Histology

Specimens are prioritised for preparation and reporting depending on:

  1. Clinical information
  2. 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.

This page contains information on:

Tests

Test name Department Protocols Further information
Crystals in Synovial fluid Histology See Protocols
Foetus Histology See Protocols
Frozen sections Histology See Protocols
Haemosiderin in urine Histology See Protocols
Histology (routine) including lymph nodes Histology See Protocols 10% formalin
Immunofluorescence (oral biopsies) Histology See Protocols
Immunofluorescence (skin) Histology See Protocols
Lymph nodes Histology See Protocols
Muscle biopsies Histology See Protocols
Nerve biopsies Histology See Protocols Fresh
Renal biopsies Histology See Protocols
Semen Samples Histology See Protocols
Testicular biopsies Histology See Protocols Bouin’s fluid

Protocols

Failure to use correct procedure may result in inability to perform test

Crystals in synovial fluid

  1. Place in a dry container and send to laboratory as soon as possible.

Foetus

  1. Foetuses > 14 weeks gestation are sent directly to Royal Victoria Infirmary (RVI), Newcastle.
  2. 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

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

Histology (routine) including lymph nodes

  1. Place specimen in 10% formalin (use 10x the specimen amount).
    • Contact lab for large specimens that do not fit into the standard range of pots and buckets available.
  2. Complete request form.
  3. Take to Pathology reception.

Immunofluorescence (skin or oral biopsies)

  1. Inform Histology at JCUH 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 JCUH before taking specimen.
  2. Place specimen in a drop of saline in a dry container.
  3. Take specimen to laboratory immediately.

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).

  1. Infertility samples are accepted on a Monday to Friday 9:00am-4:30pm at JCUH and on a Wednesday 8:30am – 4:00pm at Friarage.
  2. Post vasectomy samples are accepted Monday to Friday, 9am – 4.30 at JCUH and 8.30 – 4pm at Friarage.

Testicular biopsies

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

Turnaround times

Estimated turnaround times, excluding ICC and other further work:

Band A reported within 5 days from collection date
Including 2WR cancer-related, Nuffield, Woodlands and Private
Band AB Step down for 2WW cases, reported within 10 days from collection date
Band B reported within 10 days from collection date
Band C reported within 14 days from collection date (current TAT for Band C is 12-14 weeks – 05/07/2018)
SPECIMEN Band
Urgent reporting required including close MDT date A
2 week rule cases A
Clinical suspicion of cancer A
BREAST
Breast needle core biopsy A
Mammatome A
Breast resection for tumour B
Benign breast lump C
Breast reductions C
Gynaecomastia C
ENT
Post nasal space biopsy A
Suspicion SCC, lymphoma or other tumour A
Vocal cord biopsy A
Laryngeal biopsy B
Papilloma C
Tongue biopsy (without indication of early MDT meeting) C
Nasal polyps C
Tonsil (benign) C
GASTRO-INTESTINAL ENDOSCOPY
Urgent/2WR A
Endoscopic biopsies querying malignancy A
Endoscopic biopsies – 2WR step down B AB
Acute colitis B
Adenoma C
Barrett’s C
Crohn’s / Ulcerative colitis / inflammatory bowel disease C
Endoscopic polyps C
Gastritis C
Oesophagitis C
Endoscopy (“Endoscopic Diagnosis”– Normal/Coeliac/Micro-absorption) C
GASTRO-INTESTINAL OTHER
Urgent/2WR A
Liver biopsy (where malignancy is suspected) A
Appendix (where a tumour is suspected) B
Tumour resections B
Liver biopsy (non-malignant) B
Peritoneal biopsies C
Proctitis C
Anal fistula C
Appendix routine C
Gall bladder C
GENITOURINARY
Renal biopsy A
Prostatic biopsy A
Bladder biopsies B
Bladder chippings B
Cystectomy B
Kidney (tumour) B
Penectomy B
Penile biopsy (tumour) B
Testicular tumours B
Urethral biopsy (not polyp) B
Prostate chippings C
Circumcision (foreskin) C
Epididymal cyst C
Kidney (non-cancer) C
Testicular cyst C
Urethral polyp C
Vas defererns C
GYNAECOLOGY
LLETZ “Diagnostic” A
LLETZ “See and treat” B
Cervical biopsies B
Endometrial samples for PMB B
Ovarian biopsy for cancer B
Products of conception (suspected molar)
See below for non-molar – Band D
B
Uterus for endometrial / cervical cancer B
Ectopic pregnancy C
Other endometrial samples C
Endometriosis C
Fallopian tube C
Ovary (non cancer) C
Products of conception (unless suspected molar – Band B) C
Uterus for menorrhagia & prolapse C
Vulval cyst C
LUNG
Pleural biopsy A
Bronchial / lung biopsy B
Lung for tumour B
Wedge Lung biopsy for tumour or fibrosis B
LYMPHORETICULAR
Lymph node biopsy / biopsy for lymphoma A
Maltoma / MALT lymphoma A
Spleen (where lymphoma is suspected) A
Sentinel lymph node B
Thymus B
Spleen (rupture) C
OBSTETRICS
Placenta C
ORAL SURGERY
Buccal mucosa (without indication of early MDT meeting) C
Tongue biopsy (without indication of early MDT meeting) C
ORTHO & SOFT TISSUE
Bone, including head of femur (tumour) B
Soft tissue (tumour) B
Schwannoma (non-neouropathology) C
Bone (not tumour) C
Bursa C
Exostosis C
Ganglion C
Head of femur (non-tumour) C
Lipoma C
Morton’s neuroma C
Osteomyelitis / Infection C
Synovial biopsy C
SKIN
Skin IF A
Wider excision of melanoma A
Indeterminate pigmented lesion B
Lentigo maligna B
Melanoma B
Wider excision of dysplastic naevus / BCC / SCC B
Actinic / solar keratosis C
BCC, SCC (punch and excision) C
Bowen’s disease C
Keratocanthoma C
Melanocytic naevi C
Vasculitic rash C
All other skin rashes C
Benign pigmented skin lesions C
Cyst, NOS C
GP skins for non-cancerous lesions C
Seborrhoeic keratosis C
Wider excisions (not stated above) C
NEUROPATHOLOGY BIOPSIES
All biopsies / resections A
OTHER
Temporal artery biopsy A
Post mortem tissue B

 

Request Forms

Histology Request (104kb)
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