Histology

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Histology sample collection

The majority of specimens for histology need to be placed in an appropriately sized container with adequate amount of formalin (ideally 10x the volume of the sample) as soon as removed from the patient. Specimen containers of all sizes, pre-filled with formalin, are available from histology, please contact the laboratory. For specimens to be sent to the department not in formalin, empty specimen containers of all sizes are also available.

Supply of sample containers

We supply prefilled containers of all sizes to departments at Wythenshawe Hospital and empty buckets and prefilled biopsy pots to Tameside Hospital.

The exceptions to this rule are specimens requiring an urgent frozen section report, lung wedges and resection specimens and specimens being transferred to the department by the Biobank team for which they will have explicit patient consent for sampling. These specimens should not be sent in formalin.

Prefilled specimen pots are only to be transported by the Trust transport department using the dedicated barrels. Any formalin that is identified as out of date and therefore shouldn’t be used should be returned to the Histology department at Wythenshawe site so that the fluid can be safely disposed of.

Factors that prevent a detailed accurate diagnosis

There are several factors that prevent a detailed accurate diagnosis:

  • Insufficient tissue sent
  • Insufficient formalin or lack of formalin
  • Insufficient space within specimen container
  • Delay in placing specimen in formalin
  • Specimen being placed in a unsuitable solution, for example saline

Should any of these factors affect the issuing of a final report, then an incident may be raised in Ulysses. If a final report is able to be issued, factors that may have affected this result will be included in this report.

Frozen sections

Booking cardiothoracic frozen section requests

To book a cardiothoracic frozen please liaise with the cardiothoracic booking clerks who can access the shared electronic diary for booking such requests. The laboratory access the electronic diary regularly to see what frozen sections are booked. Any changes to these booking should be communicated to the Cellular Pathology department as soon as these changes are known.

Booking other frozen section requests

Frozen section requests, from either Wythenshawe or Tameside, need to be booked 24 hours in advance by calling the secretarial service.

Should the notice for a frozen section be less than 24 hours, the service may be unavailable.

Once specimen has been taken

Once taken, the specimens should be delivered to the department fresh (not in formalin) as soon as practically possible, together with the receipt book to audit the delivery of the specimen to the department. Wythenshawe frozen sections requests are delivered directly to the Histopathology department at Wythenshawe: specimens taken at Tameside are taken directly to the Tameside Pathology laboratory. Delay in delivery of the specimen will delay the issuing of the frozen section report.

If the frozen section service is no longer required please ring the laboratory as soon as possible to notify us of the cancellation.

A preliminary report will be issued stating the diagnosis obtained from the frozen section. To ensure a timely report is available, please provide contact details of where this report should be issued. A full report will follow once the tissue has been formalin fixed and paraffin sections examined by a Pathologist.

Bone Marrow Trephine specimens

All bone marrow trephine specimens should be placed in formalin and referral request made on the HODS database to be referred into the Manchester Haematological Cancers Diagnostic Partnership (HCDP). These specimens are sent from the clinic to Central Specimen Reception at Oxford Road Campus via the Haematology department at Wythenshawe Hospital.

Skin immunofluorescence specimens

Skin biopsies requiring immunofluorescence need two samples to be taken from the same area. One is to be placed in formalin; the other for immunofluorescence should be placed in Mikel’s medium which is obtainable from the Histopathology Department at Salford Royal Hospital. Specimens should be sent to Wythenshawe hospital histopathology; these will be booked onto the Trust laboratory system and then packaged by laboratory staff for hospital transport to Salford Royal hospital. Reports are returned to Wythenshawe histopathology, where they are then uploaded onto the laboratory information system.

Oral immunofluorescence specimens

The Oral Pathology Department at Oxford Road Campus has special gel tubes to preserve the specimens. Please contact them for advice on how to source the relevant specimen containers and any instructions that need to be adhered to for taking the specimen. Specimens should be sent to Wythenshawe hospital histopathology in the gel tubes; these will be booked onto the Trust laboratory system and then packaged by laboratory staff for hospital transport to Oxford Road Campus. Reports are returned to Wythenshawe histopathology, where they are then uploaded onto the laboratory information system.

If the specimen taken is larger than the containers in use then please contact the histopathology department at Oxford Road Campus for further advice.

Amputated limb specimens

If the patient would like their amputated limb returning to them following surgery, please contact the histology department for further information. Amputated limbs for disposal should not be sent to either the Mortuary or Histopathology for disposal. Should any limbs be received for disposal, the requesting theatre will be contacted and arrangements made for the limb to be returned immediately.

 

(Last reviewed February 2020)