Histology


General Considerations

  • Specimens must reach the laboratory by 4:00 pm Monday through Friday and 10:00 am on Saturday to ensure same-day processing.

All specimens delivered to the laboratory must adhere to the following requirements. Specimens will be accepted only from physicians or authorized clinicians.

  • 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 two unique identifiers:

    • Patient Name, D.O.B., Social Security number; Medical Record Number

    • or Type of specimen submitted.

    • Type of fixative (specimen container should be leak-proof).

  • 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

  • A specimen may be considered unacceptable if certain of the above criteria are not fulfilled. Unlabeled specimens may be returned for proper identification (This is an accreditation requirement).

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. CautionNotify 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.