ROUTINE TISSUE EXAMINATION

Routine tissue examination consists of two parts. First, the pathologist examines the tissue macroscopically performing a gross examination. After the tissue has been processed and prepared, a microscopic examination is then performed.

HANDLING AND FIXATION

Tissues submitted for routine surgical pathology should be placed in 10% buffered formalin as soon as possible after the surgical removal. 10% formalin is the most commonly used fixative. Pre-filled containers with formalin and/or containers of formalin are provided by WPM at no extra charge.

Fixation of tissue is the foundation for subsequent stages in the preparation of tissues for microscopic examination. Fixation alters tissues by stabilizing the protein so that it is resistant to further changes. Fixation also kills the tissue so that bacterial attack and autolysis (enzyme action) are prevented. The following items are essential to good quality tissue fixation:

  1. Volume ratio: The formalin volume should be sufficient to adequately and entirely cover the tissue specimen.
  2. Time: Ideally, tissue should be placed in formalin immediately after surgical removal. Small tissues, such as those from bladder biopsies and endometrium, can be ruined in a short time by drying out.

A MSDS for formalin will be provided or made available upon request.

STORAGE

Room temperature storage of fixed tissues is suitable. Refrigeration is not necessary. Do NOT freeze. Tissue fixed in formalin is stable indefinitely. Tissue held over the weekends or holidays do not need further handling or storage requirements if fixed in formalin.

LABELING

All tissue specimens received must be properly identified with the following information:

  1. Patient’s first and last name
  2. Source of specimen
  3. Physician
  4. Date of specimen collection

This information should be written on the specimen label, not on the lid.

In addition, there are adhesive labels on each requisition that can be placed on the tissue specimen container for added identification. These are especially helpful for specimens with multiple parts. There is a space on each label to indicate the specimen source or site. The number on the label (# 1, # 2, etc.) should match the corresponding specimen number on the requisition.

SPECIMEN COLLECTION, HANDLING AND TRANSPORTATION

All specimens should be placed into a proper, leak-proof primary container with a secure leak-proof lid that is tightly screwed on or fastened. Select the appropriate size of specimen container for the tissue size to be submitted. WPM Pathology Laboratory provides a variety of containers for specimen collection. Care should be taken by the person collecting the specimen not to contaminate the outside of the primary container.

Properly identify the tissue specimen using the instructions listed above.

When multiple specimens are to be examined and diagnosed individually, each specimen must be submitted in a separate, appropriately labeled container.

Before being transported to WPM, the primary container is to be placed into a secondary container (specimen transport bag), which will contain the specimen if the primary container breaks or leaks in transit to the laboratory, unless the specimen is too large. WPM provides specimen transport bags (biohazard) for use as a secondary container.

Transport to WPM, along with a properly filled out WPM SURGICAL PATHOLOGY & NON-CYTOLOGY request form.

Universal health precautions should always be followed when handling specimens and fixatives.

TURN-AROUND-TIME

Specimens are processed upon receipt, and test results are reported to clients after they are released. Most routine surgical tissue specimens will have a report issued within one to two working days after tissue receipt. Specimens requiring special stains, immunohistochemistry, or outside pathology consultation will require more time.

Selected test results are telephoned as soon as they are available. Reports may be faxed as soon as they are available, and followed up with a hard copy via courier or mail. Reports also are available by secured Internet site for those wishing to use this option. Clinicians also may call for results.

SPECIMEN ACCEPTABILITY

In order to maintain specimen integrity and accuracy of identification, it is imperative that specimens submitted to WPM be properly and completely labeled. Specimens received mislabeled or unlabeled, may be cause for rejection. Since most tissue specimens cannot be collected again, WPM personnel will notify the sender to try and amend the labeling problem. However, in some instances it may be impossible to correctly identify the specimen with the correct patient and the specimen will be rejected. Care must be taken to insure that specimen containers are properly labeled, and that the test request forms match the specimen.

contact us

  • WPM Pathology Laboratory
  • 338 N. Front St.
  • Salina, KS 67401
  • 785.823.7201