Histology

Specimens are prioritised for preparation and reporting depending on:

• Clinical information
• Referral under cancer targets

We aim to report the majority of specimens in-house but do also use the private sector to report some specimens during periods of consultant leave and to manage excess demand.

Some of the specimens received contain tumours, microscopic examination enables determination of tumour type, whether it is benign or malignant, how far it has spread in the body and whether or not excision is complete.

Usually the pathologist is able to write a report after looking at the initial slides stained by haematoxylin and eosin. Sometimes, however, special stains or immunocytochemistry may be required before a complete diagnosis can be made.

Protocols

Foetus

• Foetuses > 14 weeks gestation are sent directly to Royal Victoria Infirmary (RVI), Newcastle for primary reporting.
• If < 14 weeks gestation the clinician indicates the foetus is to be sent to JCUH or Friarage and place in 10% formalin.

Frozen sections (24 hours notice is required)

1. Phone the laboratory.
2. Specimen must be sent dry.
3. Specimen must be taken immediately to lab to prevent drying out of specimen which may affect the test.
4. Include phone number that report is to be telephoned to .

Haemosiderin in urine

• Place in a universal container and take to laboratory as soon as possible.

Histology (routine) including lymph nodes

1. The specimen should be placed in 10% neutral buffered formalin (NBF) immediately after removal from the patient.
2. The specimen should not be allowed to dry out. Cold ischaemic time (the cooling of a tissue, organ or body part after its blood supply has been cut off) should be less than 1 hour for optimal fixation of tissue.
3. There should sufficient fixative to enable the specimen to float freely, so the size of the container must be adequate. Container lids must fit well and provide a complete seal. Small biopsies should not be crushed or squeezed. Contact the laboratory for large specimens that do not fit into the standard range of pots and buckets available.
4. It is essential that the date and time the specimen was taken and placed into formalin is documented. This is particularly important for samples requiring predictive testing, which can apply to biopsy material and resection specimens.
5. Complete request form.
6. Take to pathology reception. If there is a delay in transporting formalin-fixed cellular pathology specimens to the laboratory, these specimens should be stored at ambient room temperature.

Immunofluorescence (skin or oral biopsies)

1. Inform Histology at James Cook before taking specimen.
2. Place specimen on card in a small drop of Michaels fluid in a dry container.
3. Place pot and form in plastic wallet (provided by laboratory).
   • At JCUH take specimen to laboratory immediately.
   • At Friarage take to Pathology Reception who will arrange to transport to JCUH laboratory immediately.

Lymph nodes

• 10% formalin

Muscle biopsies (48 hours notice is required)

• Muscle biopsies are not routinely provided, phone the Neuropathologist for advice.

Nerve biopsies

1. Please contact the Neuropathologist to discuss these, prior to biopsy.
2. Specimens are to be delivered , fresh, in a dry specimen container, immediately, to the Histology department.

Renal biopsies

1. Inform Histology at James Cook before taking specimen.
2. Place specimen in a drop of saline in a dry container.
3. Take specimen to laboratory immediately.
4. Renal biopsies are sent to RVI for reporting.

Semen samples

The directorate provides a non accredited technical service for the examination of semen infertility and post vasectomy samples. Clinical advice is available from a clinical embryologist in the Department of Reproductive Medicine at The James Cook University Hospital (Telephone number 01642 854856).

Testicular biopsies

1. Place in Bouin’s fluid
2. Take to Pathology reception

Request forms

All cellular pathology request forms can be found on the request forms page.