The increasing application of immunohistochemistry and pressures to contain costs have led to a decline in the use of electron microscopy, which is usually only available in large institutions.
Nonetheless, EM can still be very useful in the evaluation of renal biopsies and in the differential diagnosis of paediatric small round blue cell tumours and high-grade pleomorphic sarcomas. It can also help in the differentiation of malignant mesothelioma from adenocarcinoma and can be used on cytology specimens. Although paraffin-embedded material can be processed for EM, the best results are obtained when small cubes ( ~1 mm3) of fresh tissue are fixed without delay in a solution such as 3% glutaraldehyde in cacodylate buffer.
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