Tissues and specimens

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Material sent away for further tests

The laboratory on occasion refers material (paraffin embedded blocks or stained slides) to the Manchester Haematological Cancers Diagnostic Partnership. This is a joint partnership between Manchester Foundation Trust and the Christie Hospital for confirmation and classification of lymphomas and to the Christie Hospital for opinion and / or confirmation of pathology in a small number of cases.

Material may also be referred to St Marys Genetics department for Genetic / molecular testing which quotes a 10 day turnaround time for results. This includes EGFR, BRAF and KRAS.

A very small number of cases are referred to other Specialist Histopathologists for expert second opinion or review.

Specialised testing

The laboratory performs the following specialised tests for patients accessing Wythenshawe hospital Histopathology services as well as referral tests for hospitals within Greater Manchester and wider regions;

  • Breast HER-2 confirmatory testing (DDISH).
  • PD-L1 (triple negative breast cancer)
  • PD-L1 (lung cancer)
  • ALK (lung cancer)

Full scope of practice can be found on the UKAS website.

Return of tissues

On occasion, patients request the return of tissues following a surgical procedure. This may be for various cultural or religious reasons. Patients have a right to have their tissues returned to them. Any request for the retention of specimens should be referred to a Histopathologist and Deputy Laboratory Manager within Histopathology at Wythenshawe hospital.

1. If there is no need for the tissue to be examined histologically and the patient wishes to take it away immediately, then it does not need to be sent to the Histopathology department.

2. In some cases, the tissue needs to be examined histologically. The remaining tissue will then be returned to the patient by the Histopathology department. Sometimes the patient is hospitalised or is uncertain as to what he wants done with the tissue, in which case it will be stored by the Histopathology department. In such cases, please speak to the Deputy Laboratory Manager or Lead Biomedical Scientist to ensure that the patient’s wishes are met with regard retention and return of their tissue sample. Please be aware that failure to inform the department that the patient wishes to have their tissue sample retained and returned to them may result in the specimen being disposed of as tissue samples are only kept in the department for 4 weeks following the issue of a histology report. If the specimen is able to be returned to the patient, written advice as to the hazards of the formalin fixative used will be provided.

Disposal of tissues

Specimens are not permitted to be sent to histology for disposal purpose. We provide a diagnostic service, not a disposal service. Any specimens received where disposal is indicated will be processed and a report issued. Pregnancy remain (POC) specimens may be disposed of without histological examination if indicated by the patient on the PS1 form. If so, the specimen should be sent directly to the Mortuary for disposal to be arranged as per the patient’s wishes.

Errors happen

There is evidence that the rate of clinically significant reporting errors for Histopathologists is 1 to 2%. Since histology often provides the definitive diagnosis, error in histology may have a profound impact on patient management. There are things that you can do to reduce the occurrence and impact of errors:

  • Make sure that request cards and specimen pots meet the requirements of the sample acceptance criteria with unambiguous and correct patient demographics.
  • Provide clinical information on the request card, including details of previous specimens, whether here or in another hospital.
  • Question cases where there is an apparent discrepancy between the clinical, radiological and pathological diagnosis.
  • Review cancers at an MDT

Manchester Cancer Research Centre Tissue Bank

The Manchester Cancer Research Centre (MCRC) Tissue Bank is an initiative to collect and bank tissue samples from cancers to facilitate research. The project started collecting in April 2008. To contact the team please ring 0161 446 3659 or click on the hyperlink above.

Measurement uncertainty

For information regarding measurement uncertainty for specimens in Cellular Pathology please contact the laboratory.

(Last reviewed June 2021)