Related Terms: Biopsy; gross and microscopic pathology; histopathology; tissue examination; gross identification; stone analysis; frozen section.

Test Includes: Gross examination only or gross and microscopic examination and diagnosis; frozen section or tissue imprints on fresh tissue samples; special stains, flow cytometry, cytogenetics, molecular studies, and other analysis performed on selected cases.

Availability: Mon–Fri 08:00–17:00, Sat, 08:00–12:00; Pathologist on call at all times for consultation.

Analytic Time: 1–2 days for routine cases.

Specimen:

  • For routine processing, place tissue in appropriately sized container of 10% phosphate buffered formalin. The fixative to specimen ratio should be 10:1 or greater.
  • Breast tissue and suspected breast cancer tissue may be subject to prognostic marker analysis. ASCO and College of American Pathologists (CAP) guidelines stipulate limiting warm ischemia time and adequate tissue fixation time to insure accurate prognostic marker study results. When submitting breast tissue or suspected metastatic tumor tissue, indicate on the requisition the time and date the sample was 1) taken from the patient and 2) when the sample was placed in the fixative. Documentation of these times is a CAP requirement.
  • Fresh tissue should be submitted in cases that require frozen sections, imprints, cytogenetic studies, lymphoma work up, cultures, or require special fixatives that are not available at the time of operative procedure (kidney biopsies, DIF). The tissue should be wrapped in a sterile Telfa or gauze pad moistened with sterile saline. Prolonged warm ischemia time prior to fixation may render the specimen uninterpretable, especially small tissue samples that may be subject to drying artifacts. Call the laboratory for immediate processing when submitting unfixed tissue.
  • Foreign bodies or stones for gross identification/stone analysis can be submitted in a clean dry container.
  • Large samples that do not fit in containers can be wrapped in clean watertight material. Notify the laboratory for special specimen pickup if applicable.

Causes for Rejection: Unlabeled specimen. Insufficient demographic or clinical information for processing.

Interpretation: Gross and microscopic evaluation by pathologist.

Special Studies: Specify if special stains, cytogenetics, specimen x-ray, or molecular studies are needed. Gross and microscopic photo images are available on request (PDF report available through Atlas Medical web reporting).