Download: Specimen Collection Guide June 2017

 

I. Specimen Requirements

 

WDSL requires that all specimens received must be accompanied by an appropriate requisition and have the two patient identifiers on the specimen container.Any biopsy that does not meet the above criteria is subject to rejection.

 

II. Specimen Collection

 

  1. Tissue / Bone Biopsies Biopsies submitted from offices for Pathological and Histological studies should be submitted in a tightly sealed bottle containing 10% Zinc buffered formalin. If Microbiologic culture is desired a portion of the aseptically harvested specimen should be submitted in a sterile container for this purpose.
  1. Breast Biopsies – Note the time of collection and cold ischemic (time removed from the body until the time placed into formalin) on the requisition. If not noted on the requisition, we will need to contact the office to ensure appropriate length of fixation.
  1. Nail Biopsy – Nail biopsies for pathology may be submitted with or without formalin. If submitted in gauze, make sure the specimen is labeled with the patient’s name.  Nails for fungal culture should never be submitted in formalin. They should be accompanied by a clinical lab requisition clearly stating fungal culture requested.
  1. FNA  Fine needle aspirates may be submitted in a number of ways. 
    1. Slides  Slides may be fixed or air-dried. Fixed slides are generally preferred. Fixed slides may be spray fixed or received in a Coplin jar filled with 95% alcohol. Air dried slides may be submitted in card board or plastic slide holders.
      1. Slides need to be labeled with two patient identifiers.
  2. Aspirate – The aspirate may be submitted fresh in a capped syringe (no needles, the specimen will be returned to the office if a needle is still attached). Aspirate fluid may also be submitted in formalin for cell block.
  3. Fluid for Cytology – Any fluid for cytology (including: urines, bladder washings, abdominal fluid, pleural fluid etc.) must be in a tightly sealed container and clearly marked with the patient’s name and second identifier.  In general, it is preferable to submit fluids fresh.  Note: If submitting fluid for culture, it must be clearly marked and submitted in a sterile container.
  4. Frozen SectionBiopsies submitted for frozen section analysis must be submitted fresh. Notify WDSL ahead of time of a frozen section to schedule an immediate STAT pickup. Fresh tissue may be submitted in the following form.
    1. Fresh in gauze.
    2. In saline solution.
  5. Bone MarrowsIt is preferable that bone marrow biopsies are performed in the a.m. hours to ensure proper handling of time sensitive material and fast turn around of results. Please call WDSL for a STAT pickup for all bone marrows.
      1. Clot – bone marrow clot should be submitted in a clearly labeled formalin container.
      2. Core bone marrow core should be submitted in a clearly labeled formalin container.
      3. Flowbone marrow aspirate to be submitted for flow cytometry and/or cytogenetic analysis should be collected in a green top sodium heparinized tube. Note: Time sensitive specimen: flow must be run within 24 hours.
      4. Bone Marrow Aspiratebone marrow aspirate may be submitted in a purple top tube of K2 EDTA (clearly labeled with bone marrow aspirate), or in the form of bone marrow aspirate slides (clearly labeled with patients name). Note: Time sensitive specimen: slides/tests must be made/run within 24 hours.
      5. Peripheral Blood peripheral blood should be submitted in a purple top tube of K2 EDTA. Note: Time sensitive specimen: CBC must be run within 24 hours.
  6. Fresh Tissue for Flow Cytometry, Cytogenetics or other Special Studies – all tissue specimens to be submitted for flow cytometry, cytogenetics or other special studies should be collected in RPMI. RPMI is a transport media that will keep the tissue fresh, however it must be kept cold. Store in the refrigerator or with an ice pack (do not freeze).
  7. Stones for Analysis – if chemical analysis is requested on stones, submit fresh in a sterile container. If formalin is added, the chemical analysis cannot be performed.
  8. Specimen return policy – Any specimen returned to the surgeon’s office is removed from formalin before returning.
    1. Gallstones are routinely removed from formalin and returned to the surgeon’s office, in a clear conical tube labeled with the patient’s name, accession number and doctor’s name.
    2. Hardware and gross only samples are removed from formalin and returned to the surgeon’s office, upon request.

 

III. Specimen Rejection 

WDSL will make every effort to contact the physician office and resolve discrepancies without jeopardizing the integrity of the specimen. Below are examples of scenarios when the specimen will be returned to the office.

  1. Specimen received without proper identification, i.e., no name on the specimen or requisition.
  2. Name on the slide(s) or specimen container does not match the name on the requisition.
  3. Specimens received in a condition judged to be biohazardous, e.g. fluids received in open containers or syringes with needles attached uncapped (specimens received with the needle capped will be processed but the client will be notified and the incident reported to the designated safety officer).
  4. Slides received broken beyond repair, i.e. fragmented to an extent that pieces cannot be processed or missing specimen. The client is notified and asked to resubmit.

 

Download: Specimen Collection Guide June 2017