Histopathology: investigations available and specimen requirements

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This page contains details of the histopathology investigations performed by the ophthalmic department and the various specimen requirements:

Routine histopathology

Histopathological examination of biopsy material, either diagnostic or excisional, of any tissue from the eye or its adnexal structures is available.

Guidance on which specimens should be submitted for examination.

The choice of methodology and appropriateness of the investigation are at the discretion of the consultant pathologist who is guided by details on the clinical request form and knowledge of laboratory methods and current “best practice”.

Ophthalmologists are free to discuss the methods employed for any given specimen, but the final decision remains a remit of the clinical pathologist.

Fast paraffin processing

In urgent cases (often eyelid tumour surgery where a lesion is being excised, and subsequent reconstruction depends on knowledge of whether the margins are tumour free) a “fast paraffin” approach may be considered.

If the specimen can be delivered to the laboratory on the morning of the initial surgery, it can be processed overnight and an opinion will be available by midday on the next working day.

NB: This service is labour-intensive and must be booked in advance by contacting laboratory staff in advance to ensure both technical and clinical staff are available. This service is only available to CMFT ophthalmologists.

Unfixed specimens

Unfixed histology specimens may be sent for frozen section if other forms of rapid diagnosis are not appropriate. This service is only available to CMFT ophthalmologists.

Every attempt will be made to provide a frozen section service during working hours. Users are requested to adhere to the following requisites:

Requests for frozen sections should be booked 24 hours in advance wherever possible. Bookings can be made by contacting the Laboratory on 0161 276 8808. Patient information, clinical information, Clinician’s name and the theatre number where the surgery will be taking place will be required at this time.

Frozen sections WILL NOT be undertaken on high-risk specimens. Such information MUST be disclosed to the Laboratory and included on the request card.

The sample MUST be accompanied by a completed request card which must clearly indicate the contact number and name of the person to whom the result is to be conveyed.

Before sending the sample ring 68808 to warn the laboratory it is on the way.

Samples for frozen sections should be transported to the Laboratory in an appropriately labelled dry pot and handed directly to the technical staff as quickly as possible and arrive by 4.30pm.

Histopathology specimen requirements

Histology specimens should be submitted in an appropriately sized leak-proof container containing standard tissue fixative (10% formalin).

NB: In cases where sebaceous carcinoma is suspected specimens should still be submitted in formalin.

Conjunctival biopsies for immunofluorescence should be placed directly into transport medium. It is extremely important these specimens are NOT placed in formalin as the technique cannot be carried out on fixed tissue.  The sample in transport medium should also be labelled with relevant patient identification details. Gel tubes are available from Adult Histopathology Specimen Reception 0161 276 8808.

Immunofluorescence is not available on high risk specimens.

Urgent specimens

It should be indicated on the request form if the specimen requires urgent attention.

It is recommended that specimens deemed to be urgent are received by the laboratory as early in the day as practicable and before 1500h.

If a report is required by a particular date, this should be indicated on the request form. An attempt will be made to accommodate these requests, but a final report by a particular date cannot be guaranteed.

 

(Last reviewed 30th May 2017)