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Anatomic Pathology Specimen Collection and General Information

Collection Procedure:

 

 

General Information for Anatomic Pathology

PolicyTech: Version 6

 

Anatomic Pathology includes: All tissue specimens considered as general surgical

 

pathology specimens; muscle, nerve, kidney, and skin biopsies; products of conception;

 

and Fetal and Autopsy Pathology cases.

 

Policy

 

By medical staff policy, all specimens removed in surgery with the exception of hardware,

 

(See Surgical Services Policy titled Specimens, Pathological) must be submitted to

 

pathology.

 

Histology Laboratory Hours

 

Routine Operation 0700 - 1630 Monday through Friday excluding holidays.

 

STAT procedures needed during off hours require a call to the Pathologist On-Call and may

 

be arranged as needed. Please call ahead for any referred in biopsies etc.

 

Electron Microscopy Laboratory Hours

 

Routine Operation 0800 -1630 Monday through Friday excluding holidays.

 

Communication

 

Please call the Pathology Office approximately 30 minutes prior to delivering a frozen

 

section specimen whenever possible. Call Pathology with any questions regarding STAT

 

processing, proper preservation and transportation.

 

Telephone Assistance

 

Pathology Office                                                           (330)543-8572

 

Chair of Pathology & Lab Med Dr. Jennifer Baccon  (330)543-8567

 

Histology Lab                                                                (330)543-8743

 

Electron Microscopy Lab (                                            (330)543-8279

 

Off-Hours-Centralized Core Lab                                  (330)543-8417

 

Akron Children’s Operator (1-800-262-0333)              (330)543-1000

 

 

Requisitions - Follow the laboratory policy which minimally requires date and time of

 

specimen collection, appropriate patient identifiers including birthdate, sex, specimen type,

 

ordering physician and diagnosis for on-site specimens. Referenced in specimens require

 

the surgical number of the referring pathology department if applicable, type of transport

 

solution used, and appropriate billing information. Fill in appropriate blanks if you are using

 

an on-line or Akron Children’s form. Make sure the patient location is clear.

 

Surgical Requisition Use for submission to Histology of all specimens (tissue

 

and non-tissue) from Akron Children’s Hospital patients. Complete specimen

 

information clearly and completely.

 

Body Fluid Requisition Use for submission of body fluids CSF, Bronchial

 

Lavage, Pleural, Abdominal, Joint, and Tumor/Cyst aspirates.

 

 

Specimen Labeling

 

Follow the hospital policy on labeling a specimen (Specimen Labeling/Request Form

 

Completion), making sure that the specimen and the requisition have two matching patient

 

identifiers and dates. The Surgical Requisition is designed to allow for multiple specimens

 

on the same patient in an A, B, C… format. Label the SIDE of the container with the

 

patient label and appropriate letter. Do not use the lid of the container for labeling as lids

 

could be interchanged. Include two identifiers which are also on the paperwork.

 

 

Transportation

 

Surgery Routine surgical specimens are taken from the individual surgery suites

 

to the surgical specimen room. Specimens for routine diagnostic histology are

 

collected by histology technicians a minimum of twice a day at 1130 and 1500

 

hours. Specimens not being put in formalin and requiring frozen sections and/or

 

other special studies will be delivered by surgery personnel to Histology.

 

Patient Care Units and Outpatient Offices are responsible for the transportation of specimens to the lab.

 

Off-campus ACH facilities AGMC special care nursery, Mahoning Valley,

 

   Hudson, ACHP’s should use the courier routinely used to send specimens to the

 

   Akron Campus.

 

Non ACH facilitiesSumma, AGMC, Youngstown, etc. should call Pathology.

 

Couriers may be arranged by calling 330-543-8572.

 

0800 to 1600, deliver all specimens not otherwise indicated to Histology;

 

1600 to 0800, specimens should be sent to Centralized Core Lab.

 

Weekends-Do not send fresh specimens on nights or weekends unless the On-call

 

Pathologist has been notified. The address below should then indicate:

 

ATTENTION - Centralized Core Lab Rm 5460

 

 

Shipping Address and Information for ReferredIn Specimens

 

Akron Children’s Hospital

 

One Perkins Square

 

Akron, Ohio 44308

 

Daytime ATTENTION Histology Laboratory, Rm 4531

 

or

 

After 1600 and on Weekends ATTENTION CCL, Rm 5460

 

 

Specimen Preservation See Chart on separate page.

 

Always separate specimens from different sources into separate containers. Specimens

 

being sent Fresh require a sterile container. Place small specimens on a saline wet gauze

 

while larger specimens can simply be placed in the container. Do not place specimens on

 

dry gauze as it will cause dehydration.

 

Special studies - Culture and/or Chromosome studies (FISH, Cytogenetics,

 

Karyotypes, Microbiology)

 

 

PRODUCTS OF CONCEPTION

 

(Stillborn, Fetus, Intact Gestational Sac, Curetted Products of Conception, Placentas)

 

 

 

Products of conception are evaluated at the request of the attending obstetrician and

 

with the agreement of the Department of Pathology of the referring hospital. The

 

general purpose of these evaluations is to establish the mechanism of fetal loss and to

 

determine whether or not there are implications for future reproduction or immediate

 

implications for the care of the post-partum patient. The expectations for a provisional

 

anatomical diagnosis should be one week and for the Final Report should be

 

approximately 6 weeks.

 

Follow General Information provided at the beginning of this procedure to

 

obtain contact numbers, specimen labeling, requisition information, etc. for

 

notification of the Akron Children’s Pathology Department. Provide

 

Gestational Age instead of birthdate.

 

Validate proper requisition (stamped with mother’s hospital card) and

 

specimen labeling as listed above. Always label the specimen container not

 

the lid and be sure to include date of service.

 

Place in sterile container using sterile wrappings. Maintain aseptic

 

techniques. No fixative should be added. Store refrigerated.

 

Provide mother’s reproductive and Clinical History.

 

Include a signed and witnessed Release for Autopsy and Disposition of

 

Remains form (mandatory for all fetuses over 20 weeks). This may take the

 

form of a written consent witnessed, signed, and faxed by one of the parents

 

(provided they are 18 years or older and of sound mind), grandparents, or

 

legal guardians.

 

Fetal Death Certificate for all fetuses 20 weeks or greater.

 

Indicate if funeral services are planned and any appropriate contact

 

information and numbers.

 

Delivery should be to the Security Office located beside the Emergency

 

Department where Security will escort the courier to CCL for small cases or

 

the morgue for larger cases.

 

Additional Info:

SPECIMEN PRESERVATION OF TISSUE AND/OR FLUIDS FOR PATHOLOGIC EXAM

 

Specimen Type

In-House

Referred In, @ Night, or Expected Delay

Routine specimens e.g. Hernia Sacs/Hydroceles, Small Fluid Filled Cysts,

Tonsils, GI Biopsies, etc.

Formalin - Add approximately 3 times the volume of fixative relative to the size of the specimen.

Formalin Add approximately 3 times the volume of fixative relative to the size of the specimen. Keep cold at 4oC.

Frozen Sections-Indicate FS on Req

Fresh-Deliver STAT.  Notify Pathology 38572

Have operator notify Pathologist on call.

Lymph Nodes/Biopsies

Fresh-Deliver STAT

Transport on a wet saline gauze in a cup. Deliver STAT.

Tumor/Tumor Biopsies

Fresh-Deliver STAT to Histology;

Have operator notify Pathologist on call.

Skin Biopsy for FA

Fresh-Deliver STAT; Keep moist on Telfa pad. Do not immerse in saline or wrap in soaking gauze.

Place in Histocon and transport cold. May be stored up to 24 hours.  Deliver STAT.

Kidney for FA and Immunohistochemistry

Place in Histocon and transport cold. Can not be sent in Glutaraldehyde.

Place in Histocon and transport cold. May be stored up to 24 hours.  Can not be sent in Glutaraldehyde.

Kidney for EM ONLY –

Place specimen in 2.5% Glutaraldehyde available by calling the Lab (38279).  Store at 4oC.  Do not freeze.

Place specimen in 2.5% Glutaraldehyde available by calling the Lab (38279).  Store at 4oC.  Do not freeze.

Nerve Biopsies Histology and EM

Fresh-Place on a saline moistened gauze or telfa pad.  Do not immerse in saline or wrap in soaking gauze. Deliver STAT.

If delay > 24 hours expected, place specimen in 2.5% Glutaraldehyde which is available by calling the Lab (38279).  Store at 4oC.  Do not freeze.

Muscle Biopsies – Histology and EM

Fresh-Place on a moist saline gauze. Do not soak or immerse or expose to heat.  Deliver STAT.

Fresh–Place on a moist saline gauze & inside a sealed baggie or Petri dish.  Keep cold during transport using ice chips.

Nasal Biopsies/Bronchial Brush preps for Cilia for EM

Fresh-Deliver STAT to Electron Microscopy.  Call EM at 38572.

Place specimen in 2.5% Glutaralde-hyde available by calling the Lab (38279).  Store at 4oC.  Do not freeze.

Bone Marrow Biopsies

B+Fixative(Zink-formalin)-Deliver STAT

B+Fixative(Zink-formalin)-Deliver STAT

Aspirate e.g. thyroid

Fresh-Deliver STAT to CCL

Place in Cyto-Lyte.  Deliver STAT.

Large Fluid filled Cyst, Body Fluid other than CSF, Bronchial Lavage

Fresh-Deliver STAT to CCL

Refrigerate @ 4oC (Keep cold during transport).  Deliver STAT.

Non Tissue Specimens

No fixative (Items part of a criminal investigation should follow surgery’s procedure for chain of command documentation.)

No fixative (Items part of a criminal investigation should follow surgery’s procedure for chain of command documentation.)

Specimen other than blood for Karyotype

Fresh-Deliver STAT to Cytogenetics

Hanks, Keep cold.  Deliver STAT to Cytogenetics Monday thru Friday only.

Products of Conception– Fetal, Stillborn, Placenta, Gestation Sac, Curettings.

Fresh-Deliver to Histology; Send completed Placental form/requisition.

See separate page for details.

Refrigerate @ 4oC (Keep cold during transport) Send/ complete Placental form/requisition.

Possible specimens from Mahoning Valley are Highlighted.