Specimen Requirements

All specimens must be labelled according to the pathology labelling standards. Specimens that are not fully labelled will not be reported. Please refer to the Specimen Labelling Policy for further details.

Pathology Specimen Labelling Policy

If the labelling of a request form or specimen does not meet minimum labelling standards, and it is not possible to provide a repeat specimen, the requesting clinician will be asked to sign a declaration form. This form details the labelling deficiencies and places responsibility upon the clinician for clinical decisions based upon the results.

Inadequately Labelled Specimen Declaration Form

High Risk Specimens

To comply with national Health and Safety guidance and to alert laboratory staff that a specimen may require processing differently, some specimens must be labelled as ‘High Risk’ (Danger of Infection).

Clinical judgement must be used to label specimens correctly, and the onus for this is on the requestor.

Specimens from the following require “Danger of Infection” labelling:

Patients with proven infection with a Hazard Group 3 (HG3) pathogen eg: hepatitis B and C, HIV, tuberculosis and other mycobacteria, typhoid, brucella and anthrax
Patients suspected of having a HG3 pathogen (information from clinical history and examination e.g. injecting drug user, haemophiliac, vCJD)
Patients who are a part of an ongoing outbreak caused by a HG3 pathogen.
Inmates of Her Majesties’ Prisons

Important Warning

On no account should specimens be taken from patients suspected of having any pathogen in Hazard Group 4, e.g. viral haemorrhagic fever (Lassa, Marburg, Ebola and Congo-Crimean), or Hendra or Nipah viruses without prior consultation with the on-call medical microbiologist / virologist.

Handling “Danger of Infection” Specimens

“Danger of Infection” labels should have black print on a yellow background, and should be self-adhesive.
A label must be placed on the high-risk specimen container and its request form, which must give sufficient clinical information to enable the receiving laboratory staff to know what special precautions are necessary in the laboratory. The request form may be folded so that the information need not be conspicuous to other people, but the “Danger of Infection” label must be clearly visible.
The specimen container must be placed in an individual transparent plastic bag, which should then be sealed. High Risk specimens must not be transported to the laboratory via the air tube.

For further information please refer to:

Trust’s Infection Prevention and Control Policy

Special Instructions

Tissue Collection

10% Formal Saline is the routine fixative used for all histopathology specimens. The volume of fixative must be appropriate to the size of the sample.

The exceptions to fixed tissue are:

Must be received fresh, as soon as possible.

Place in isotonic saline or Michel’s medium and send to lab as soon as possible.

Must be received fresh or placed in Michel’s medium, and sent to the lab as soon as possible.

Must be received fresh, as soon as possible. A limited examination on both muscle and nerve biopsies may be performed on fixed tissue.

Samples may be dropped off fresh (i.e. not in formal saline) between the hours of 7.30 am and 7.00pm Monday to Saturday to be placed into formal saline by laboratory staff. Any sample that needs to be placed in formal saline and cannot be brought to the laboratory immediately should be refrigerated and delivered to the laboratory at the earliest opportunity during opening hours.

Muscle for histological and histochemical analysis can be sampled as either an open biopsy or a needle biopsy.

The Histopathology Laboratory must be informed by telephoning 0113 2064710 when a muscle / nerve is being sent and also of the expected time of arrival. Biopsies should arrive no later than 4.00pm.

Further information can been found on the protocol for sending muscle and nerve biopsies by downloading the: Muscle and Nerve Biopsy Protocol Document.

Please give 24 hours notice wherever possible. Please call the laboratory again when the specimen is being dispatched.

Inform the laboratory as soon as possible and deliver the specimen directly to the Bexley Wing laboratory.