Histology

Routine
Immunoperoxidase Staining
Renal Biopsy

Routine

Routine specimens should be submitted to the Histology Laboratory in containers filled with 10 percent Carson's formalin. The volume of formalin should be at least 10 times that of the specimen. Both requisition and container should be clearly labeled with the patient's name and specimen site. The requisition also should contain the submitting physician's name and any pertinent clinical information such as pre- and/or postoperative diagnoses. Including a social security number or medical records number for the patient is extremely important as we try to correlate previous specimens in order to have a more complete historical representation of the patient's specimen. Without an identifying number it is extremely difficult to identify with certainty a patient with a very common name such as Mary Jones, Rebecca Brown, etc.

Depending on the nature of the specimen, separate containers should be used for multiple specimens. However, only one completed requisition is necessary. Please use the following example when labeling specimens: "A," left lip lesion; "B," right arm lesion; and "C," right leg lesion. The only time more than one requisition is necessary is if there is not sufficient room to write all specimens on one requisition.

When evaluation of margins is critical, the specimen should be marked and requisition noted so that orientation is possible.

Hours of Operation
The histology section is staffed from 5:00 a.m. until 7:30 p.m. Monday through Friday and from 8:00 a.m. until 12 noon on Saturday. The section is closed on Sundays.

Obtaining Supplies
The histology section supplies specimen containers and fixative for all in-house collection areas. Please call 9089 or come directly to the department located on the ground floor in the research wing. Call the laboratory at 305.9705 to deliver containers and fixative for out of hospital customers. Should your floor or office be without suitable containers at the time a biopsy is obtained, contact histology at 305.9089 for advice as to suitable preservation and/or pickup.

Turnaround Time
Most specimens received by 3:00 p.m. will be processed and delivered to the pathologist for sign out the following morning. Thus, our turnaround time generally is 24 hours. However, at times we receive specimens that need to fix for longer periods of time (very fatty or dense specimens sometimes require longer fixation times) and, occasionally, additional tissue will need to be submitted for sectioning, which can further delay the report. In general, most specimens are signed out, and the report is made available and delivered within 24 to 48 hours. If there are questions concerning the signed out report or report status, please call the pathology office at 305.9080.

Special handling procedures for immunofluorescence studies require notation on specimen requisition to notify the laboratory.

Top ^ Immunoperoxidase Staining

The Department of Pathology currently offers immunohistochemical detection of more than 65 different tissue markers of clinical significance. These procedures employ specific antibodies that will bind to the tissue components of interest if they are present. The presence of antibody-alkaline phosphatase enzyme complexes on the tissue enables the conversion of chromagen Fast Red to a red color, signifying a positive reaction. A hematoxylin counterstain will present the nuclear material in shades of blue. A staff pathologist reviews every stain as a quality control measure.

Additional information concerning this service can be obtained by calling 865.305.9089.

Specimen/Sample Submission
Requisitions can be obtained by calling 305.9089. Some immunoperoxidase stains lend themselves to being performed on fresh specimens such as cell blocks, while others do better following fixation and embedding in paraffin. If you need specifications for a specific stain, please call 305.9089.

Submit specimen as either paraffin block or 3 to 4 micron sections mounted on standard plus slides or poly-l-lysine coated slides. Be sure to indicate on an accompanying requisition the patient's name, social security number, age, submitting physician and a list of the specific stains ordered.

Availability
Immunohistochemical procedures are performed Monday through Friday. Same-day results can be obtained if the specimen reaches the laboratory by 9:00 a.m.

Top ^ Renal (Kidney) Biopsies:

Kidney biopsies are very specialized specimens, and cores should be submitted in both Michele's fixative and 10 percent Carson's formalin and containers marked appropriately. A complete patient history should accompany the specimen, or the clinician should speak directly with the Director of the Laboratory, Dr. John Neff, to acquaint him with vital patient information. Kidney biopsy studies include routine H&E stain, Jones silver stain, trichrome stain, immunofluorescence studies and EM studies.