Special specimens

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In order to gain the maximum amount of information we need to treat certain specimens in a special 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.

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).

If there are any queries out of hours then the advice of the on call Consultant Paediatric Histopathologist (contacted through CMFT switchboard) should be sought.

The following specimens should be sent FRESH immediately following surgical removal and should be discussed with us in advance by telephoning the laboratory on ext 12240 (fresh specimens should be refrigerated whilst awaiting porter/transport to the laboratory):

  • Tumours
  • Rectal biopsies for Hirschsprung’s Disease
  • Renal biopsies – see below
  • Muscle biopsies – some muscle biopsies are for mitochondrial disease in which case some material will have to be sent to the Willink Laboratory.  We need to be informed if this is the case.
  • Lymph node specimens suspicious of tumour
  • Skin biopsies for electron microscopy.
  • Skin biopsies for fibroblast culture are not for histopathology, and should be sent to either the Willink Laboratory or Cytogenetics.
  • Lung biopsies
  • Liver biopsies for metabolic disease (usually glycogen storage disease)
  • Some specimens e.g. muscle biopsies may be forwarded to other laboratories for further examination. For details please contact the Histology laboratory on 12240
  • Cytology specimens for the limited repertoire detailed above.
  • Skin immunofluorescence on skin biopsies from paediatric patients – External provider.  These samples need to be sent unfixed.  However there is no out of hours service.  The on-call paediatric pathologist will be able to advise you what to do.

Any other specimens not listed above 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.

Native Renal Biopsies

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 ideally placed into gel transport medium for immunofluorescence.

Transplant Renal Biopsies

Two cores, if possible, and both placed into 10% Formalin.


(Last reviewed 19th July 2017)