Procedure Guidelines
General Considerations
All specimens delivered to the laboratory must adhere to the following
requirements.
-
It
is extremely important that all requisition forms include:
-
Patient's
legal name -- legibly printed or typed.
-
Patient's
date of birth.
-
Preliminary
diagnosis/Clinical history.
-
Type
of specimen submitted.
-
All
tests desired.
-
Office
or hospital submitting specimen.
-
Date
of service.
-
Physician's
signature.
-
The
specimen container must indicate:
-
All
specimens are in a leak-proof container that is placed in a sealed biohazard
specimen bag.
-
All
bagged specimens shall have an accurately completed requisition accompanying
them.
Unacceptable Specimens
Note:
if cytology fixed slides are co-submitted--they must be placed in a separate bag
from the histology specimen to avoid formalin fume contamination.
Fixative Requirements for Specific Tissue Samples
| Biopsies |
Tissues
for routine processing-- place in 10% formalin.
Renal biopsies or tissue for electron microscopy are to be placed
in special fixative,
call histology
laboratory to order. |
| Bone Marrows |
Obtain a bone marrow kit from histology
laboratory. Follow the procedural instructions included in the
kit. Make certain all paperwork is
complete to ensure processing and special studies if required. |
| Cytogenetic/Flow Cytometry Studies |
Call
histology laboratory for special RPMI fixative.
If there is a delay in obtaining RPMI, the specimen may be placed
in a sterile container with sterile saline. |
| Hormone Receptor Assays |
Submit
specimen in 10% formalin. After
processing ER/PR studies are done on paraffin blocks. |
| Frozen Sections |
Notify
the
Pathology Department immediately. DO NOT place specimen in any fixative. If there will
be a delay due to transportation, place in normal saline. |
| Leukocyte Alkaline Phosphatase (LAP) |
Smears made from blood collected in either oxalate or
heparin. Caution:
Notify the
histology laboratory before sending specimen. Be certain to send the tube
of blood, CBC report and peripheral smear. |
| Limbs |
Wrap
any exposed bone in several thicknesses of gauze. Double bag and place in
refrigerator. |
| Lymph Nodes and other Tissue where Lymphoma is Suspected |
A
pathologist should always be summoned for the purposes of proper specimen
handling. The tissue should be
properly prepared immediately after removal.
DO NOT PLACE IN FIXATIVE.
If there is any delay, wrap the biopsy gently with gauze pads
soaked with normal saline. |
| Muscle Biopsies |
A
pathologist should always be summoned for the purposes of proper specimen
handling. The muscle biopsy should be properly prepared immediately after
removal. DO NOT PLACE IN
FIXATIVE. If there is any
delay, wrap the biopsy gently in gauze pads soaked with physiological
saline. |
| Nerve Biopsies |
See Muscle Biopsies |
| Skin Biopsies |
For
immunofluorescent studies -- place immediately into immunofluorescent
fixative. Ammonium sulfate fixative supplied on request.
Call the histology lab to order. |
| Testicular Biopsies |
Fix
in Bouin's fixative for 4 hours. Remove
specimen and place in 70% alcohol or tissue fixative. Tissue fixative may
be used if no Bouin's is available. |
| Urate Crystals (uric acid) |
Tissue
for crystal identification should be fixed in 95% alcohol or tissue
fixative. Special processing is required. |
|