\u00e1c s\u1eafc t\u1ed1 t\u1ebf b\u00e0o b\u1ed5 sung, ch\u1eb3ng h\u1ea1n nh\u01b0 c\u1ee7a Zenker, \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 g\u00e2y lo ng\u1ea1i n\u1ebfu nh\u00e0 nghi\u00ean c\u1ee9u m\u00f4 b\u1ec7nh h\u1ecdc kh\u00f4ng bi\u1ebft r\u1eb1ng m\u1eabu \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh trong m\u1ed9t ch\u1ea5t kh\u00e1c ngo\u00e0i formalin. Trong khi Zenker’s (kali dicromat\/th\u1ee7y ng\u00e2n clorua) ph\u1ea7n l\u1edbn kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng do \u0111\u1ed9c t\u00ednh c\u1ee7a n\u00f3, c\u00f3 m\u1ed9t s\u1ed1 n\u01a1i v\u1eabn c\u00f3 th\u1ec3 t\u1ef1 s\u1ea3n xu\u1ea5t.<\/p>\n

    \"H\u00ecnh
    H\u00ecnh 15.<\/strong> S\u1eafc t\u1ed1 Hemosiderin tr\u00ean m\u1ed9t ph\u1ea7n m\u00f4<\/figcaption><\/figure>\n

    Tr\u01b0\u1edbc \u0111\u00e2y, khi c\u00e1c lam k\u00ednh t\u00edch \u0111i\u1ec7n \u0111\u01b0\u1ee3c coi l\u00e0 qu\u00e1 t\u1ed1n k\u00e9m cho vi\u1ec7c c\u1eaft l\u00e1t th\u00f4ng th\u01b0\u1eddng, c\u00e1c ph\u00f2ng th\u00ed nghi\u1ec7m \u0111\u00e3 d\u1ef1a v\u00e0o albumin ho\u1eb7c c\u00e1c protein kh\u00e1c \u0111\u1ec3 gi\u00fap c\u00e1c m\u00f4 b\u00e1m v\u00e0o c\u00e1c lam k\u00ednh.<\/p>\n

    Ch\u1ea5t k\u1ebft d\u00ednh c\u00f3 nh\u1eefng h\u1ea1n ch\u1ebf ri\u00eang v\u00e0 th\u1eadm ch\u00ed c\u00f3 th\u1ec3 c\u1ea3n tr\u1edf nhu\u1ed9m h\u00f3a m\u00f4 mi\u1ec5n d\u1ecbch<\/a><\/p>\n

    C\u00e1c ch\u1ea5t thay th\u1ebf Xylene hi\u1ec7n \u0111\u01b0\u1ee3c b\u00e1n r\u1ed9ng r\u00e3i v\u00e0 c\u00f3 th\u1ec3 cung c\u1ea5p th\u00eam l\u1edbp an to\u00e0n cho ph\u00f2ng th\u00ed nghi\u1ec7m. H\u00e3y nh\u1edb r\u1eb1ng ch\u00fang c\u00f3 nh\u1eefng h\u1ea1n ch\u1ebf ri\u00eang, ch\u1eb3ng h\u1ea1n nh\u01b0 kh\u1ea3 n\u0103ng ch\u1ecbu n\u01b0\u1edbc th\u1ea5p. C\u0169ng c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i s\u1eed d\u1ee5ng ch\u1ea5t k\u1ebft d\u00ednh t\u01b0\u01a1ng th\u00edch theo khuy\u1ebfn ngh\u1ecb c\u1ee7a nh\u00e0 s\u1ea3n xu\u1ea5t, v\u00ec kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 ch\u00fang \u0111\u1ec1u t\u01b0\u01a1ng th\u00edch v\u1edbi g\u1ed1c xylene th\u00f4ng th\u01b0\u1eddng.<\/p>\n

    M\u1ed9t trong nh\u1eefng c\u00e1ch d\u1ec5 nh\u1ea5t \u0111\u1ec3 gi\u1eef cho c\u00e1c ti\u00eau b\u1ea3n nhu\u1ed9m H&E<\/a> ch\u1ea5t l\u01b0\u1ee3ng l\u00e0 ch\u1ec9 c\u1ea7n \u0111\u1ea3m b\u1ea3o thay thu\u1ed1c th\u1eed th\u01b0\u1eddng xuy\u00ean.<\/p>\n

    Nh\u1eefng \u0111i\u1ec1u ch\u1ec9nh d\u01b0\u1edbi \u0111\u00e2y s\u1ebd t\u1ed1i \u01b0u m\u00e0u s\u1eafc khi nhu\u1ed9m:<\/p>\n