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Department of Pathology and Laboratory Medicine

Department of Pathology and Laboratory Medicine

Surgical pathology: clinical services - specimen collection

All specimens removed during surgery must be submitted to surgical pathology for gross and/or microscopic examination. This includes major surgery performed within the hospital, ambulatory surgery, or satellite surgical suites and minor surgeries performed in outpatient clinics or hospital units.

 

 

Specimen Identification

The specimen label must contain the patient's name, medical record number, and identity of the tissue. Use of the patient's addressograph plate is strongly encouraged. Unlabeled or unidentified specimens will NOT be accessioned until properly labelled by physician or their designee. The specimen must be accompanied by a Surgical Pathology Request form. A total of nine separate specimens may be entered on a single request form. Completion of ALL essential information will optimize tissue interpretation and patient care. The following information MUST be completed:

  1. Patient name, medical record number, account number, age and sex. Use of the patient's addressograph plate is strongly encouraged
  2. Date and time of collection
  3. Requesting physician's name, service, physician index number, and pager number
  4. Preoperative and postoperative diagnoses, clinical history including previous biopsies, surgeries, prior therapies, and diagnoses
  5. Special requests for the pathologist including photos, special stains, and consultation
  6. Names of physicians other than the submitting physician who should receive copies of the report
  7. Multiple specimens from the same operative procedure are designated as letters "A", "B":, etc. Each specimen must be listed with a precise description of the anatomic site

 

 

Results

The turnaround time for simple cases is 48 hours (two working days). Complex cases requiring extensive dissection, decalcification, special stains, and consultations will require additional time. Preliminary verbal reports from the attending pathologist or pathology resident can be obtained by calling the Surgical Pathology Service Desk at extension (916) 734-2525 between 8:00 a.m. and 5:00 p.m., Monday through Friday. The patient's name and medical record number must be supplied.

Once the report has been finalized and signed electronically by the staff pathologist, results are available on the Laboratory Information System.

High-priority specimens received at any time may be processed rapidly by special consultation with the pathologist on call.

 

 

Amputated Limbs

Limbs should be securely wrapped, correctly labelled and delivered to the grossing room (SESP Room 3P506, main hospital) during working hours, 7:30 a.m. - 5:00 p.m. After hours and on weekends and holidays, deliver to SESP Room 3P506, main hospital and place in refrigerator labelled "Placenta". The accompanying Surgical Pathology Request Form should be kept with limb at all times.

 

 

Bone Marrow Aspirations and Biopsies

Specimens should be placed in 10-percent buffered formalin fixative and delivered promptly to surgical pathology, SESP Room 3P506, main hospital.

 

 

Brain Biopsies

Advance arrangements with the neuropathologist or the pathology resident on call ((916) 734-2525) should be made to discuss the appropriate specimen size, location and studies required and to provide frozen section confirmation that the lesion has been sampled adequately. Small specimens should be placed directly on a smooth, firm surface such as plastic to avoid loss of tissue in porous material such as gauze. If an infectious disease is suspected, a duplicate specimen should be sent directly from the operating room to the microbiology laboratory.

 

 

Endomyocardial Biopsies

Submit in formalin and Karnovsky's solution (if electron microscopy is desired) and deliver to the surgical pathology grossing room, SESP Room 3P506, main hospital.

 

 

Fresh Tissue

This includes all unfixed tissues, including those for frozen section, immunohistochemistry, hormone receptors, electron microscopy, tissue culture, muscle biopsy and special stains. Such tissues should be delivered immediately to the surgical pathology grossing room, SESP Room 3P506, main hospital, between the hours of 7:30 a.m. and 5:00 p.m. After hours, and on weekends and holidays, contact the resident pathologist on call for handling of these tissues. The Intraoperative Pathology Request Form should be utilized and completed for such tissues.

 

 

Hormonal Receptors

Specimens should be submitted as fresh tissue (see above).

  1. Patient name, medical record number, age and sex. Use of the patient's addressograph plate is strongly encouraged
  2. Requesting physician, operating room site, and phone number
  3. Date and time of collection
  4. Preoperative and postoperative diagnoses, clinical history, including previous biopsies, surgeries, prior therapy, or prior fine needle aspiration biopsy
  5. Special requests, including special stains and consultations

Complex specimens should be clearly oriented and identified regarding the location of surgical margins and other significant anatomic structures.

The attending pathologist will contact the submitting surgeon by intercom or telephone to deliver a verbal report expeditiously. Additionally, the pathologist will complete the diagnosis portion for each specimen submitted and sign the report, including his/her pager number. The original white copy of this form will be placed in the consultation section of the patient's chart.

 

 

Intraoperative Consulation/Frozen Section

Between 8:00 a.m. and 5:00 p.m. Monday through Friday, bring specimens to SESP Room 3P506, main hospital. After 5:00 p.m. and before 8:00 a.m. Monday through Friday, weekends or holidays, contact the resident pathologist on call to arrange this service. Specimens for frozen section must be submitted without fixative in an appropriately sized clean container. Do not suspend the tissues in saline or other fluids. The specimen should be accompanied by the patient's chart and an Intraoperative Pathology Consultation Form. This form must be carefully completed including the following essential information:

  1. Patient name, medical record number, account number, age and sex. Use of the patient's addressograph plate is strongly encouraged
  2. Requesting physician, physician index number, operating room site, and phone number
  3. Date and time of collection
  4. Preoperative and postoperative diagnoses, clinical history, including previous biopsies, surgeries, prior therapy, or prior fine needle aspiration biopsy
  5. Special requests, including special stains and consultations

Complex specimens should be clearly oriented and identified regarding the location of surgical margins and other significant anatomic structures.

The attending pathologist will contact the submitting surgeon by intercom or telephone to deliver a verbal report expeditiously. Additionally, the pathologist will complete the diagnosis portion for each specimen submitted and sign the report, including his/her pager number. The original white copy of this form will be placed in the consultation section of the patient's chart.

 

 

Muscle Biopsies

Advance arrangements with the neuropathologist or pathology resident on call ((916) 734-2525) should be made if special studies such as enzyme histochemistry or electron microscopy are required. Sufficient clinical information should be supplies to determine which special studies are indicated. For enzyme studies, the biopsy should be done early in the day to allow transport of the specimen to UC Davis Campus for special processing. A 1 x 1 x 2 cm specimen is adequate for all studies. Specimens should be sent unfixed, untethered, and in a screw-top container, chilled and wrapped in saline moistened gauze (wring out all excess saline) to the Surgical Pathology Grossing Room (SESP Room 3P506) for subdivision. Muscle clamps, sutures, or tongue depressors are not to be used to tether the specimen.

 Muscle Biopsy Triage, 2009

 

 

Outside Pathology Material

Prior to additional surgery or therapy at UC Davis Medical Center, pathologic material from prior biopsies and surgeries must be reviewed by surgical pathology. These should be delivered to Pathology Building, Grossing Room 0205, for accessioning, or alternatively to SESP Room 3P506, main hospital.

 

 

Peripheral Nerve Biopsies

Advance arrangements with the neuropathologist or the pathology resident on call ((916) 734-2525) should be made if special studies such as high-resolution light microscopy, electron microscopy or immunostaining are required. A biopsy of adequate length (minimum 3 to 4 cm) should be placed directly on a cardboard or notecard, allowed to dry, then transported immediately to the Surgical Pathology Grossing Room (SESP Room 3P506) for subdivision. Clamps, sutures, or tongue depressors are not to be used. Frozen section confirmation that the specimen is truly a nerve may be required.

 

 

Quantitative Metal Analysis

Tissue should be submitted in a specially marked metal-free container which can be obtained from the histopathology laboratory.

 

 

Renal Biopsies

Contact the histopathology laboratory, (916) 734-3824 or (916) 734-2534 to notify of pending renal biopsy. If a technologist cannot be reached, contact the pathology resident on call at (916) 734-2525 immediately upon collection. Contact histopathology for transport.

 

 

Routine Specimens

Tissue not requiring special handling should be placed in 10-percent buffered formalin, which can be ordered from the store room. Use adequately sized containers to allow a formalin:specimen ratio of at least 5:1. Please insure that the container is closed securely. Surgical specimens should be placed in a designated area for pick-up by the laboratory between 7:30 a.m. and 5:00 p.m.

 

 

Stone Analysis

Renal and bladder stones should be submitted for chemical analysis in a clean, dry container.

 

 

Tissue Culture

The tissue submitted must be sterile and unfixed. Prior arrangements with the Department of Pathology are necessary.