Cellular Pathology
	Contacting the Department Departmental Diary Request forms Specimen containers Fixatives Reports High Risk Specimens

CONTACTING THE DEPARTMENT

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NORMAL WORKING HOURS

9 am – 5 pm, Monday to Friday.

OUT OF HOURS

A pathologist and mortuary technician are on call at weekends and public
holidays for hospital or consented post-mortem examinations. Requests
for post-mortem examinations should be directed to the Mortuary
technician who can be contacted through the hospitals switchboards.

There is no Out of Hours service for frozen section or biopsy reporting.

CLINICO-PATHOLOGICAL MEETINGS

There are specific request forms for specimens requiring

1	Histopathological and Non gynaecological Cytopathology
2	Breast – Core biopsies and FNAs NHS Breast Screening NHS Breast Symptomatic
3	Histopathological Examination of Placenta
4	Gynaecological Cytopathology (cervical smears)
5	Clinical Summary for Autopsy

Please ensure that request forms are fully completed. Addressograph labels are helpful. If the patients Health and Care Number (a unique 10 digit patient identifier) is known, please write this on the form.
The Department of Cellular Pathology computer database is linked to the hospital PAS System and to the Family Practitioner Services database for population demographic information. It is part of a Regional Cellular Pathology System. This is important for managing the call-recall function of the NHS Cervical Screening Programme. In order to prevent more than one entry per patient, and to allow correct matching of previous specimens from a patient, all patient identification details, including address, must be given.

Patient Identification Minimum Dataset Requirements

In order to protect patients from harm as a result of inadequate or incorrect patient information, the Department of Cellular Pathology requires the following items of information on request forms and specimen containers.

Fixation is a process of preserving tissue by interfering with the intrinsic enzyme activity which leads to cell degeneration and breakdown.

A variety of fixatives are available but, for optimal effect, it is important to use the correct fixative for the correct type of specimen. It is also important that fixation is rapid and thorough.

Histopathology specimens

• 10% formalin
  
• use at least 4 times volume of specimen, the specimen should be floating free in the specimen container.
  
• very large specimens e.g. mastectomies, colectomies, ovarian cysts - please ensure that these reach the Department of Cellular Pathology as soon as possible, preferably on the same day as operation. We can then prepare the specimen for fixation in a way that does not compromise the pathological assessment of stage of disease and assessment of resection margins.

Serous fluids, urines

• No fixative required
  
• Please ensure that urine samples arrive as soon as possible. Delayed
  processing frequently allows bacterial overgrowth resulting in a suboptimal
  specimen preparation.
  

FNA slides

• Rapid air drying is a method of fixation and is the preferred method for aspirates from the breast.
  
• For aspirates from all other sites, it is helpful to fix some slides in 95% industrial methylated spirits. Fixation must be immediate, i.e. within seconds and slides should be immersed for at least 30 minutes.

Bronchial brushings

• Prepare a direct smear (brush swept over surface of slide) and fix immediately (i.e. within 10 seconds) in 95% industrial methylated spirits.
  
• The brush can be cut off from its handle and immersed in a container (sterilin jar)
  of normal saline.

Bronchial washings

• Washings are taken in saline. No further fixative is required.

Gynaecological Cervical Samples

A typed report will be issued to the consultant or general practitioner in charge of the patient on all specimens which are submitted to the Department of Cellular Pathology. Reports are also available electronically on the 'Web browser'. We aim to report the vast majority of cases within the following turnaround times:

Urgent Reports

If an urgent result is required, please indicate this on the request form, with a contact telephone number. It is also helpful to telephone the laboratory when sending the specimen. Please ensure that the specimen reaches the laboratory without delay.

Telephone Reports

We would encourage use of Web browser to access reports. If a report is not authorised and the case is urgent, it is possible to telephone the laboratory and you will be passed to the Consultant Pathologist in charge of the case.
Please note also that, to ensure patient confidentiality, reports will only be discussed with a member of the clinical team looking after the patient.


Faxed Reports

We would actively discourage requests for faxed reports, for reasons of confidentiality and because authorised reports are available remotely with Web Browser. If it is absolutely necessary to have the full text of a report immediately (e.g. patient in attendance for results) our secretaries will check that the report has been authorised and will only then fax the report through to you, using a ‘Safe Haven’ method. Usually this entails you, the requestor being at the end of the fax telephone line ready to receive the report and telephoning the secretary back to confirm that the fax has arrived at the correct destination.

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HIGH RISK SPECIMENS

There is a small risk of infection to those handling tissue and cell samples from any patient. Where the patient is known or suspected to have a high risk infection such as Tuberculosis, HIV, Hepatitis B or Spongieform Encephalopathy, extra precautions must be taken when submitting tissue to the Department of Cellular Pathology.

The doctor requesting examination of the tissue must ensure that

1.	Any risk in clearly explained in the ‘Clinical History’ section of the request form.
2.	The request form and specimen container must be labelled with the ‘High Risk’ sticker.
3.	The tissue must be submerged in an adequate amount of fixative (i.e. the specimen should be free-floating).
4.	The specimen container must be tightly sealed. Any leakage from the container may contaminate its surroundings.

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Specimen Containers

Histopathology

Specimens for histopathological examination should be placed in an appropriately sized container (available from histopathology laboratory ext 2691/2692) which allows complete immersion in fixative and which allows the specimen to move freely. Very large specimens, which will not fit easily into a conventional large, white, rigid container, eg ovarian tumours, limbs, should be placed in an opaque plastic bag and sent to the histopathology laboratory without delay. Specimens which include a fetus should be placed in an opaque container.

The specimen container should be labelled with the patient's name and date of birth or unit number. The nature of the specimen should also be stated. A histopathology request form should be completed, placed in a plastic bag and attached to the specimen container. The specimen container, with form, should be left at a designated collection point.

Non-Gynaecological Cytopathology

Fluid specimens should be placed in adequately sized containers and sealed securely to prevent leakage during transport of the specimen to the laboratory and during handling. Please do not send pleural or ascitic fluids in the collecting bags. These are made of soft plastic and are easily punctured. Suitable containers can be obtained from the laboratory.

Gynaecological Cervical Cytology Samples

Cervical brooms for sample collection and sample vials containing PreservCyt (fixative) may be requisitioned as stock items for the customer services Department, CAH.

Endocervical brushes used to sample the endocervix are available from the cytopathology laboratory ext. 2540.

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