Ordering Guidance

For a pathology consultation on paraffin embedded tissue and slides only (ie, no wet tissue being sent to be processed), order PATHC / Pathology Consultation.

Additional Testing Requirements

Shipping Instructions

Vitreous fluid/aqueous humor specimens: ship overnight; Attention: Ophthalmic Pathology Working Group. Call 800-533-1710 to request an Expedite on this order since vitreous fluid will have no fixative and needs to reach the laboratory as quickly as possible.

Attach the green pathology address label to the outside of the transport container.

Necessary Information

The following information is required:

1. All requisitions must be labeled with:

-Patient name, date of birth and medical record number

-Name and phone number of the referring pathologist or ordering physician

-Anatomic site and collection date

2. All specimens must be labeled with:

-Two patient identifiers (first and last name, date of birth or medical record number)

-Specimen type and anatomic site

3. A brief patient history is essential to achieve a consultation fully relevant to the ordering physician's needs.

4. A preliminary pathology report is preferred, if available, in order to ensure that the specimen is known to a referring pathologist.

All requisition and supporting information must be submitted in English.

Specimen Required

Specimen Type: Lung biopsy

Supplies:

-Pathology Packaging Kit (T554)

-Formalin, 10% (T118)

-Michel's Transport Media for Immunofluorescent Testing on Tissue (T321)

Specimen Volume: Entire specimen

Collection Instructions:

1. Submit portion of lung tissue in 10% neutral buffered formalin for light microscopy processing. Alternatively, submit a representative hematoxylin and eosin (H and E) slide from the light microscopy sample along with the tissue in Michel's transport media. Pathology Packaging Kit can be used to submit H and E slide.

2. Place a portion of the unfixed lung tissue in Michel's transport media for immunofluorescence.

Specimen Type: Cardiac biopsy

Supplies:

-Pathology Packaging Kit (T554)

-Formalin, 10% (T118)

-Michel's Transport Media for Immunofluorescent Testing on Tissue (T321)

-Electron Microscopy Kit (T660)

-Gluta (Trumps) (T130)

Specimen Volume: Entire specimen

Collection Instructions:

1. For ideal analysis, collect 4 to 6 biopsy specimens and submit all in 10% neutral buffered formalin unless electron microscopy (EM) is requested.

2. If EM is needed, submit at least 1 biopsy into 2.5% to 3% buffered glutaraldehyde preservative using the Electron Microscopy Kit along with the formalin biopsy specimens. If formalin biopsy specimens are not available, light microscopic slides would also be acceptable.

Additional Information: If the question is drug toxicity, storage disease, or if the patient is younger than 25 years old, send at least 1 biopsy specimen in 2.5% to 3% buffered glutaraldehyde in case EM is needed for diagnosis.

Specimen Type: Cardiac explant

Supplies:

-Pathology Packaging Kit (T554)

-Refrigerate/Ambient Shipping Box, 5 lb (T329)

Specimen Volume: Entire specimen

Collection Instructions:

1. Fix entire explant specimen in formalin for a minimum of 24 hours.

2. Following fixation, lightly wrap specimen in formalin-soaked paper towel, place in a leak-proof sealable bag with a small amount of formalin, seal, and ship ambient in a sturdy shipping container (ie, Refrigerate/Ambient Shipping Box, 5 lb).

Additional Information: Include the last pretransplantation echocardiogram with report and images as well as all other relevant clinical documents.

Specimen Type: Enucleated eye

Supplies:

-Pathology Packaging Kit (T554)

-Formalin - 10% Histo Prep, 45 mL (T117)

Specimen Volume: Entire specimen

Collection Instructions:

1. Immediately after removal, place specimen in approximately 300 mL of 10% neutral buffered formalin.

2. Enucleated eye should not be opened or punctured.

3. After 48 hours in the originating laboratory, the specimen should be transferred from the larger, 300 mL container to a smaller container with fixative (Formalin - 10% Histo Prep, 45 mL) to be shipped without risk of leakage.

Specimen Type: Iris, conjunctiva, cornea, and other small biopsies from eye

Supplies:

-Pathology Packaging Kit (T554)

-Formalin - 10% Histo Prep, 45 mL (T117)

Specimen Volume: Entire specimen

Collection Instructions:

1. Obtain biopsy.

2. Place iris, conjunctiva, cornea, and other small biopsies on a paper mount (a piece of filter paper or other porous paper). This helps to keep the specimen from curling when it is fixed.

3. Immediately but gently place specimen (on the paper mount) into 10% formalin, approximately 20 times the volume of the biopsy (Formalin - 10% Histo Prep, 45 mL).

4. In cases where margins are important, placing sutures at the margins of resection with accompanying explanatory draft will help orientation of the specimen in the lab.

5. Patient history and clinical/surgical notes should be included if available.

Specimen Type: Vitreous fluid/Aqueous humor

Supplies:

-Pathology Packaging Kit (T554)

-Sarstedt Aliquot Tube, 5 mL (T914)

Specimen Volume: Entire specimen

Collection Instructions:

1. Obtain liquid specimen.

2. Place the liquid (vitreous or aqueous) concentrate into a small tube with a screw-top cap. Seal the tube tightly.

3. Put the specimen immediately on a refrigerated cool pack (not dry ice or frozen cool pack).

4. If a washing (diluted) is available, it can also be sent in similar manner.

Specimen Stability Information: Refrigerated