The department provides a comprehensive routine diagnostic service as well as Consultant cover at the weekly rapid diagnosis breast clinic. It hosts over 30 clinical or MDT meetings per month. Adequate notice regarding which cases are to be discussed at the meeting should be given by the clinical teams and MDT coordinators.
Small specimens received before 15.30 hours are normally processed overnight if they have undergone adequate fixation. Final authorisation and issue of the typed report usually occurs within 3-4 working days. Cases which require further levels, further blocks or Immunocytochemistry to be examined will take longer than this, dependent on complexity.
Larger specimens and skin samples of medium to large size require further time for adequate fixation. Typically a specimen such as a hysterectomy/colectomy/ mastectomy will be opened and sliced on the day it arrives in laboratory and allowed to fix over night. Blocks will be taken the following day and processed overnight. Such cases will be reported within 5-7 working days from receipt unless further complex investigations are required.
RcPath turnaround time guildelines are
Primary report by
7 days 80%
10 days 90%
Urgent small specimens are usually processed overnight with a telephone report being available by lunchtime the next day. The request form should be clearly labelled as “Urgent” and a bleep or extension number supplied for communicating the report. Results on larger specimens will generally not be available until day 4.
Under exceptional circumstances small biopsies may be processed and a provisional report issued the same day if received before 12.00. This requires a specially shortened processing schedule and must be arranged in advance with the Consultant Histopathologist.
Please note renal biopsies (except those where malignancy is suspected) are referred to John Radcliffe Hospital, Oxford. Please contact lab on ext 7738 for more details.
All routine specimens should be submitted in Formalin and stored at room temperature. Appropriate containers of various sizes, Formalin and small pre filled pots can be obtained from the Pathology Issue room on the standard order form. See User Services for details. All containers must be securely closed to prevent leakage. All containers must be correctly labelled on the side of the container and Patient Identification stickers should be used where possible. Specimen containers must be placed in leak proof plastic bags.
Danger of infection labels, when appropriate, must be placed on specimen containers and request forms.
Unlabelled and incorrectly labelled specimens are unacceptable and will either be returned to the sender or the sender will be asked to come to the laboratory to identify and label the specimen.
Within the laboratory once we receive a specimen we aim to eliminate or reduce to a minimum the levels of uncertainty for the results that are issued. In areas where uncertainty could be introduced we have implemented control measures to ensure that the results we produce are as accurate as possible.
Sources of uncertainty
Reduction in size of tissues after removal from body due to loss of blood volume is unknown.
Reduction in size of tissue when fixed in formalin (not relevant if tissues are assessed unfixed)10–20% decrease depending on tissue.
Technical difficulties in assessing three dimensional sizes of some neoplasms, including distortion of tissues by handling unknown (10–20%, possibly).
Lack of homogeneity of the tissue means that there will be random effects due to the precise plane of slicing the tissue. Unknown (10–20%, possibly)
Changes in size of tissues during fixation, processing and section cutting. Unknown; factors work in different ways to decrease or increase size of the tissue which, in turn, will influence the area assessed. Precise estimate of U of M is not possible, mainly due to lack of homogeneity and no known ‘true’ value.
For further information on specimen transport and associated policies and procedures please see User Services/Specimen Transport section of the Pathology Handbook.
Specimens of fresh tissue should be submitted only by prior arrangement with the department. Please use telephone ext 7738.
Skin biopsies and occasional minor salivary gland biopsies for Immunofluorescence (IMF) must be submitted fresh with the request form clearly marked “Skin/salivary gland for Immunofluorescence”
For all frozen sections the department must be informed before the sample is sent, even if the need for a frozen section only becomes apparent as a result of unexpected findings during the operation.
A minimum of 24 hours notice should be given for an elective frozen section and any change to the agreed arrangements and planned arrival time of samples must be notified immediately. If the frozen section is cancelled, please inform the lab.
Specimens must be taken directly to the Pathology Specimen Reception immediately – IN A FRESH STATE WITHOUT FORMALIN OR ANY OTHER FLUID
Request forms should be stamped URGENT SAMPLE FOR FROZEN SECTION.
A chain of custody form must accompany the specimens.
Renal biopsies must be submitted directly to the laboratory in formalin.
Pre filled containers of this can be obtained from the laboratory ext 7767.
Please follow the guidelines given in sending muscle biopsies.