In this section
All specimens should be sent to the laboratory in an appropriately labelled specimen pot that is large enough to easily accommodate the specimen. It is unsafe practice to label specimen pots in advance of a procedure.
The following is a list of factors known to significantly affect the performance of examination and interpretation of results:
Specimens for routine histology are required to be placed into 10% neutral buffered formalin, which is available on request from the laboratory. Formalin is used to fix the specimen and preserve the tissue in as life-like state as possible. If there is a delay between the removal of the tissue and fixation in formalin, this can adversely impact the specimen integrity and therefore report.
To ensure proper specimen fixation, the following guidelines should be adhered to:
All specimens in formalin should be stored at room temperature and not in the fridge prior to transport to the laboratory.
TopSpecimens that potentially contain category 3 pathogens (for example, SARS-coV-2, mycobacterium, HIV, hepatitis B or hepatitis C) must be clearly labelled as HIGH RISK on both the request card and on the specimen pot to ensure the health and safety of all staff. Please refer to the Advisory Committee on Dangerous Pathogens (ACDP) website for a comprehensive list of Category 3 human pathogens.
The date and time that the specimen is taken should be recorded on the request card for all high risk specimens to enable the laboratory to calculate the fixation time on receipt. This information will minimise the infection risk to staff and prevent undue delay to processing. All high risk specimens are to be fully fixed before being processed by the laboratory.
Frozen sections, muscle biopsies and immunofluorescence investigations will not be performed on any high risk or potentially high risk specimen.
TopAll intra-operative frozen sections should be booked with the laboratory by contacting the laboratory on 0161 701 2240 to ensure the availability of the appropriate scientific and consultant staff. Every attempt will be made to provide frozen sections during the laboratory opening hours, providing appropriate clinical and technical staff are available.
Fresh samples for frozen section must arrive at the Paediatric Histology department between 9am and 4.30pm Mon – Fri.
Frozen sections should be booked 24 hours in advance after discussion with a Consultant Pathologist. If this is not possible, for example in an emergency, a Consultant Pathologist should be contacted as soon as possible. When booking a frozen section, please provide the following information;
The specimen for frozen section should be transported to the laboratory in an appropriately labelled dry specimen container and must arrive by 5.00pm. Formalin must not be added. Specimens should be handed directly to the technical staff at histopathology specimen reception as a matter of urgency to ensure a timely report is issued.
Frozen sections will not be performed on any high risk or potentially high risk specimen.
When the specimen is ready to be sent to the laboratory, or if there is a delay in theatre, please contact the laboratory. If a frozen section is no longer required, please contact the laboratory immediately to cancel.
TopIf a specimen requires an urgent report, the laboratory should be contacted on 0161 701 2240 to request this. However, it is important to state that specimens for histological analysis do need at least 24 hours fixation and a further 24 hours preparation time. It is sometimes unwise to shorten this time, as it puts the quality of the specimen at risk. Please liaise with us and we can advise you on the optimum way to deal with the sample, bearing in mind both the need for a rapid result and the requirement for good histology to make an accurate diagnosis.
TopIn order to gain the maximum amount of information we need to treat certain specimens in a specific way. In order to do this you need to liaise with us before you take the specimen, to discuss appropriate fixation, if any and transport.
Fresh samples must arrive at the Paediatric Histology department between 9am and 4.30pm Mon – Fri.
The following specimens should be sent FRESH immediately following surgical removal and should be discussed with us in advance by telephoning the laboratory on 0161 701 2240 (fresh specimens should be refrigerated whilst awaiting porter/transport to the laboratory):
If you are unsure about anything, including whether a specimen should be sent fresh or fixed in formalin, please discuss this with us by ringing either a consultant histopathologist or a senior member of the technical staff (techniques requiring fresh specimens will not be available once the specimen is fixed)
Any other specimens should be fixed in formalin as soon as possible before transport to the laboratory. Formalin fixed specimens should be kept at room temperature.
Turnaround of specimens is at least 2-3 days for routine formalin fixed specimens. If extra specialist work is required the turnaround time will be increased. Specimens containing bone or teeth require decalcification and this can take days to weeks depending on the size of bone.
Factors that can significantly affect the interpretation of the sample results include poor fixation, drying artefact of unfixed specimens and cauterisation that occur from sampling artefact.
TopWe offer electron microscopy via the electron microscopy suite in Clinical Sciences Building.
Electron microscopy will be undertaken at the specific request of the reporting Consultant Histopathologist. If the user would specifically like to request electron microscopy on a specimen, an appropriate Consultant Histopathologist must be contacted prior to biopsy.
TopThe Paediatric Immunohistochemistry Laboratory is situated within Paediatric Histopathology on the 4th floor of the Children’s Hospital and provides IHC testing for our ISO 15189 accredited histology service. We currently house an automated Ventana Ultra BenchMark staining machine which we use to carry out our routine clinical work. We are enrolled in the UKNEQAS ICC quality assurance scheme.
TopFrozen sections of pancreatic tissue for congenital hyperinsulunism (CHI) should be discussed in advance by the Clinicians, Surgeons and Pathologists. Where consent for enrolment in the CHIPS study is taken, discussions should also include the University of Manchester.
The specimen for frozen section should be transported immediately to the laboratory in an appropriately labelled dry specimen container. Formalin must not be added. Specimens should be handed directly to the technical staff at Paediatric Histopathology as a matter of urgency.
Fresh samples must arrive at the Paediatric Histology department between 9am and 4.30pm Mon – Fri.
TopBone biopsies for metabolic investigations should be discussed in advance by Clinicians, Pathologists and technical Laboratory staff. These samples require 70% alcohol fixative. Please contact the laboratory (X 12240) to inform of this type of biopsy and to obtain fixative.
Once received in Paediatric Histology a courier will be arranged to send the sample to the Royal Hallamshire for metabolic bone and histomorphometry pathway analysis.
It is important to communicate with the laboratory when a sample is being taken.
Do not fix these samples in formalin, a full analysis will not be possible in these circumstances.
TopMolecular Diagnostics is situated over two floors, 4th Floor Paediatric Histology and 5th Floor Research. This service offers Fluorescent in -Situ Hybridisation (FISH) for soft tissue tumours and neuroblastomas (turnaround time of 3-4 days) involving approximately 30 probes. The department utilises a Leica DM2500 Fluorescent Microscope and image capture system and is enrolled in UKNEQAS for Cytogenomics (GenQA) quality assurance scheme. Any clinician wishing to request FISH should discuss this with the reporting Pathologist. It is not appropriate to contact the laboratory directly to request FISH.
TopThe department regularly receives requests for expert/second opinion from other hospitals within and outside the UK. Similarly, the department also refers cases to other services for expert opinion, diagnostic services and in response to service pressures. The following are the most commonly used.
| Type | Address |
| Reporting/Vacancy cover |
LDPath NHS Department, 6 St Johns Place, London EC1M 4NP |
| Genetics, CNS tumour DNA |
Genomic Diagnostics Laboratory Manchester Centre for Genomic Medicine 6th Floor, St Mary’s Hospital, Oxford Road, Manchester M13 9WL |
| Mitochondrial Studies Muscle |
Wellcome Trust Centre for Mitochondrial Research Newcastle Mitochondrial NSCAG Diagnostic Laboratory University of Newcastle |
| Limb Girdle Muscular Dystrophies |
NCG Limb-Girdle MD Referral Centre Muscle Immunoanalysis Unit Dental Hospital Lower Ground Floor Richardson Road Newcastle upon Tyne NE2 4AZ |
| Lymphomas – HODS | Christie Hospital |
| Cytogenetics, Second Opinion | Christie Hospital |
| Metabolic Bone |
Sheffield Teaching Hospitals Department of Histopathology, E Floor, Royal Hallamshire Hospital, Glossop Road Sheffield S10 2JF |
The department supports research both internally to this Trust and externally, for all research enquires please contact Peter Collins 0161 701 2263.
Paediatric Histology provides a biobanking service for the Children’s Cancer and Leukaemia Group. The department also performs biobanking for molecular diagnostic analysis and molecular based pathways such as Whole Genome Sequencing.
TopAny samples for Paediatric Histology taken at Wythenshawe theatres must be transported to CSR at Wythenshawe. All samples must be clearly labelled FAO PAEDIATRIC HISTOLOGY, 4th Floor, RMCH, Oxford Road. These samples are taken by transport and delivered to Oxford Road Campus CSR. Please ensure an email is sent to the department to inform sample is on the way.
TopTwo pieces of skin should be sent immediately to Paediatric Histopathology, one skin should be sent fresh and the other in formalin. These should be handed directly to the technical staff.
If a skin biopsy for Immunofluorescence requires to be taken outside of laboratory hours, the fresh sample should be placed in Zeus Tissue fixative and stored in a fridge. Please arrange collection of fixative from Paediatric Histology prior to biopsy, during laboratory opening hours.
Please note the fixative only allows samples to be stored for up to 5 days.
Fresh samples must arrive at the Paediatric Histology department between 9am and 4.30pm Mon – Fri.
TopAll renal biopsies should booked in advance with the laboratory, by telephoning the laboratory on 0161 701 2240. This is to ensure the availability of the appropriate scientific staff to handle the specimen. Any urgent renal biopsies that require a report on the same day must arrive to laboratory before 11.00am of that day.
Where possible, two cores of native renal tissue should be obtained to enable investigation into native renal disease. A good quality core of renal tissue is required for routine histology investigations and should be placed in an appropriately labelled container of 10% Formalin. The second core should be kept fresh or if taken outside of laboratory hours, placed in Zeus Tissue Fixative and is appropriately labelled for immunofluorescence accompanied with a request card.
Fresh samples must arrive at the Paediatric Histology department between 9am and 4.30pm Mon – Fri.
Cores requiring Immunofluorescence that are fresh should be delivered immediately to Paediatric Histology. If it is not possible to transport these samples immediately they should be placed into Zeus Fixative. These specimens should not be placed into formalin as this technique cannot be performed on fixed tissue. Zeus Fixative is available on request from our laboratory. Immunofluorescence will not be performed on high risk or potentially high risk specimens due to the health and safety risk it poses to staff.
Two cores of renal tissue if possible and placed in an appropriately labelled container of 10% Formalin accompanied with a request card.
TopAll rectal biopsies should booked with the laboratory in advance before the procedure, by telephoning the laboratory on 0161 701 2240. This is to ensure the availability of the appropriate scientific staff to handle the fresh specimen.
Fresh samples must arrive at the Paediatric Histology department between 9am and 4.30pm Mon – Fri.
All rectal biopsies should be transported to the laboratory in an appropriately labelled dry specimen container accompanied with a request card. Small biopsies should be wrapped in gauze/foil to prevent the specimen from drying out. These specimens need to be transported to the laboratory immediately.
An Acetylcholinesterase histochemistry stain is needed to be performed on all rectal biopsies to aid diagnosis and this technique cannot be performed if specimens are placed into formalin.
Any high risk or potentially high risk specimens can be placed into formalin immediately.
TopPaediatric Histology provides a diagnostic service for both Paediatric and Adult Muscle biopsies.
All Muscle biopsies should booked with the laboratory in advance before the procedure, by telephoning the laboratory on 0161 701 2240. This is to ensure the availability of the appropriate scientific staff to handle the specimen.
Fresh samples must arrive at the Paediatric Histology department between 9am and 4.30pm Mon – Fri.
All muscle biopsies should be transported to the laboratory in an appropriately labelled dry specimen container accompanied with a request card. Muscle biopsies should be wrapped in foil to prevent the specimen from drying out. These specimens need to be transported to the laboratory immediately.
If the muscle biopsy requires mitochondrial analysis, a portion of the muscle is given to the Willink Laboratory. It is the responsibility of the requesting consultant to inform the laboratory if mitochondrial analysis is needed and to fill out all the necessary forms.
Enzyme histochemistry staining is essential for all muscle biopsies for diagnosis and this technique cannot be performed if specimens are placed into formalin.
All Muscle biopsies should booked with the laboratory in advance before the procedure, by telephoning the laboratory on 0161 701 2240.
Once the muscle biopsy has been sampled and collected by the courier, it essential to contact Paediatric Histology Ext 12240/12931 to inform them the sample has been collected and is on the way.
Instruction must be given to the Courier that upon their arrival at Paediatric Histology to call Ext 12240 and to hand the sample directly to a member of staff
Muscle biopsies will not be performed on any high risk or potentially high risk specimen.
TopPaediatric histopathology primarily receives placentas but does not receive pregnancy remains below 13 weeks 6 days gestation.
Paediatric histopathology follow the Royal College of Pathologists tissue pathway for histological examination of placenta.
For MFT referral, ensure that the order is made for Paediatric Histology and that the smart text for ‘Placenta’ is used, please do not use free text.
Always complete a ‘Request form for Histological Examination of Placenta’. These can also be obtained from Paediatric Histology if required.
Please note, all samples MUST be delivered directly to Paediatric Histopathology not to a transport drop off point and double check you have correctly labelled the sample with the patient’s details and included a request form.
It is best practise to fix the placenta including all the length of cord that is not taken for genetics examination* and membranes in 10% formalin as soon as possible to prevent autolysis. The pot should be sufficiently large enough to allow fixation and optimum histological examination, about 10 to 12 inches in diameter and larger than the diameter of the placenta.
Top(Last reviewed August 2024)