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Histology Specimen Collection and Transport Advice

Specimens should be sent to the department as soon as practicable after removal. Medium and small sized specimens should be put in containers of appropriate size containing a suitable volume of fixative (ideally some ten times more than the volume of specimen) which are obtainable from the Pathology Department. All small biopsies (e.g. endoscopic, needle biopsies) should be placed in the biopsy capsules provided. The number of endoscopic biopsies should ideally be stated on the request form. Biopsy capsules for this purpose are available in the endoscopy suite and at various sites around the hospital where small biopsies are commonly taken. Please contact the department for advice where any doubt exists. Fresh specimens from theatres must be double bagged, with a patient identification label attached to the inner bag. Place the Histology request form in another clear bag and place both the specimen and the request form in to another bag and knot it. These specimens are kept in the theatres’ fridges prior to collection by the porters.

All fresh specimens should be delivered to the Microbiology department in the theatre tins provided. Care must be taken in the transportation of all such specimens and they must be handled as potentially infectious.

Fixatives and Specimen Containers

  1. Routine Histology specimens: Containers of 10% buffered formalin should be used. Containers of various sizes are available from the laboratory.
  2. Immunofluorescence: Petri dishes and containers of Zeus tissue fixative should be used.
  3. Electron microscopy: Containers of Mirsky’s Fixative containers should be used.
  4. Testicular biopsies: Containers of Bouin’s Fixative should be used.
  5. Biopsy capsules should be used for the secure transport of small biopsies.
  6. Cork boards are available for pinning out specimens prior to fixation.

When used accordance with the safety data sheets provided, and in conjunction with the appropriate use of Personal Protective Equipment, the fixatives outlined below present a low risk to staff. In the unlikely event of any formalin spillages within normal working hours please contact the histology laboratory on 5728.

Outside normal working hours spillages should be absorbed with inert, damp non-combustible material, then flush the area with water. Absorb small quantities with paper towels and evaporate in a safe place. Allow sufficient time for vapours to completely clear, and then place the paper towels in a clinical waste bag away from combustible material.

Storage

Formalin pots and buckets should be stored at room temperature in a dry well ventilated area. Keep containers securely closed.

Disposal

Out of date formalin pots should be returned to laboratory medicine for disposal.

Health and Safety

Formalin is harmful by inhalation, in contact with skin and if swallowed. May cause sensitisation by skin contact. Use protective gloves, and wear eye protection when handling formalin.

First Aid Measures

EYES Wash eyes immediately with plenty of water whilst lifting eyelids. Seek medical attention immediately. Continue to rinse.

SKIN Remove affected person from source of contamination and immediately flush contaminated skin with plenty of water. If clothing soaked through, remove it immediately and flush skin with water. Should irritation persist seek medical attention immediately

INGESTION Never make an unconscious person vomit or drink fluid. Let affected person drink lots of water immediately in order to dilute the swallowed liquid. After the liquid has swallowed try to induce vomiting.

INHALATION Move the exposed person to fresh air immediately. If breathing has stopped, perform artificial respiration immediately. Keep the affected person warm and at rest whilst seeking medical attention.


Frozen Sections (York only)

These should be requested by telephoning the Histology Laboratory at least 24 hours in advance. The specimen should be received fresh and delivered directly to the laboratory. The procedure takes about 15 minutes from receipt of the specimen to the telephoned report. If several frozen sections are required (e.g. for the exclusion of malignancy in lymph nodes), each separate specimen will take a further 10 to 15 minutes. The extension number to which the report should be telephoned MUST be clearly stated on the request form to prevent any delay.

Lymph Nodes

Lymph nodes removed for suspected lymphoma should be sent to the laboratory immediately in a fresh unfixed state. The laboratory must be informed that a specimen is to be taken to ensure staff are available to deal with the specimen immediately. Out of hours these specimens should be refrigerated.

Skin Biopsies for Immunofluorescence

Notice is required for immunofluorescence. The specimen should arrive in a Petri dish, moistened with saline. If it is sent from another hospital it should be placed in Zeus tissue fixative.

Skin Biopsies for Marker Studies (York only)

Notice is required for marker studies. The specimen should arrive in a petri dish, moistened with saline.

Renal biopsies (York only)


Notice is required to allow the laboratory time to make up the Mirsky’s Fixative. When booking the specimen the following details are required: Patient name, DOB, Hospital number, Consultant, Date and time of biopsy, degree of urgency, and details as to whether it is a native or transplant biopsy. The renal biopsies should be placed in the appropriate fixatives according to the clinical details: (i) 10% Formal Saline (ii) Mirsky’s fixative is required for the EM specimen (iii) Zeus tissue fixative for immunofluorescent studies. The specimens should be sent immediately. Specimens that are received into the Histopathology Department at St James's Hospital, Leeds after 12:30pm will not receive a same day diagnosis. Urgent specimens need to arrive in the Histology department no later than 11:15am to be dealt with the same day. The requesting doctor must ring St James's Hospital, Leeds to inform them of any urgent renal biopsies on 0113 20677498 or 0113 2067530.

Testicular biopsies

Notice is required. Bouin’s fixative will be provided. The specimen should be sent immediately.

Muscle biopsies


These specimens require advance notification on 0113 3927880 or 0113 3927830. They should be sent by taxi directly to Britannia House, Britannia Road, Morley, Leeds, LS27 0DQ. The muscle biopsy should be wrapped in saline moistened gauze and placed in a sterile specimen pot and labelled appropriately.

Placenta Specimens

York

These specimens should be placed in the clear plastic bags provided by main theatres (swab bags). Please do not use the bags labelled ‘pathology specimens’ as they are prone to leak. The placenta must be placed in one bag and the top of the bag knotted. A patient identification label must be placed on this bag. Place the Histology request form in another clear bag and place both the placenta and the request form in to another bag and knot it. During working hours the bagged placenta is then placed in a white bucket and sent to the laboratory via a porter (buckets are obtained from the Histology department). Out of hours the specimen is refrigerated and sent as above the following day. If the placenta is too large to fit in to a bag it is placed directly in to the bucket with the lid securely placed on top. The patient identification label is placed on the outside of the bucket and the bagged request form is securely attached to the bucket lid.

Cytogenetics (York only)


Specimens should be sent directly to the Histopathology Department in the appropriate transport medium, accompanied by a Cytogenetics request form. The transport medium is provided by the Cytogenetics Department at St. James’s Hospital where the test is performed.

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