HISTOLOGY SPECIMEN COLLECTION MANUAL

Transcription

1 Lee Memorial Health System Lee County, FL CLINICAL LABORATORY HISTOLOGY SPECIMEN COLLECTION MANUAL Abdominal Fluid Minimum Volume No fixative in an appropriate sized container. 1 ml The container must contain 5 units of heparin for every 1 ml of aspirated fluid. Abcess 10 % Formalin Abortion/Products of Conception (With no request for Chromosome Analysis/Cytogenetics). If Chromosome Analysis/Cytogenetics is requested - no. See Chromosome Analysis/Cytogenetics Acid Fast Bacilli/AFB (Kinyoun's Stain) - Brushings or holder for glass slides. Spray alcohol fixative/70%-85% alcohol (ethyl or reagent) Rev. 04/13 Page 1 of 44

2 Acid Fast Bacilli/AFB (Kinyoun's Stain) - Fluid None - Fresh Fluid Please note request for this stain on Histology Requisition in Epic. Acid Fast Bacilli/AFB (Kinyoun's Stain) - Tissue Please note request for this stain on Histology Requisition in Epic. Adenoids Adnexa Rev. 04/13 Page 2 of 44

3 Adrenal Gland Alcian Blue, ph 2.5 for Acid Mucopolysaccharides 7:30am - 4:00pm Please note request for this stain on Histology Requisition in Epic. Amyloid Stain - Crystal Violet, Congo Red Please note request for this stain on Histology Requisition in Epic. Aneurysm If saline is used during the procedure please pour it off and add 10% formalin. Rev. 04/13 Page 3 of 44

4 Aortic Valves - Heart Valves If saline is used during the procedure please pour it off and add 10% formalin. Appendix If a plastic bag is used during a laproscopic procedure the bag must be removed by nurse before adding 10% formalin. Arm/Limb Double bagged - large red biohazard bags None - Because of specimen size Needs to be refrigerated after hours. Place Epic requistion in Histology receiving area to alert Histology staff that the limb is in the refrigerator. Artery - Temporal Biopsy; Biopsy, Aneurysm Rev. 04/13 Page 4 of 44

5 Ascites Fluid No fixative in an appropriate sized container. 1 ml The container must contain 5 units of heparin for every 1 ml of aspirated fluid. Autopsy - Adult Appropriate cadaver bag LMH Autopsy Authorization form #0511, copy of patients chart, death record and copy of Physician's order requesting autopsy are all required if an autopsy is requested. The Autopsy Authorization must be signed by the family and witnessed by a nurse. any exclusions to the complete autopsy must be listed on the Autopsy Authorization. Histology must be notified. Autopsy - Pediatric - 3 year old or less Appropriate cadaver bag HP Autopsy Authorization form #0511, copy of patients chart, death record and copy of Physician's order requesting autopsy are all required if an autopsy is requested. The Autopsy Authorization must be signed by the family and witnessed by a nurse. any exclusions to the complete autopsy must be listed on the Autopsy Authorization. Histology must be notified. Bladder - Biopsy, Total/Subtotal Resection, Tumor, or TUR Rev. 04/13 Page 5 of 44

6 Bladder Washings Volume No fixative in an appropriate sized container. 1 ml Bone - Biopsy, Tumor, Osteomylitis Bone Marrow Aspirations/Biopsies EDTA for aspirate and 10% formalin for bone core biopsy Minimum Volume 2 ml aspirate and 1 cm bone core biopsy Contact Histology or the Pathologist for assistance. Touch preparations on glass slides must be obtained from the bone core biopsy before it is placed in formalin. Brain Biopsy Fresh tissue is required for Frozen Section Rev. 04/13 Page 6 of 44

7 Breast Cancer Profile - ER/PR, Ki-67, p53, HER2/NEU Reference Laboratory Note this request on the Histology Requisition. Since this test is done from the paraffin block it may be ordered at ay time by contacting the Histology Department at. Breast Cyst/Fluid Aspiration Minimum Volume No fixative in an appropriate sized container. 1 ml or less Breast Discharge Fixed slides in a crush resistant holder 1-2 spray fixed slides Slides and spray fixative can be obtained from Histology Breast Tissue - Biopsies or Mastectomies Rev. 04/13 Page 7 of 44

8 Bronchial Brushings Fixed slides in a crush resistant holder 1 or more slides fixed immediately in 85% alcohol or spray fixed Slides and alcohol can be obtained from Histology. The material from the brush smeared thin in the center of the slide, the size of a nickel. Never allow slides to air dry. Prepare 1 slide at a time. Bronchial Washing Minimum Volume No fixative in an appropriate sized container. Separate for Culture. 1 ml 25 ml of sterile saline is rinsed into the lung and aspirated back out Bursa Cartilage Rev. 04/13 Page 8 of 44

9 Cerebral Spinal Fluid/CSF Minimum Volume No fixative in an appropriate sized container. 1 ml After hours or weekends send specimen to hematology for processing. Cervix - Biopsy and Cervical Cone Biopsy Cholesteatoma Chromosome Analysis/Cytogenetics - Bone Marrow or Blood Sodium Heparin (Green Top Tube) Minimum Volume 2 ml Reference Laboratory Note this request on the Histology Requisition in Epic. Rev. 04/13 Page 9 of 44

10 Chromosome Analysis/Cytogenetics - Tissue (sterile preferred) None, Fresh Tissue Required (tissue transport media will be added by the laboratory) Note this request on the Histology Requisition in Epic. Colon - Biopsies or Partial Resection Common Bile Duct Brushings Fixed slides in a crush resistant holder 1-2 spray fixed slides Slides and spray fixative can be obtained from Histology. Congo Red Stain - Amyloid Stain Please note request for this stain on Histology Requisition in Epic. Rev. 04/13 Page 10 of 44

11 Conjuctiva Copper Measurement, Hepatic Quantitative - Liver Wedge or Biopsy Reference Laboratory Please note request on Histology Requisition in Epic. Cornea Crystal Violet Stain - Amyloid Stain Please note request for this stain on Histology Requisition in Epic. Rev. 04/13 Page 11 of 44

12 Cytogenetics/Chromosome Analysis - Bone Marrow or Blood Sodium Heparin (Green Top Tube) 2 ml Reference Laboratory Note this request on the Histology Requisition in Epic. Cytogenetics/Chromosome Analysis - Tissue (sterile preferred) None (tissue transport media will be added by the laboratory) Note this request on the Histology Requisition in Epic. Diverticulum CCH, HPMC, LMH Duodenum - Biopsy or Resection Rev. 04/13 Page 12 of 44

13 Elastic Stain (EVG) Please note request for this stain on Histology Requisition in Epic. Endocervix - Biopsy or Curretings Endometrium - Biopsy or Curretings Esophageal Brushings Fixed slides in a crush resistant holder 1-2 spray fixed slides Slides and spray fixative can be obtained from Histology Rev. 04/13 Page 13 of 44

14 Esophagus - Biopsy or Resection Estrogen and Progesterone Receptor Assay, DNA Analysis. Reference Laboratory Note this request on the Histology Requisition in Epic. Since this test is done from the paraffin block it may be ordered at any time by contacting Histology Department at. Eye - Enucleation Fallopian Tube - Biopsy, Ectopic Pregnancy, Sterilization Rev. 04/13 Page 14 of 44

15 Fat Stain (Oil Red O) - Fluid None Fresh fluid required. Please note request for this stain on Histology Requisition in Epic. Fat Stain (Oil Red O) - Tissue. None (Frozen section required) Fresh tissue required. Please note request for this stain on Histology Requisition in Epic. Femoral Head Fresh tissue not needed unless Cultures or ORC requested. Fetus Over 20 Weeks Gestation or wrapping. None Autopsy Authorization form #0511, copy of mother/babies chart, death record and copy of physician's order are all required if parents requested autopsy. If Chromosome Analysis/Cytogenetics are requested please note on Authorization along with any exclusions to the autopsy, autopsy authorization to be signed by the parent and two witnesses. Rev. 04/13 Page 15 of 44

16 Fetus Under 20 Weeks Gestation or wrapping. None Epic Histology requisition required. No autopsy authorization or death record required (surgical specimen). If Chromosome Analysis/Cytogenetics are requested please note on Histology requisitionin Epic. Parents may request a gross examination only (no dissection, no internal examination) Fibroids - Uterine Fine Needle Aspirations (FNA) Minimum Volume saline container for cell block 1 ml or as much as can be obtained Contact Histology or the Pathologist for assistance. Contact Histology for the supplies. Spray fix slides. Fingers/Toes Rev. 04/13 Page 16 of 44

17 FISH - Fluorescent In-Situ Hybridization Reference Laboratory Note this request on the Histology Requisition in Epic. Since this test is done from the paraffin block it may be ordered at any time by contacting Histology Department at. Fissure/Fistula Flow Cytometry - Bone Marrow or Blood Sodium Heparin (Green Top Tube) Minimum Volume 2 ml Reference Laboratory Note this request on the Histology Requisition in Epic. Flow Cytometry - Tissue (sterile preferred) None (Tissue Transport media will be added by the laboratory) Reference Laboratory Note this request on the Histology Requisition in Epic. Rev. 04/13 Page 17 of 44

18 Fluorescent In-Situ Hybridization (FISH) Reference Laboratory Note this request on the Histology Requisition. Since this test is done from the paraffin block it may be ordered at any time by contacting Histology Department at. Fontana-Masson Stain for Melanin and Argentaffin Granules Please note request for this stain on Histology Requisition in Epic. Foreskin Frozen Section. None, special instructions listed below for after hours and weekends. Note the Frozen section request on the Histology Requisition in Epic. After hours and weekend frozens require clinical laboratory to be given 30 minutes notice prior to need. This is to ensure pathologist and Technologist have travel time. Rev. 04/13 Page 18 of 44

19 Gallbladder If a plastic bag is used during a laproscopic procedure the bag must be removed before adding. Ganglion Cyst Gram Stain for Tissue Sections Please note request for this stain on Histology Requisition in Epic. H&E/Hematoxylin and Eosin Staining Rev. 04/13 Page 19 of 44

20 Heart Valve - Mitral and Aortic Valves If saline is used during the procedure please pour it off and add 10% formalin. Heliocobacter pylori - Diff-Quik Stain CCH Please note request for this stain on Histology Requisition in Epic. Hematoxylin and Eosin (H&E) Staining HER2/NEU Reference Laboratory Note this request on the Histology Requisition. Since this test is done from the paraffin block it may be ordered at any time by contacting Histology Department at. Rev. 04/13 Page 20 of 44

21 Ileum - Biopsy or Resection Immunofluorescence - Kidney and Skin Biopsy None (tissue transport media will be added by the laboratory) Reference Laboratory Fresh tissue must be submitted. Iron Measurement, Hepatic Quantitative - Liver Wedge or Biopsy Reference Laboratory Note this request on the Histology Requisition in Epic. Iron Stain - Prussian Blue for Ferric Iron Note this request on the Histology Requisition in Epic. Rev. 04/13 Page 21 of 44

22 Jejunum - Biopsy or Resection Kidney Kidney Biopsy for Tumor Kidney Biopsy Other Than Tumor None (Tissue transport media will be added by the laboratory) Reference Laboratory These are generally collected in CAT Scan and are checked for the adequacy of the specimen by a Pathologist during the procedure. Rev. 04/13 Page 22 of 44

23 Kidney Washings Minimum Volume No fixative in an appropriate sized container. 1 ml Kinyoun's Stain - Acid Fast Bacilli/AFB See Acid Fast/AFB depending on specimen (tissue or fluid) Please note request for this stain on Histology Requisition in Epic. See instructions for appropriate fixative under AFB Stain. Large Bowel - Biopsy or Partial Resection Larynx - Biopsy, Partial or Total Resection May be sent fresh at the request of the surgeon. Rev. 04/13 Page 23 of 44

24 Leder Stain - Specific Esterase for Tissue Sections Please note request for this stain on Histology Requisition in Epic. Leg/Limb Double bagged - large red biohazard bags None - Because of specimen size Specimen must be refrigerated after hours. Place Epic requisition in Histology receiving area to alert Histology staff that the limb is in the refrigerator. Leiomyoma Lipid Laden Macrophages Minimum Volume No in an appropriate sized container. 1 ml Rev. 04/13 Page 24 of 44

25 Lipoma Liver Wedge or Biopsy for Copper/Iron Measurements Reference Laboratory Note this request on the Histology Requisition in Epic. Liver Wedge or Biopsy for Tumor/Cyst/Hemangioma/Hepatitis Lung - Biopsy, Wedge Resection, Partial Lobectomy, Lobectomy Rev. 04/13 Page 25 of 44

26 Lymph Nodes for Lymphomas Studies (sterile preferred). None (Tissue Transport media will be added by the laboratory), Reference Laboratory Note this request on the Histology Requisition in Epic. Lymphoma Studies - Any Tissue (sterile preferred). None (Tissue Transport media will be added by the laboratory), Reference Laboratory Note this request on the Histology Requisition in Epic. Melanin Stain - Fontana-Masson Stain Please note request for this stain on Histology Requisition in Epic. Mitral Valves - Heart Valve If saline is used during the procedure please pour it off and add 10% formalin. Rev. 04/13 Page 26 of 44

27 Mucicarmine Stain (Mayer's) for Staining of Epithelial Mucins Please note request for this stain on Histology Requisition. Muscle and Muscle Biopsy Any appropriate container with Muscle Clamp attached.` None (tissue will be separated by the laboratory) Reference Laboratory Fresh tissue must be submitted in muscle clamp. Nasal Sinus Tissue/Contents Neck Dissection (Radical) Fresh (unless fixative is requested by submitting Physician) Usually sent fresh and oriented by the Surgeon. Rev. 04/13 Page 27 of 44

28 Nerve Biopsy None (Tissue will be separated by the laboratory) Reference Laboratory Fresh tissue must be submitted in clamp. Neuroma - Morton's/Traumatic Nipple Discharge Minimum Volume Spray fixed slides in a crush resistant holder. 1-2 spray fixed slides 7am - 5pm Slides and spray fixative can be obtained from Histology. Oil Red O (Fat Stain) Fluid or Tissue Fresh fluid required. Please note request for this stain on Histology Requisition Epic. Rev. 04/13 Page 28 of 44

29 Omentum Operating Room Consultations/ORC None, special instructions listed below for after hours and weekends. Note the OR consult request on the Histology Requisition in Epic. After hours and weekend frozen require clinical laboratory to be given 30 minutes notice prior to need. This is to ensure pathologist and technologist have travel time. Oral Mucosa and Gingival Tissuse Ovary Rev. 04/13 Page 29 of 44

30 Pancreas - Biopsy or Total/Subtotal Resection Pancreatic Brushings Minimum Volume Spray fixed slides in a crush resistant holder 1-2 spray fixed slides Slides and spray fixative can be obtained from Histology Pap Smear Minimum Volume Spray fixed slides in a crush resistant holder or fluid based Thin Prep Pap Test container 1-2 spray fixed slides or fluid based Thin Prep Pap Test Reference Laboratory Slides and spray fixative can be obtained from Histology Thin prep bottle must be brought with the collecting physician from their office. Paracenesis Fluid Minimum Volume No fixative in an appropriate sized container. 1 ml The container must contain 5 units of heparin for every 1 ml of aspirated fluid. Rev. 04/13 Page 30 of 44

31 Parathyroid None Fresh tissue is required for weight and frozen section for confirmation of parathyroid tissue. Parotid Gland - Salivary Gland Pelvic Washings Minimum Volume No fixative in an appropriate sized container. 1 ml The container must contain 5 units of heparin for every 1 ml of aspirated fluid. Pericardial Fluid Minimum Volume No fixative in an appropriate sized container. 1 ml The container must contain 5 units of heparin for every 1 ml of aspirated fluid. Rev. 04/13 Page 31 of 44

32 Periodic Acid Schiffs for Polysaccharides, neutral Mucosubstance, Basement Membranes and Fungus Please note request for this stain on Histology Requisition in Epic. Peritoneum Biopsy Pituitary None (unless fixative is requested by submitting physician) Fresh tissue is required for Frozen Section. Placenta - No request for Chromosome Analysis/Cytogenetics If Chromosome Analysis/Cytogentics requested - no fixative. See Chromosome Analysis/Cytogenics. Rev. 04/13 Page 32 of 44

33 Plaque Pleural Fluid/Effusion Minimum Volume No fixative in an appropriate sized container. 1 ml The container must contain 5 units of heparin for every 1 ml of aspirated fluid. Pneumocystis carinii (PCP) - Silver Stain. See Silver Stain depending on specimen (tissue or fluid) Please note request for this stain on Histology Requisition in Epic. See instructions for appropriate fixative under silver stain. Polyp - Any Rev. 04/13 Page 33 of 44

34 Products of Conception - No request for Chromosome Analysis/Cytogenetics If Chromosome Analysis/Cytogentics requested - no fixative. See Chromosome Analysis/Cytogenics. Prostate - Needle Biopsy, Radical Resection, Chips/TUR or Bouin's (for biopsies if requested) Fresh tissue is not needed unless Frozen or ORC requested. The surgeon may request Bouin's fixative for a needle core biopsy. Prussian Blue for Ferric Iron - Iron Stain Please not request for this stain on Histology Requisition in Epic. Rectum - Biopsy or Partial Resection Rev. 04/13 Page 34 of 44

35 Reticulum Stain Please note request for this stain on Histology Requisition. Salivary Gland - Parotid, Submaxillary, Sublingual Silver Stain - Brushings for Fungus, Spirochete, Bacteria or holder for glass slides Spray alcohol fixative/70-85% alcohol(ethyl or reagent) Please note request for this stain on Histology Requisition in Epic. Silver Stain - Fluid for Fungus, Spirochete, Bacteria. None - fresh fluid Please note request for this stain on Histology Requisition in Epic. Rev. 04/13 Page 35 of 44

36 Silver Stain - Tissue for Fungus, Spirochete, Bacteria Please note request for this stain on Histology Requisition in Epic. Sinus Tissue/Contents Skin -Biopsy or Excisions Small Bowel - Biopsy or Partial Resection Rev. 04/13 Page 36 of 44

37 Spleen Sputum Minimum Volume No fixative in an appropriate sized container. Submit immediately. 1 ml Collect sputum early in the morning, just after waking. Have the patient rid their mouth of saliva and other material by rinsing. Forceful coughing with aerosol inducement may be necessary. Steiner Stain for Spirochetes, Campylobacter, Legionella Please note request for this stain on Histology Requisition in Epic. Stomach - Biopsy or Partial Resection Rev. 04/13 Page 37 of 44

38 Stone - Bladder, Kidney, Renal, Urethral, Ureteral No fixative in an appropriate sized container. Minimum Volume One or more stones of any size CCH, HPMC, LMH - Stone Analysis Reference Laboratory Send to laboratory with Epic Histology Requisition noting for analysis. Do not fastened to a card or paper with cellophane tape. Care should be taken with small fragments; their loss may interfere with the accuracy of the test. Sublingual Gland - Salivary Gland Submaxillary Gland - Salivary Gland Synovium Rev. 04/13 Page 38 of 44

39 Temporal Artery Biopsy Testis - Biopsy, Tumor, Castration Thoracentesis Fluid Minimum Volume No fixative in an appropriate sized container. 1 ml The container must contain 5 units of heparin for every 1 ml of aspirated fluid. Thrombus Rev. 04/13 Page 39 of 44

40 Thymus Thyroid - Resection, Biopsy, Fine Needle Aspiration Fresh tissue is required for Frozen or ORC. Contact Histology for assistance for a fine needle aspiration. Tissue Toes/Fingers Rev. 04/13 Page 40 of 44

41 Tongue - Biopsy or Resection Trichrome Stain (Masson) Slides and alcohol spray fixative Please note request for this stain on Histology Requistion. Tzanck Prep Minimum Volume Alcohol container for slides. As much as can be obtained. Contact Histology or the Pathologist for assistance. Contact Histology for suppplies. Urinary Bladder - Biopsy, Total/Subtotal Resection, Tumor, TUR Rev. 04/13 Page 41 of 44

42 Urine for Cytology Minimum Volume No fixative in an appropriate sized container 1 ml Fresh voided urine (clean catch) for male and female. Submit urine while still warm for best results. Uterus Uvula Vagina Rev. 04/13 Page 42 of 44

43 Vas Deferens - Biopsy, Sterilization Vein - Biopsy or Varicose Vein Vulva Wilson's Disease - Copper Measurement, Hepatic Quantitative - Liver Wedge or Biopsy Reference Laboratory Note this request on the Histology Requisition in Epic. Rev. 04/13 Page 43 of 44

44 Wright Stain - Bone Marrow EDTA (Lavender Top Tube) None - any fixation will be done in Histology Rev. 04/13 Page 44 of 44