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Pathology & Mortuary Services

The Scottish Cytology Training School (SCTS) is a National Health Service Cervical Screening Programme (NHSCSP) Accredited Training Centre. The SCTS provides training and continuing professional development (CPD) for relevant professional staff in cervical cytology screening and associated work areas as part of the Scottish Cervical Screening Programme.

Course/Application Information

Please send completed application forms to: ggc.scts@ggc.scot.nhs.uk

Scottish Cytology Training School Courses

Introductory Course in  Gynaecological Cytology [NHSCSP Diploma] – (Thinprep®) – Minimum entry qualification

Trainee Cytoscreener – 4 GCSE’s

Trainee Biomedical Scientist – ‘A’ levels or equivalent to allow entry to a Health Profession Council (HPC) approved degree course or a recognised HPC/Institute of Biomedical Science (IBMS) approved degree.

Eligibility – All students must be employed in an NHSCSP Cytopathology department, as a trainee to undertake this course as part of the 2 year UK registration training.

Length of time in post: Learners should attend the introductory course ideally within the first 6 months of employment. Learners should spend a minimum of 6 weeks in the home laboratory learning how to set up and use a light microscope to visualise cells for interpretation and be familiar with normal cell morphology and basic infections.

NHSCSP – Registration: Prior to starting the introductory course pre-registration students must be registered by their employers with the NHSCSP Education office. The laboratory training officer (assessor) must also be registered prior to learners commencing their portfolio. This course is the first part of an intensive two year training plan for registration in Cytology which includes written portfolio work, slide logbook and attendance at compulsory courses at the training centre with a final one day external examination.

Follow –up Course in Gynaecological Cytology [NHSCSP Diploma] – (Thinprep®)

Course for candidates who have previously attended the NHSCSP Introductory Course in Gynaecological Cytology. This normally takes place 6-12 months after the Introductory Course. 

Pre-examination Course [NHSCSP Diploma] – (Thinprep®)

The introductory and follow up courses are supported by a pre-examination course. This normally takes places between 3 months and 3 weeks before the examination. 

Biomedical Scientist (BMS)/Cytoscreener One Day Update Course

Update course to refresh qualified screeners knowledge and inform them about developments in Cervical Cytology and the NHSCSP. 

Arranging a Hospital Autopsy (Post Mortem Examination)

In September 2006 the Scottish Government introduced a national authorisation form for post mortem examinations. By law this is the only “consent form” that can be accepted. The authorisation form, together with two types of information leaflets and a summary form are contained within a distinctive dark blue sleeve for adults and a pale green one for children and infants.

The forms are available online through the Scottish Pathology Network.

Guidance for completing these forms can be found here: Hospital PM authorisation process – Sioban Fraser

Current guidelines recommend that only senior medical staff should obtain authorisation. Junior doctors or ward staff should act as witnesses.

It is important that the authorisation form is completed correctly; otherwise the post mortem may not be carried out.

The nearest relative, or a nominated person must be given the top (white) copy and the other two copies (pink and blue) are retained.

The form is a legal document and must not be altered without the relatives consent. Any changes must be made by having all three copies together and only writing on the top white copy to ensure that all the forms are identical.

Small samples of tissue, for histological purposes only, will be retained in every post mortem to confirm macroscopic findings unless consent for this is withheld.

Detailed neuropathological examination of the brain is best done if the organ is first immersed in formalin for three weeks. If the patient has died due to a complex neurological disorder (e.g. MS, dementia, Parkinson’s disease) and it is considered that examination of the brain is very important, then specific permission to retain the brain after the post mortem should be obtained and noted in section 2A and 2B of the authorisation form.

In cases where there is an infectious risk to those handling the body after death (i.e. pathologists, mortuary technicians, undertakers) e.g. deaths from tuberculosis, AIDS, hepatitis B or C etc. the body must be transported to the mortuary in a cadaver bag with “danger of infection” stickers attached and clearly visible.

In cases of “bodies donated to medical science” or any other issue, please contact the mortuary staff.

Delivery of Request Authorisation Form to the Pathology Department

Authorisation forms are available from the mortuary offices during working hours and from the booking in areas in every mortuary.

Wards should arrange for collection/delivery of authorisation forms together with the summary and case records. Do not use internal mail.

All post mortems will be carried out within the mortuary at the Queen Elizabeth University Hospital, with all adult NHS post mortems being carried out on Tuesdays and Thursdays only.

Reporting Autopsy Findings

On completion of the autopsy the pathologist will contact the requesting clinician and where practical invite them to come and discuss the findings in the mortuary at their earliest convenience. If the requesting clinician is unable to attend the mortuary, then a summary of the finding is provided via email.

A preliminary autopsy report is dispatched to the Consultant in charge of the patient within three working days of the autopsy. Case notes are normally returned with the full PM report within 3-4 weeks.

Copies of the final report, which includes histological findings, are sent to the patient’s GP and hospital consultant usually within two weeks (this can be longer if additional tests are required) of the autopsy.

Fiscal Post Mortems

Deaths must be discussed with the procurator fiscal under the following circumstances:

  1. Uncertified death
  2. Any death which was caused by an accident due to the operation of a vehicle, or which was caused by an aircraft or rail accident.
  3. Any death associated with employment, by accident, industrial disease or poisoning.
  4. Any death due to poisoning (coal gas, barbiturate, etc.).
  5. Any death where the circumstances would seem to indicate suicide.
  6. Any death where there are indications that it occurred under an anaesthetic.
  7. Any death resulting from an accident in the home, hospital or institution or any public place.
  8. Any death following abortion.
  9. Any death apparently caused by neglect (malnutrition).
  10. Any death occurring in prison or a police cell where the deceased was in custody at the time of death.
  11. Any death of a new-born child whose body is found.
  12. Any death (occurring not in a house) where the deceased’s residence is unknown.
  13. Death by drowning.
  14. Death of a child from suffocation (including overlaying).
  15. Where a death occurred as a result of smallpox or typhoid.
  16. Any death as a result of fire or explosion.
  17. Any sudden and unexplained death.
  18. Any other death due to violent, suspicious or unexplained cause.
  19. Deaths of foster children.
  20. Any complaint concerning care or treatment of the deceased noted by nursing or medical staff.

Do not issue a death certificate until the case has been discussed with Fiscal.

If the Fiscal decides to instruct a post mortem, the body will be removed to QEUH Mortuary. Fiscal post mortems are carried out 5 days per week.

Request for Pacemaker/Loop Recorder/Other Cardiac Device Removal

A pacemaker or other metal containing cardiac device must be removed from a body prior to cremation. This can be done by the technical staff in the mortuary at the QEUH provided that written consent from relatives for removal and retention has been obtained and delivered to the QEUH mortuary prior to the body being released to the funeral director. This service is not generally available at other mortuaries. If the pacemaker has not been removed the MCCD must indicate that a pacemaker is in situ.

Examination of the Body by a Clinician

Clinicians wishing to view remains should phone the mortuary staff to arrange a time to visit the mortuary and conduct a viewing.

Contacts:
Mortuary Operations Manager: Eileen Docherty0141 354 9351
Mortuary Scheduling and Performance Manager: Kevin Smith0141 451 5795
Mortuary Contact Numbers:
QEUH0141 354 9357
GRI0141 201 3186
GGH   (Enquiries should be directed to QEUH mortuary)0141 354 9357
RAH0141 314 6648
IRH01475 504 301
VOL   (Enquiries should be directed to QEUH mortuary)0141 354 9357

The Mortuary provides comprehensive mortuary services for adults and children in NHSGGC including services for the Crown Office Procurator Fiscal Service (COPFS) and Police Scotland.

The Mortuary is located mainly on level 0 with some facilities also on level 1 of the Laboratory Medicine & Facilities Management Building at Queen Elizabeth University Hospital.

  • Mortuary Services provided on QEUH site include:
    • Body store facilities for Queen Elizabeth University Hospital Campus and wider Health Board area, Police Scotland and Crown Office and Procurator Fiscal Service (COPFS).
    • Autopsy services for NHSGGC – all adult, paediatric and perinatal post mortems are undertaken within the facility.
    • Paediatric and perinatal autopsies for other Scottish Health Boards.
    • Paediatric Forensic autopsies undertaken on behalf of COPFS undertaken by NHSGGC Paediatric Pathologists.
    • Adult Forensic autopsies undertaken on behalf of COPFS undertaken by visiting Forensic Pathologists from University of Glasgow, Department of Forensic Medicine.

The mortuary is staffed and open 24 hours/day, 365 days/year for the receipt of bodies from the QEUH Campus and on behalf of Police Scotland and COPFS

Viewings are by appointment only.

Normal working day (Mon-Fri) 8:30am – 4:30pm

Out of Hours (Saturday/ Public Holidays) 10:00am – 2:00pm

Service hours and contact information for on-site mortuary and satellite sites as follows:

Mortuary SiteHospital AddressLocation Within HospitalContactWorking Hours
Queen Elizabeth University Hospital (QEUH)1345 Govan Road, Glasgow, G51 4TFSeparate entrance at side of Laboratory Medicine Building0141 354 9357   Eileen DochertyMonday – Friday: 8:30am – 4:30pm Out of Hours (Saturday/Public Holidays): 10:00am – 2:00pm
Royal Alexandra Hospital (RAH)Corsebar Road, Paisley, PA2 9PNWhen coming from Paisley town centre direction enter via the second hospital entrance (not the main one at car park and follow road to the end.0141 314 6648   Stephen DochertyMonday – Friday: 8:30am – 4:30pm
Inverclyde Royal Hospital (IRH)Larkfield Road, Greenock, PA16 0XNReport to main hospital information desk01475 504301   Jan DennyMonday – Friday: 10:00am – 2:00pm
Glasgow Royal Infirmary (GRI)84 Castle Street, Glasgow, G4 0SFEnter hospital grounds at traffic lights via the small road between the hospital and Glasgow Cathedral. The mortuary door is located under the canopy.0141 201 3186   Lynn TervitMonday – Friday: 08:30am – 4:30pm
Gartnavel General Hospital (GGH)1053 Great Western Road, Glasgow, G12 0YNReport to hospital admissions deskContact QEUH   0141 354 9357Unmanned Site*
Vale of Leven (VoL)Main Street, Alexandria G83 0UAEnter hospital from Main Road Alexandria, stay on the internal road to the top of the hill and the mortuary is the first low building on the rightContact QEUH   0141 354 9357  Unmanned Site*


*Service hours for Vale of Leven Hospital and Gartnavel General Hospital Satellite sites:

A body receipt and release service is provided in conjunction with Facilities Management colleagues. Viewing can be accommodated on request by telephoning QEUH Mortuary on 0141 354 9357

Please click on the relevant boxes below for more information on the histology services offered by the department.

Further information can be found in the departmental user manual or by contacting the department: 0141 354 9513 (89513)/0141 354 9514 (89514)

Digital Pathology

NHS Greater Glasgow & Clyde Pathology Department is undergoing a digital transformation whereby glass slides are digitised and are able to be viewed on digital workstations, rather than microscopes.  This change is being undertaking in partnership with Philips Healthcare and is partially funded as part of the iCAIRD Consortium by Innovate UK. 

The transformation will take several years to complete for histology (and longer for cytology where the technology is less mature).  We are following national guidelines and best practice recommendations from the Royal College of Pathologists (RCPath) and pathologists reporting digitally are following the RCPath validation process.  Digital Pathology is being incorporated into our quality management system and we are working towards UKAS extension to scope. 

We fully believe that this development will deliver both quality and safety benefits to our service users. 

Clinical Tests Available
NAME OF TESTSPECIMEN/CONTAINER REQUIREMENTS:FURTHER INFORMATION:
Routine Histopathology including Immunohistochemistry and Molecular AnalysisFix specimens as soon as possible (except where the testing requires fresh samples).

Fix the specimens with 10% Neutral Buffered formalin (ideally at least 10 times the volume of the specimen should be used, however this will not be practical for larger specimens, in this case aim for at least 3 times the volume of the specimen).
Package according to legislation with a minimum:
·leak proof container (specimen)
·sealable bag containing absorbent material
·secondary, opaque container (this can contain multiple specimens)
 
Fresh Samples – only send samples fresh if there is a clinical need, otherwise fix as per instructions. If in doubt, please discuss with the appropriate consultant pathologist.
 
Samples to be placed in a purple specimen bag.
Frozen Section
Intraoperative Samples (non-neurosurgical)
MOHS rapid interoperative diagnosis
DO NOT ADD ANY FIXATIVE! Send the sample FRESH and IMMEDIATELY!


Place in clearly labelled container
Indicate “For Frozen Section” on form and include details of who to contact with report.

Contact the laboratory (89513/89514) upon specimen dispatch

Do not send FRESH specimens with a known/suspected DANGER OF INFECTION (e.g. TB, HIV, COVID-19 etc.)
Package according to legislation with a minimum:
·leak proof container (specimen)
·sealable bag containing absorbent material
·secondary, opaque container (this can contain multiple specimens)
 
Fresh Samples – Only send samples fresh if there is a clinical need, otherwise fix as per instructions. If in doubt, please discuss with the appropriate consultant pathologist.
 
Samples to be placed in a purple specimen bag.

Contact lab (89513/89514)  in advance with details of the:
·Expected arrival/delivery time
·Patients name/identifier
·Name and contact details of the caller
·Page / contact details for communicating the results (confirm if the same as the caller)
Immunofluorescence
Skin, Renal and Conjunctival Biopsies
 
Venous Blood
DO NOT FIX THE SAMPLE IN FORMALIN!

Send skin, renal or conjunctival biopsies in Michel’s fixative

Venous blood that requires immunofluorescence should arrive in a Vacuette® blood collection tube.

Place in clearly labelled container

Specimens that are suspected or are known DANGER OF INFECTION with category 2 organisms (e.g. HIV, Hep B, Hep C) are accepted for testing.

Do not send FRESH specimens with a known/suspected DANGER OF INFECTION from Category 3/4 organisms (e.g. TB, HIV, CJD, etc.)


Michel’s Fixative must be stored between 2-250c prior to use.
Michel’s Fixative is capable for preserving the specimen for up to 5 days without any deterioration.

Michel’s Fixative is available upon request from:

Pathology Department, Level 3, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9518/9518).

Samples to be placed in a purple specimen bag.
Neurosurgical Intraoperative Samples (Brain smear or frozen section)DO NOT ADD ANY FIXATIVE!

Send the sample FRESH and IMMEDIATELY!

Place in clearly labelled container
Contact the laboratory (89530 or page 17627) upon specimen dispatch
Contact lab (89530 or page 17627)  at least 24 hours in advance with details of the:
·Surgical Procedure
·Location
·Expected arrival/delivery time
·Patients name/identifier
·Name and contact details of the caller
·Page / contact details for communicating the results (confirm if the same as the caller)
 
Samples to be placed in a purple specimen bag.
Neurosurgical biopsy for Paraffin HistologyThe sample should be fixed with 10% formal saline

DO NOT FIX WITH 10% NEUTRAL BUFFERED FORMALIN!

Contact the laboratory (89530 or page 17627) upon delivery
10% formal saline will be supplied by the Neuropathology section of the lab when requested by theatre.
 
Samples to be placed in a purple specimen bag
AmputationThe orthopaedic theatre should contact Pathology specimen reception (89513/89514) at least 24 hours before procedure is scheduled so that a suitable specimen container can be supplied

Large amputations that have a high ratio of surface area covered by skin should be sent fresh and not fixed
To contain potential leakage amputations should be placed into a large plastic bag or wrapped in drapes before being put into the specimen container.

NEVER use yellow or orange bags/containers as this corresponds to the code for waste incineration
Products Of ConceptionPlease ensure the specimen arrives with a FULLY COMPLETED specimen request form and the CORRECT & FULLY COMPLETED consent form (SD7/SD8/FORM 2)SD7 Form [PATH-MOR-LF-003]: Authorisation for sensitive disposal following pregnancy loss

SD8 Form [PATH-MOR-LF-004]: Release of Tissue/Family wants to take pregnancy loss away from hospital

Pregnancy Loss FORM 2: Authorisation for burial or cremation following pregnancy loss up to 23 weeks and 6 days gestation.
PlacentaThe Placental Request Form MUST be used
Please see the full Placenta Histology Requests section for more information on the clinical information required and how these specimens are triaged within the department.
The form MUST include the following information:
·Mother’s name
·Mother’s date of birth
·Address
·Hospital number and CHI number
·Date of delivery
·Date placenta sent for pathology examination
·Referring Hospital
·Referring Consultant
·Midwife or trainee doctor’s name and contact extension/bleep number
·Gravida and parity
·GESTATION
·Apgars of the baby/babies delivered
·Weight of the baby/babies delivered
 
Samples to be placed in a purple specimen bag.
Urgent Paediatric Specimens
 
Frozen Sections
 
Fresh tumour Biopsies
 
Fresh Tumour Resections
Any queries regarding urgent specimens should be addressed by telephoning the paediatric office on 89478 and asking to speak to the duty paediatric pathologist.

Any out-of-hours queries should be directed to the on-call pathologist who can be contacted via hospital switchboard. 

The paediatric laboratory team may be contacted on 89531.

All cases must be booked in advance (ideally the day before) by telephoning 89478 and discussing the case with the duty paediatric pathologist.
The paediatric laboratory team may be contacted on 89531.
Package according to legislation with a minimum:
·leak proof container (specimen)
·sealable bag containing absorbent material
·secondary, opaque container (this can contain multiple specimens)
 
All fresh paediatric specimens must be conveyed immediately in person or by porter to pathology (3rd floor, Laboratory Medicine Building). The surgical team is responsible to arrange this.

Samples to be placed in a purple specimen bag.
Routine Paediatric SpecimensFix as per routine histopathology specimens above, unless the specimen is indicative of paediatric neoplasia/cancer/tumour. In this case telephone the paediatric office on 89478 and asking to speak to the duty paediatric pathologist.

Paediatric rectal biopsies for diagnosis of Hirschsprung’s disease may be sent in formalin

Paediatric tonsils do not need to be sent fresh unless there is a high clinical suspicion of malignancy. These specimens may be sent in formalin.
The paediatric laboratory team may be contacted on 89531.
Package according to legislation with a minimum:
·leak proof container (specimen)
·sealable bag containing absorbent material
·secondary, opaque container (this can contain multiple specimens)
 
All fresh paediatric specimens must be conveyed immediately in person or by porter to pathology (3rd floor, Laboratory Medicine Building). The surgical team is responsible to arrange this.

Samples to be placed in a purple specimen bag.
Paediatric Renal BiopsiesContact lab (89531) with AS MUCH NOTICE AS POSSIBLE before taking a biopsy, the case may need to be discussed with the duty pathologist before proceeding.

The deadline for same day processing is 1:00pm
 
NATIVE & TRANSPLANT BIOPSIES: These specimens will normally be collected in theatre by a biomedical scientist who will separate the sample for immunofluorescence and electron microscopy.
Adult Renal Biopsies (Medical/Native/Transplant)If URGENT the specimen should be sent directly to the laboratory by porter/eagle couriers.
 
The deadline for same day processing is 1:00pm
 
Each patient sample should be received in 3 parts: Main (largest) sample in formalin, a sample in buffer for immunofluorescence and a sample in 2% Glutaraldehyde for electron microscopy.
 
The clinical information MUST specify if the renal biopsy is Transplant, Native (Medical) or other
THE SPECIMEN MUST BE HANDED TO A MEMBER OF LABORATORY STAFF ON DELIVERY
 
Freshly prepared glutaraldehyde has a 7 day shelf life and must be stored to 4-80c prior to use.

Buffer and Glutaraldehyde are available with advance notice from:
Pathology Department, Level 3, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9513/9514).

All unused Glutaraldehyde should be returned to the EM unit for disposal.
 
Samples to be placed in a purple specimen bag.
Adult Renal Biopsies (Tumour/Cancer/RCC)Fix specimens in formalin as soon as possible
 
The clinical information must specify that the renal biopsy is querying Tumour/Cancer/RCC.
Samples to be placed in a purple specimen bag.
Cardiac Transplant Biopsies (Adult)If URGENT the specimen should be sent directly to the laboratory by taxi/courier.
 
The deadline for same day processing is 1:00pm
 
Contact the laboratory reception (89513/89514) to inform them of the biopsy and indicate whether this is a routine or urgent biopsy. This information will be passed to the duty cardiac pathologist.

Alternatively, contact the duty cardiac pathologist directly to discuss the case.
THE SPECIMEN MUST BE HANDED TO A MEMBER OF LABORATORY STAFF ON DELIVERY
 
Samples to be placed in a purple specimen bag.
Native Cardiac (Endomyocardial) BiopsiesIf URGENT the specimen should be sent directly to the laboratory by taxi/courier.
 
The deadline for same day processing is 1:00pm
 
Contact the laboratory reception (89513/89514) to inform them of the biopsy and indicate whether this is a routine or urgent biopsy. This information will be passed to the duty cardiac pathologist.

Alternatively, contact the duty cardiac pathologist directly to discuss the case.
If a storage/metabolic disorder is being considered, then contact the duty cardiac pathologist to discuss the need for sampling for electron microscopy.
IF URGENT, THE SPECIMEN MUST BE HANDED TO A MEMBER OF LABORATORY STAFF ON DELIVERY
Muscle BiopsyContact lab (89530 or page 17627) with AS MUCH NOTICE AS POSSIBLE before receipt of the biopsy.

An additional muscle biopsy request form MUST be used, please follow the instructions on this form.
 
The laboratory can receive muscle biopsies between 9:00am and 4:00pm, Monday – Friday (excluding public holidays).
 
Specimens must be placed in a dry, clean universal container. No saline, gauze or formalin should be used.
 
If the sample will take longer than 20 minutes to reach the department it is recommended that the universal container (NOT the muscle directly) is put into a bag of ice.
Contact lab (89530 or page 17627, for external sites: 0141 354 9530)  with AS MUCH NOTICE AS POSSIBLE providing details of the:
·Any Danger/Risk of Infection
·Expected arrival/delivery time
·Patients name/identifiers
·Name and contact details of the caller
·Page/contact details for communicating the results (confirm if the same as the caller)
 
THE SPECIMEN MUST BE HANDED TO A MEMBER OF LABORATORY STAFF ON DELIVERY
 
Samples to be placed in a purple specimen bag.
Nerve Biopsy – for Frozen SectionDO NOT ADD ANY FIXATIVE! Send the sample FRESH and IMMEDIATELY!

Place in clearly labelled container
Contact the laboratory (89530 or page 17627, for external sites: 0141354 9530) upon specimen dispatch
Contact lab (89530 or page 17627)  at least 24 hours in advance with details of the:
·Surgical Procedure
·Location
·Expected arrival/delivery time
·Patients name/identifier
·Name and contact details of the caller
·Page / contact details for communicating the results (confirm if the same as the caller)
 
Samples to be placed in a purple specimen bag.
Urgent Fresh Specimens (including Frozen Sections)

Intra-Operative Frozen Section Requests

Pre-Booking a Frozen Section

 The requesting clinician MUST ensure that:

  • Pathology Duty Consultant is notified of frozen section request 24 hours in advance of sample collection, via Pathology Specimen Reception on 0141 354 9513 or 0141 354 9514 (89513/89514)
  • As per national guidance, the department will routinely process requests for frozen section analysis unless the clinician or request form indicate the patient potentially being COVID positive.
  • On the day of surgery, theatre staff notify Pathology reception that the frozen section is on its way to the Laboratory.

Failure to pre-book an intra-operative frozen section may result in delays in reporting and in exceptional circumstances the request being declined.

When pre-booking an intra-operative frozen please provide the following details:

  • Patient’s name and CHI number
  • Requesting clinician
  • Theatre name/number including hospital
  • Likely time of operation
  • Contact number
  • Specimen type

The Consultant Pathologist will phone the result to the requesting clinician on the contact number given.

Queen Elizabeth University Hospital (QEUH)

An intra-operative frozen section service is available Monday – Friday 9:00am – 5:00pm

Golden Jubilee National Hospital (GJNH)

An intra-operative frozen section service is provided, on site at GJNH, Monday-Thursday 9:00am – 1:00pm. Any cases requiring a frozen section should be recorded on the GJNH theatre lists.

To arrange an intra-operative frozen section out with these times please contact the Duty Pathologist via Pathology Specimen Reception at QEUH on the telephone number below.

These specimens will be transferred to Pathology Department at QEUH for processing and should be sent by taxi to:

Specimen Reception (L3/B/021),

NHSGGC Pathology Department

Level 3, Laboratory Medicine and Facilities Management Building

Queen Elizabeth University Hospital

Tel:  0141 354 9513 (89513)/0141 354 9514 (89514)

It is the responsibility of staff at GJNH to arrange rapid transfer of these specimens to QEUH as per local protocol.

Glasgow Royal Infirmary (GRI)

An intra-operative frozen section service is available Monday – Friday within normal laboratory working hours, between 9am – 5pm.

This Laboratory is only manned for pre-booked requests. It is, therefore, imperative that frozen section requests for onsite analysis at GRI are received by the Pathology Department more than 24 hours in advance, by phone call.

From time to time an urgent frozen section is required due to an unexpected finding at surgery. The department provides this service, but for intra-operative frozen section requested on site at GRI, a short delay is inevitable to allow staff to travel.

Alternatively the specimen can be sent to QEUH urgently by courier by telephoning:

0845-123-1230 and following the information below for Transporting Urgent Fresh Specimens.

Labelling Frozen Section Specimens

The normal requirements for labelling specimens and request forms apply to frozen sections in addition to the following criteria on the request form:

  • Hospital
  • Theatre
  • Date and time of request.
  • Requesting clinician
  • Alerts to known or suspected danger of infection
  • Clinical History
  • Theatre contact number

Transporting Urgent Fresh Specimens

QEUH site:

Fresh (unfixed) specimens should be sent directly to:

Specimen Reception (L3/B/021),

NHSGGC Pathology Department

Level 3, Laboratory Medicine and Facilities Management Building

Queen Elizabeth University Hospital

Tel:  0141 354 9513 (89513)/0141 354 9514 (89514)

Other Sites

Fresh (unfixed) specimens taken at other sites out with stated service provision at GJNH and GRI should be sent directly to the Pathology laboratory at QEUH by courier.

The courier should be telephoned by theatre staff, telephone Eagle Couriers on 0845-123-1230 at least 30 minutes before the specimen is available on the day of the operation.

 The information required by Eagle couriers includes:

  • Hospital site
  • Theatre collection point
  • Advise that this is an “Emergency Pathology Specimen”.
  • Codes used for each location should be as per local protocols.
  • Please telephone Pathology Specimen Reception on 0141 354 9513 or 0141 354 9514 (89513/89514) when the courier is on the way

Fresh/Urgent Paediatric Specimens

Paediatric Rectal biopsies for diagnosis of Hirschsprung’s disease via Acetylcholinesterase histochemistry MUST be sent fresh (not fixed) as is done for frozen sections (see above).

Please ensure that for all specimens indicative of paediatric neoplasia/cancer/tumour that the paediatric team are notified (89531) in advance of submission and the specimens are submitted fresh/unfixed as is done for frozen sections (see above).

Fresh Lymph Nodes for Suspected Lymphoma

Excised lymph nodes, for suspected lymphoma should be bisected alone their long axis at the time of removal.

Half of the specimen should be placed into a sealed container with buffered formalin. The second half of the specimen should be placed in dry container, without formalin and sent “fresh” to the Pathology Department to allow ancillary testing to be undertaken.

It is particularly important that any Danger of Infection is recorded on the request form.

Follow the instructions above for Transporting Urgent Fresh Specimens.

Orthopaedic Amputations

The orthopaedic theatre should contact Pathology Specimen Reception at least 24hrs before procedure is scheduled on 0141 354 9513 or 0141 354 9514 (89513/89514) to request that a dedicated large amputation specimen container is sent to relevant theatre.

Specimens such as amputations that have a high ratio of surface area covered by skin should be sent unfixed. If there is a surgical stocking, leave in place.

Reasons for this are:

  • Poor penetration of skin by formalin
  • Moving and handling considerations

To contain potential leakage, put the amputation into a large plastic bag or wrap in drapes as appropriate and then put into the amputation container.  Never use yellow or orange bags or containers as this corresponds to the code for waste incineration.

Please follow the instructions for transporting urgent fresh specimens above. It is important to advise the courier that this is a large specimen (requires van rather than motorcycle courier).

Paediatric Specimens

Paediatric rectal biopsies for diagnosis of Hirschsprung’s disease do not need to be sent fresh. These specimens may be sent in formalin. There is no requirement to discuss these cases with the duty pathologist.

Paediatric tonsils do not need to be sent fresh unless there is a high clinical suspicion of malignancy. These specimens may be sent in formalin. There is no requirement to discuss these cases with the duty pathologist unless there is a high clinical suspicion of malignancy.

Please ensure that for all specimens indicative of paediatric neoplasia/cancer/tumour that the day duty pathologist is notified in advance of submission and the specimens are submitted unfixed as specified by the day duty pathologist’s instructions. ALL fresh specimens including frozen sections must be discussed directly with the day duty pathologist in advance of submission.

Urgent Paediatric Specimens

The following procedures must be followed for all urgent paediatric fresh specimens including frozen sections, fresh tumour biopsies and fresh tumour resections.

Any queries regarding urgent specimens should be directed to the duty Paediatric pathologist by telephoning the paediatric office on 89478 and asking to speak to the duty paediatric pathologist. Any out-of-hours queries should be directed to the on-call pathologist who can be contacted via hospital switchboard. The paediatric laboratory team may be contacted on 89531.

DISCUSSION WITH THE DUTY PATHOLOGIST – ALL CASES

All cases must be booked in advance (ideally the day before) by telephoning 89478 and discussing the case and your requirements with the duty paediatric pathologist. Please provide patient details, including name and CHI number, date of surgery, approximate time of surgery and a contact number for theatre.

The surgeon or interventionalist performing the biopsy / resection must speak directly to the duty Paediatric pathologist prior to the procedure in every case to establish the specimen requirements.  Failure to follow this procedure may render the biopsy un-interpretable.

The instructions below are general instructions and must not replace a case by case discussion with the duty pathologist.

  • Tissue for frozen section should be kept dry and placed in a suitable container labelled with the patient’s details (ideally a small plastic dish wrapped in a yellow plastic bag). Do not place small biopsies on paper or wrap them in gauze or paper.
  • Unless indicated otherwise by the day duty pathologist, all fresh tumour biopsies should be placed in PINK tissue culture fluid for transport to the laboratory.
  • Unless indicated otherwise by the day duty pathologist, all fresh tumour resections should be kept dry and placed in a suitable container labelled with the patient’s details.

TRANSPORT TO THE LABORATORY – ALL CASES

All fresh paediatric specimens must be conveyed immediately in person or by porter to pathology (3rd floor, Laboratory Medicine Building). It is the responsibility of the surgical team to arrange urgent transport of the specimen to pathology. The sample must not be sent via the POD system and must not be placed in a purple bag. It must be taken directly to pathology specimen reception on the 3rd floor. The specimen should be marked as “Urgent. Frozen section.” Staff transporting the specimen must inform specimen reception staff that it is an urgent fresh specimen for frozen section.

When the specimen leaves theatre, theatre staff must inform the laboratory by telephoning 89531.

Paediatric Renal Biopsies

The following procedures must be followed for all paediatric renal biopsies:

DISCUSSIONS WITH THE DUTY PATHOLOGIST AND THE LABORATORY

All Renal biopsies must be discussed with the Duty Paediatric Pathologist on 89478 as well as with laboratory staff on 89531 (see below).

These specimens will be collected in theatre by a biomedical scientist who will separate the sample for immunofluorescence and electron microscopy.  Notification of such biopsies to the laboratory must be done as far in advance of the biopsy as possible by telephoning 89531. Failure to do so may result in delay since staff will have to be available to attend theatre to undertake this procedure.

Placentas

The placental request form is linked here

The local criteria for placental examination are:

Stillbirth

Miscarriage > 14/40

Birth weight < 3rd centile

Drop in fetal growth of > 2 quartiles or > 50 percentiles

Absent or reversed EDF on umbilical artery Dopplers

Spontaneous preterm delivery or prolonged preterm rupture of membranes less than 32/40

Iatrogenic preterm delivery less than 32 weeks

Severe early onset (less than 32/40) pre-eclampsia requiring iatrogenic delivery

Massive abruption with retroplacental clot

Fetal hydrops

Severe fetal distress defined as: pH<7.05 or base Excess > -12 or scalp lactate >4.8mmol/l

Severe maternal sepsis requiring adult ICU admission

Severe fetal sepsis requiring ventilation / level 3 NICU admission

Caesarean hysterectomy for morbidly adherent placenta and

Monochorionic twins with twin to twin transfusion.

Listed below are the data items that are required for pathological examination of placentas. Obligatory data items are in bold and the remainder should be added as required. Please include these data items on the pathology request form accompanying the placentas.

Please write clearly on the forms

· Mother’s name

· Mother’s date of birth

· Address

· Hospital Number and CHI number

· Date of delivery

· Date placenta sent for pathology examination

· Referring Hospital

· Referring consultant

· Midwife or trainee doctor’s name and contact extension / bleep number

· Gravida and Parity

· GESTATION

· INDICATION FOR EXAMINATION (see below)

· Livebirth (Y/N):

· Birth Weight and Centile:

· Mode of delivery:

In cases of stillbirth / late miscarriage, page 2 of the placenta form must be completed by a doctor of ST7 or consultant level. Please provide the following information:

Presence or absence of maceration

Interval between IUD diagnosis and delivery

Additional clinical details including any relevant antenatal history

Any placentas not indicated for placental examination by our local protocol do not need to be sent for pathology. If sent to pathology, they will be stored with no initial examination. A brief report indicating the placenta has been stored will be issued shortly after the placenta is received (generally within a fortnight). These placentas will be retained for 3 months in the pathology department prior to disposal. Full macroscopic examination with histology will only be performed on request with additional clinical details indicating why such examination is required.

Placentas with the following are NOT indicated for examination and do not need to be sent to pathology unless there are additional relevant indications:

  • Pre-eclampsia with onset after 32/40 and not requiring iatrogenic delivery
  • Maternal sepsis not requiring adult ICU admission
  • Maternal pyrexia
  • Possible abruption
  • Fetal distress not fulfilling the following criteria: pH<7.05 or base Excess > -12 or scalp lactate >4.8mmol/l
  • Maternal Group B streptococcus
  • Maternal diabetes or other maternal disease with normal pregnancy outcome
  • Known trisomy 13, 18, 21 / Turners
  • Congenital anomaly
  • Uncomplicated twin pregnancy
  • Twin placentas for assessment of chorionicity
  • “Gritty” placenta
  • Placenta praevia
  • Post-partum haemorrhage
  • Polyhydramnios
  • History of previous molar pregnancy
  • Cholestasis
  • Hepatitis B/C, HIV
  • Single umbilical artery
  • Uncomplicated velamentous cord
  • Placenta with accessory lobe
  • Normal pregnancy

The EM service is a highly specialised sub-division of Pathology and provides a diagnostic ultrastructural pathology service for both adult and paediatric cases including a national paediatric cilial diskenesia service in addition to a regional and supra-regional service for renal, muscle and nerve.

Within the EM unit the main function is to undertake specialist specimen processing and analysis using a transmission electron microscope (TEM) to evaluate diagnostically significant pathological changes observed in disease tissue at the ultrastructural level, the most significant of which are digitally captured to provide interpretative reports for the consultant pathologists as an aid to effective diagnosis and treatment.

Location

The Electron Microscopy (EM) service is situated on the second floor (L2/B 086-090) of the Laboratory Medicine and Facilities Management Building located at the Queen Elizabeth University Hospital.

Laboratory Hours

9:00am – 5:00pm Monday – Friday (excluding public holidays). There is no out of hours service.

Specialist Advice

Further advice, if urgent can be sought from the Speciality Manager, Jennifer Sweeney (0141 3549420) or the relevant pathologist. For non-urgent enquiries please contact the EM laboratory on 0141 3549422 or email: em.histology@ggc.scot.nhs.uk.  Please contact the department before sending an unexpected/unusual sample.

Clinical Tests Available
Test NameSpecimen/Container RequirementsFurther Information:
Electron MicroscopySpecimens for electron microscopic analysis should ideally be no larger than 1-2 mm3 and placed into a vial of fresh 2% Glutaraldehyde fixative as soon as possible after specimen retrieval.

Blood/Fluid Specimens should be discussed with the EM unit directly. (0141 3549420/ 01413549422).

If specimens are sent through the post they must comply with post office regulations.

EM sampling from a histology wax block must be accompanied by a representative light microscopy slide.
Freshly prepared glutaraldehyde has a 7 day shelf life and must be stored to 4-80c prior to use.

This fixative is available with advance notice from:

Electron Microscopy Unit, Pathology Department, Level 2, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9487).

All unused Glutaraldehyde should be returned to the EM unit for disposal.

Samples to be placed in a purple specimen bag.
Primary Cilial Diskenesia ServiceSpecimens are only accepted in the laboratory if taken from the clinic

Specimens should be placed into M199 media with penicillin-streptomycin added – supplied by the EM laboratory.
Contacts for more info about the service and clinic.: 
paul.french@ggc.scot.nhs.uk 
jennifer.sweeney@ggc.scot.nhs.uk  
anne.devenny@ggc.scot.nhs.uk 
Specimen Requirements

Specimens for EM analysis should ideally be no larger than 1-2mm3 and placed into a vial of fresh 2% Glutaraldehyde fixative as soon as possible after specimen retrieval apart from blood/fluid specimens which must be discussed with EM unit directly.

Freshly prepared glutaraldehyde has a seven day shelf life and must be stored between 4-80c prior to use. This fixative is available with advanced notice from the Electron Microscopy Unit, NHSGGC Pathology Department, Level 2, Facilities Management and Laboratory Medicine Building, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF (0141 3549422).

Each specimen must be accompanied by a request form with the minimum of 3 matching patient identifiers.

Due to the small size of the specimen container there is limited space for patient’s details but at least the patients CHI and first and surname must be provided on the specimen container.

Requests for urgent results should be clearly marked on the request form and contact telephone or bleep numbers provided. The consultant pathologist should be notified first by telephone, if an urgent result is required.

Transport/Handling

Specimens should be sent for EM analysis in the same manner as routine histopathology specimens.

If specimens are sent through the post they must comply with post office regulations. EM sampling from a histological wax block must be accompanied by a representative light microscopy slide.

All unused Glutaraldehyde should be returned to the EM unit for disposal.

Results

EM Analysis should normally be available within 5-12 days once the sample has been received by the department for processing. This may change due to service provision. If appropriate any samples marked as urgent will have an accelerated turnaround.

Sample results are affected by a number of factors including delay in fixation, use of inappropriate fixative/old fixative and incorrect sample size (1-2mm3 is recommended; if a sample is too big this can cause sub-optimal fixation, if too small will not give a good representation of morphology).

General Info

The Diagnostic Cytology Laboratory is part of the pathology department:

Address

Cytology Laboratory,

The Laboratory Medicine Building, Level 3,

Queen Elizabeth University Hospital

1345 Govan Road,

Glasgow

G51 4TF.

The working hours for the Diagnostic Cytology Laboratory are:

Monday – Friday 9:00am – 5:00pm

Saturday 8:00am – 12:00pm

Specimens should be sent to the laboratory as soon as possible.

If a specimen is taken out of hours, the specimen should be placed in a fridge overnight and sent to cytology immediately the next morning.

Clinical Tests Available
Name Of TestSpecimen/Container Requirements:Further Information:
Respiratory: Sputum Bronchial Aspirates, Washings, Lavages, BrushingsDo not fix sample in formalin, please use saline.

SEE BELOW FOR SPECIMENS REQUIRING A DIFFERENTIAL CELL COUNT PLEASE SEND THE SPECIMEN IMMEADIATELY. 

If this is not possible, the specimen(s) can be refrigerated overnight but MUST be delivered at the earliest opportunity the next day.
Samples to be placed in a purple specimen bag.  
Bronchial Differential Cell CountsSpecimens requiring a differential cell count must be clearly described/marked on the request form.

Specimens for Bronchial differential cell counts must be lavages in saline (the test requires mucoid material).

PLEASE SEND THE SPECIMEN IMMEADIATELY. If this is not possible, the specimen(s) can be refrigerated overnight but MUST be delivered at the earliest opportunity the next day.
Differential Cell Counts cannot be performed on patients who are positive for COVID-19  

Samples to be placed in a purple specimen bag.  
Pancreatic BrushingsDo not fix sample in formalin, please use Preservcyt solution.

PLEASE SEND THE SPECIMEN IMMEADIATELY. If this is not possible, the specimen(s) can be refrigerated overnight but MUST be delivered at the earliest opportunity the next day.
Preservcyt solution is available with advance notice from:

Cytology Department, Level 3, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9569).

Samples to be placed in a purple specimen bag.  
Fine Needle Aspirate (FNA): Head & Neck, Breast, Lymph Node etc.FNA specimens should be sent on 4 glass slides: 2 slides air dried and 2 slides treated with Cytofix fixative spray

More information can be found in the document: Fine Needle Aspirate Labelling Guide for Cytology Users

FNA specimens do not need to be refrigerated
Cytofix fixative spray is available with advance notice from:

Cytology Department, Level 3, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9569).

Samples to be placed in a purple specimen bag.
Endobronchial Ultrasound Guided Transbronchial Needle Aspirate (EBUS-TBNA) Endoscopic Ultrasound Guided Fine Needle Aspirate (EUS FNA): Pancreas, LiverDo not fix sample in formalin, please use Preservcyt solution.Preservcyt solution is available with advance notice from:

Cytology Department, Level 3, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9569).

Samples to be placed in a purple specimen bag.
Joint (Synovial) Fluid Analysis Gout Crystal AnalysisDo not fix sample in formalin, please send FRESH and with no additives.

Please DO NOT add EDTA  
This test has been fully validated within the cytology department but is not UKAS accredited.

Samples to be placed in a purple specimen bag.
Serous EffusionsDo not fix sample in formalin, please send FRESH and with no additives.

The volume of sample sent should be a minimum of 75ml if possible, but preferably no more than 150ml.

PLEASE SEND THE SPECIMEN IMMEADIATELY. If this is not possible, the specimen(s) can be refrigerated overnight but MUST be delivered at the earliest opportunity the next day.
Samples to be placed in a purple specimen bag.
Urine SamplesDo not fix sample in formalin, please send FRESH and with no additives.

DO NOT send a urine sample taken early in the morning or shortly after waking.

The volume of sample sent should preferably be 50ml

PLEASE SEND THE SPECIMEN IMMEADIATELY. If this is not possible, the specimen(s) can be refrigerated overnight but MUST be delivered at the earliest opportunity the next day.
Samples to be placed in a purple specimen bag.
Cerebrospinal Fluid (CSF)Do not fix sample in formalin, please send FRESH and with no additives.

PLEASE SEND THE SPECIMEN IMMEADIATELY.
Samples to be placed in a purple specimen bag.
Flow CytometryDO NOT SEND TO CYTOLOGY DEPARTMENT, Send to Haemato-Oncology, Gartnavel.

Samples NEED to be analysed by the lab within 72 hours of sample collection-This is especially important for patients with a clinical history including Lymphoma  
Samples to be placed in a purple specimen bag.

Samples should be sent directly to Flow Cytometry laboratory by porter/courier:

Haemato-Oncology, Gartnavel General Hospital, Paul O’Gorman Building, 21 Shelley Road, Glasgow, G12 0XB (0141 3017729)
Specimen Repertoire

Specimen types routinely processed by the Diagnostic Cytology Laboratory include:

Serous Fluids Cytology: Ascitic fluid, pericardial fluid, peritoneal washings and pleural fluid.

Respiratory Cytology: Bronchial aspirates, bronchial lavages, bronchial brushings and sputa.

Brushings Specimens: Pancreatic biliary, ureteric and common bile duct.

Fine Needle Aspiration (FNA) Cytology: Superficial FNA’s taken from thyroid, breast, lymph node, supraclavicular and submandibular. Endoscopic FNA’s including TBNAs (Transbronchial needle aspirations) from lymph nodes or masses, FNA from pancreas, stomach or oesophagus and fine needle biopsy (FNB) from pancreas/nodes.

Cerebrospinal Fluid (CSF): CSF and other neuropathology fluids are processed by cytology and reported by the Neuropathology Consultants.

Synovial Fluids (NB: This test is not UKAS accredited): Synovial fluids are examined for the presence of monosodium urate and calcium pyrophosphate crystals in cytology. Synovial fluids are also examined for microscopic assessment if septic arthritis, inflammation or infection is queried. Any Synovial fluid specimens where septic arthritis is suspected MUST have a separate additional specimen and request form being sent to Microbiology. Bursa fluid and ganglion fluid may be examined for the presence of crystals and microscopic cell evaluation.

Other Fluids: Cyst Fluids (e.g. ovarian cyst, parotid and Thyroid)

Urine: Urine, ureteric washings and renal pelvic washings. Cytology CAN test for the presence of casts in urine.

Specimen Transport

Certain specimens for Diagnostic Cytology can be transported by the previously listed normal specimen transport methods as well as the internal pneumatic tube system

Specimens from the Queen Elizabeth University Hospital may be sent via the internal pneumatic tube system. ONLY the following specimens may be sent via the internal pneumatic tube system: Fluids, FNAs which are fluids (NOT slides), respiratory specimens and CSFs. Please do not send specimens with a danger of infection via the pneumatic tube system. Please ensure all specimens are sent in leak-proof containers (white lidded, screw top universal tubes are ideal).

The Diagnostic Cytology laboratory should be contacted on 89569 before a specimen is sent through the pneumatic tube system.  The pneumatic tube extension for cytology is 1616

Laboratory Acceptance Criteria

The Diagnostic Cytology laboratory follows the same specimen acceptance criteria as the pathology department.

Specimens that are Mislabelled/Erroneous/Have Insufficient Information

In the event that a specimen received in diagnostic cytology where the specimen and /or the request form has been mislabelled or erroneous, the team leader or appropriate biomedical scientist will make every attempt to contact the sender and clarify what has happened.

This may be by email or by telephoning the clinician given on the request form.

If the event that there is insufficient information to contact the source regarding a specimen e.g. specimen sent with no request form. The specimen will be kept for 1 week, in the hope that the laboratory will be contacted. If no contact has been made at the end of this period, the specimen will be discarded.

A cytology trakcare request form should be sent for cytology tests NOT a histopathology trakcare request form. The cytology department does issue reports via trakcare.

Danger of Infection (D.O.I) Specimens

Specimens taken specifically for the diagnosis of infectious diseases should NOT be sent to Cytology, but instead be sent directly to microbiology/virology as appropriate.

Specimens which are highly suspicious of, or from known Group 3 infectious diseases MUST be labelled as D.O.I

Examples of Group 3 infectious diseases include: Coronavirus (COVID-19), Human Immunodeficiency Virus (HIV), Hepatitis C&D, Mycobacterium tuberculosis, and Creutzfeldt Jakob Disease (CJD)

CSF Cytology – Specimens which are highly suspicious of CJD or known CJD should be labelled as D.O.I. A specimen should be sent directly to the Edinburgh CJD unit if there is a clinical suspicion of CJD.

Group 4 Infectious Diseases: Should NOT be sent to Cytology for processing. E.g. Viral haemorrhagic fever.

Sending a D.O.I Specimen to Cytology

Specimens which pose a risk from infectious diseases MUST:

  • Be placed in a D.O.I specimen bag (ONLY send D.O.I specimens in these bags)
  • Have a D.O.I label on the Specimen Container
  • Indicate there is a Danger of Infection by ticking the box on the request form
  • Describe the nature of the risk (known or highly suspicious of) on the request form
Urgent Specimens

Urgent specimens MUST be clearly labelled as urgent on the specimen request form.

The request form must also have the contact information of the clinician who requires the urgent result e.g.  telephone number or page of the clinician . If a specimen is required urgently for a Multi-disciplinary Meetings (MDT), please put this on the specimen request form and the date of the MDT.

Fine Needle Aspirate Labelling Guide for Cytology Users
Clinical Tests Available
Name of TestSpecimen/Container Requirements:Further Information:
Cervical Cytology/HPV Screening LBC SmearsThe specimen should be taken following the normal smear taking protocol.

The collected specimen should then be rinsed out into a Hologic™ Thin Prep Pap Test (LBC) specimen vial

Please ensure the vial is within the date specified. If it is out of date then it must NOT be used.
Each LBC sample should be placed in a clear polythene bag and sent to the laboratory in the appropriate white cervical cytology samples only (LBC) bag and accompanied with a Specimen Dispatch Note.

For general/technical enquiries please contact:
Gillian Collins: 0141 354 (8)9501
Lab: 0141 354 (8)9524

The specimen should be taken as described in the LBC Training CD Rom supplied to smear takers by NHS Greater Glasgow & Clyde. Other boards should follow their normal smear taking protocol. The collected specimen should then be rinsed out into a Hologic™ Thin Prep Pap Test (LBC) specimen vial.

Please ensure the vial is within the date specified. If it is out of date then it must NOT be used.

Requests for cervical smears should be generated electronically at the smear taker location using the Scottish Cervical Call and Recall computer system (SCCRS). The vial should be appropriately labelled using the bar coded SCCRS label and sent to the laboratory.

Each LBC sample should be placed in a clear polythene bag and sent to the laboratory in the appropriate White Cervical Cytology Samples Only (LBC) bag (NHSGGC) and accompanied with a Specimen Dispatch note.

Sample takers from other health boards should use their respective collection bags and tracker sheets as appropriate. Samples are then transferred on to the local ‘hub’ for forwarding to the lab in NHSGGC using the provided DX courier and collection/delivery bags.

In exceptional circumstances cervical smear samples can be sent to the laboratory accompanied by a paper request form. Smear takers who send paper requests with the sample to the laboratory must use the official SCCRS Cervical Cytopathology Request Form, which can be downloaded from the NHS Scotland website.

A4_GynaeForm_HPV53_2020.pdf (scot.nhs.uk)

Smear takers must give a reason as to why a paper request was sent, such as SCCRS not working at smear taker location  

Contacts

The Cervical Cytology Department aims to provide the best possible diagnostic service. Should you have a general/technical enquiry or comments about any aspect of the service please contact:

Gillian Collins: 0141 354 (8)9501

Laboratory: 0141 354 (8)9542

For more information on the national screening programme please visit:

https://www.nss.nhs.scot/specialist-healthcare/screening-programmes/cervical-screening/

All semen analyses within Greater Glasgow and Clyde NHS Trust are carried out by the Andrology Laboratory within the Pathology Department of the Queen Elizabeth University Hospital.

The laboratory is able to perform the following analyses:

  • Sub-Fertility
  • Post Vasectomy
  • Reversal of Vasectomy
  • Antegrade Ejaculation (spinal injuries)
  • Retrograde Ejaculation
Clinical Tests Available
Name of TestSpecimen/Container Requirements:Further Information:
  Semen AnalysisSemen analysis is strictly by pre-booked appointment only.

Andrology semen analyses are requested by clinicians/G.P.’s The specimen should be brought by the patient at their appointment time and within one hour of production (sub-fertility and reversal of vasectomy or two hours of production (post vasectomy).

Please refer to Patient leaflet for more information

Only Laboratory provided containers will be accepted for analysis. 

These are available as part of the specimen kit. Specimen kits  are available on request from:

Andrology Department, Level 3, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9488).
Booking an Appointment

Appointments can be arranged by either the requesting clinician/GP or directly by the patient when the have been issued a kit by their referring clinician/GP.

They are booked by telephoning the Pathology Department Office on 0141 354 9487, option 1 “Andrology Appointments”. This booking in service is available between 9:00am – 12:00pm and 1:00pm – 4:00pm Monday to Friday (excluding public holidays).

Currently due to measures put in place to limit the spread/risk of COVID-19 transmission, appointments are only available between 9:00am and 15:00pm.

Interpreter Services

Usually, a range of spoken language and British sign language interpreters are available on request. Please ensure these are booked at the time of making an appointment.

Patient Preparation – Specimen Kits

Each patient should be issued with a specimen kit comprising of the following:-

  • In-date laboratory toxicity tested specimen container (60mls)
  • Request form [PATH-AND-LF-027]
  • Directions to the Queen Elizabeth University Hospital GC0145
  • How the NHS handles your data 2018 leaflet L00089
  • Either a sub fertility leaflet [PATH-AND-LI-001] or post vasectomy leaflet [PATH-AND-LI-002]

To obtain a supply of these kits please contact the laboratory on 0141 354 9488 from 9:00am – 5:00pm, Monday – Friday (excluding public holidays).

Attending an Appointment During the COVID-19 Pandemic

Whilst samples can currently be produced on site, there is very limited availability, due to the added precautions put in place to ensure the health and safety of both our staff and patients attending andrology appointments.

Current WHO Lower Reference Values of Semen Variables

The lower reference values as published in the WHO manual for the Examination and Processing of Human Semen (2010) are shown in the table below. These values represent the quality of semen where a couple may expect to achieve a pregnancy within 12 months of unprotected intercourse. Semen is a non-homogenous fluid and measurements cannot be completely accurate as is evidenced in the confidence limits provided.

ParameterLower Reference ValueConfidence Limits
Volume≥ 1.5 ml1.4 – 1.7 ml
Sperm Concentration≥ 15 Million/ml12 – 16  Million/ml
Sperm Morphology≥ 4 %3 – 4 %
Total Motility (PR+NP)≥ 40 % (within 1 hour of production)38 – 42 %
Progressive Motility (PR)≥ 32  % (within 1 hour of production)31 – 34 %
 Other consensus threshold values
pH7.2 or more 

Lower reference limits (5th centiles and their 95% confidence intervals) for semen characteristics

The Advanced Staining section of the laboratory comprises Immunocytochemistry, Immunofluorescence, Neuropathology, Enzyme Histochemistry (Muscle & Nerve biopsies) and Special Stains

Please see the full list of staining techniques and ICC markers that are under our scope of accreditation with UKAS for further details.

The accreditation section on the front page of this web-site details any staining tests/ICC Markers/other techniques that are not currently under our scope of accreditation.

See the sections below and the user manual for specific information on sending neuropathology specimens, muscle biopsies, nerve biopsies or specimens for immunofluorescence.

Neuropathology
Neurosurgical Biopsies for Intra-operative Diagnosis (Smear or Frozen)

The laboratory must be notified of all potential intra-operative investigations, a minimum of 24 hours in advance of surgery via 0141 353 9530 (89530) or by paging 17627.  When initially contacting the lab, the patient name, CHI Number, surgical procedure, location and estimated time of biopsy should be provided so that appropriate medical and laboratory staff cover can be arranged.

Failure to notify the lab of a case in advance of the surgery taking place may lead to delays in obtaining an intra-operative report if pathologist/laboratory staff are unavailable or allocated elsewhere.

Ideally all intra-operative cases should be discussed with a neuropathologist at the appropriate MDT meeting.

Containers

Sterile, screw cap containers should be used and are stored and managed by theatres. Please contact: 0141 354 9530 (89530) if you urgently require additional containers, you will need to send a porter to collect them.

All containers should be clearly labelled with patient name, date of birth, CHI number, ward number and consultant.

If a specimen is small, the specimen can be put on a glass slide within the container. Please do not add any fluid to the container.

HIGH-RISK SPECIMENS MUST CARRY APPROPRIATE DANGER OF INFECTION LABELS AND CLINICAL INFORMATION PROVIDED

Point of delivery

Please contact Neuropathology 0141 354 9530 (89530) to alert us that a fresh specimen is on its way so that we can prepare for its arrival.

The specimen should be brought by the porter to:

Neuropathology, NHSGGC Pathology Department

Level 3, Laboratories & Facilities Management Building

Queen Elizabeth University Hospital

Glasgow

G51 4TF

It is the clinician’s responsibility to arrange immediate transportation of a specimen to Neuropathology.

The specimen must be handed to a member of Laboratory staff on delivery.

Neurosurgical Biopsy for Paraffin Histology

No prior notification is necessary.

Containers

Sterile, screw cap containers should be used and are stored and managed by theatres. Please contact: 0141 354 9530 (89530) if you urgently require additional containers, you will need to send a porter to collect them.

All containers should be clearly labelled with patient name, date of birth and CHI number.

High-risk cases must carry appropriate hazard labels.

Tissue Fixation

10% formal saline will be supplied by the Pathology Specimen Reception when requested by theatres. Please contact 0141 354 9513 or 0141 354 9514 (89513/89514) when required.

Institute of Neurosciences Theatres 

Please contact the department and organise a porter to bring suitable empty containers to the department.

Royal Hospital for Children Theatres

The neuropathology department will supply containers with 10% formal saline on request. Please contact the department before requesting a porter to come and collect the containers.

The container should be at least twice the volume of the specimen and filled with 10% formal saline.

Accompanying Information

Completed request forms should carry the consultant’s name, ward number, patient’s name, CHI number, address with post-code, date of birth, date of operation and relevant clinical information.

For more technical information/specimen enquiries, please contact Neuropathology on 0141 354 9530 (89530)

Point of Delivery

Neuropathology, NHSGGC Pathology Department

Level 3, Laboratories & Facilities Management Building

Queen Elizabeth University Hospital

Glasgow

G51 4TF

Muscle & Nerve Biopsies
Muscle Biopsy

Prior notification

Elective cases should be booked with the lab with as much notice as possible. The cases can be booked by contacting the neuropathology laboratory via 0141 354 9530 (89530) or through page 17627 or the appropriate consultant.

If there is a danger of infection, these cases must be discussed with medical staff before biopsy as the range of investigations which may be performed with these specimens is limited.

COVID-19

Muscle biopsies are being processed routinely, however the department should be contacted in advance of sending the sample, if the patient is a known COVID positive patient.

Fresh muscle specimens will only be accepted in Neuropathology between  9.00am until 4:00pm, Monday to Friday (excluding public holidays).

ANY SPECIMEN ARRIVING OUTSIDE THESE HOURS WILL NOT BE PROCESSED APPROPRIATELY

Specimens must be placed in a dry, clean universal container. No saline, gauze or formalin should be in the container. The muscle should be dropped into the container and the lid screwed on. The specimen should be transported immediately to Neuropathology.

If there is to be a delay of any longer than 20 minutes it is advisable that the universal container (not the muscle directly) should be transported on ice (NOT DRY ICE). If transported in this manner, the specimen container should be well insulated to prevent direct contact with the ice and potential damage to the muscle biopsy.

All containers should be clearly labelled with patient name, date of birth, CHI number, ward number and consultant. Universal containers must be placed in a specimen bag accompanied by a request card and muscle biopsy request form. This form also contains detailed handling instructions and our full delivery address.

High-risk cases must carry appropriate hazard labels.

Universal containers must be placed in a specimen bag accompanied by a request card and muscle biopsy request form.

Accompanying Information

A muscle biopsy request form and the completed request form must carry the consultant’s name, ward number, patient name, CHI number, address with post-code, date of birth, date of operation, relevant concise clinical data and the nature of the laboratory request. Muscle Biopsy request forms are linked here or available from the Pathology Lab. Tel. 0141 354 9530 (89530)  

Point of delivery

Contact Neuropathology on 0141 354 9530 (89530) or page 7627 who will advise on delivery of specimen.

Neuropathology, NHSGGC Pathology Department

Level 3, Laboratories & Facilities Management Building

Queen Elizabeth University Hospital

Glasgow

G51 4TF

Contact: 0141 354 9530 (89530)

Further details for the submission of muscle biopsies can be found on the muscle biopsy request form 

Nerve Biopsy

COVID-19

Fresh nerve biopsy samples are being routinely processed for analysis within the department. However, if the patient is known to be COVID Positive, please can this be indicated clearly on the form so the laboratory will be able to take the appropriate precaution when processing these samples.

Prior notification

Elective cases that require a frozen section should be booked with the lab with as much notice as possible. Any nerves for neuropathology which do not require a frozen section should be sent in formalin.

Nerve biopsies which require frozen section must be booked in advance (more than 24 hours) by calling 0141 354 9530 (89530) or through page 17627 or the appropriate consultant. The cases can be booked by contacting the neuropathology secretaries via 0141 354 9486 (89486) or through page 17627 or the appropriate consultant.

If there is danger of infection, these cases must be discussed with medical staff before biopsy.

A service to receive unfixed nerve specimens can be offered until 4.00pm, Monday – Friday (excluding public holidays). Specimens must be placed in a dry, clean universal container. No saline, gauze or formalin should be in the container. (The nerve should be dropped into the container and the lid screwed on). The specimen should be transported immediately to neuropathology.

Please contact Neuropathology 0141 354 9530 (89530) to alert the team that a fresh specimen is on its way so that they can prepare for its arrival

High-risk cases must carry appropriate hazard labels.

Universal containers must be placed in a specimen bag accompanied by a request form.

All containers should be clearly labelled with patient name, date of birth, CHI number, ward number and consultant. Universal containers must be placed in a specimen bag accompanied by a request card.

Accompanying Information

Completed request forms must carry the consultant’s name, ward number, patient name, CHI number, address with post-code, date of birth, date of operation, relevant concise clinical data and the nature of the laboratory request.

Point of delivery

Neuropathology, NHSGGC Pathology Department

Level 3, Laboratories & Facilities Management Building

Queen Elizabeth University Hospital

Glasgow

G51 4TF

Contact: 0141 354 9530 (89530)

The specimen must be handed to a member of Laboratory staff on delivery.

Immunofluorescence

The pathology department offers a service for immunofluorescence testing on skin, renal, conjunctival and oral biopsies as well as venous blood.

Venous blood that requires immunofluorescence should be sent to the department in a Vacuette® blood collection tube. Skin, Renal, Oral and Conjunctival Biopsies requiring immunofluorescence should be placed in Michel’s fixative immediately after collection.

Michel’s fixative is capable of preserving fresh tissue for up to 5 days before there is any deterioration in the sample. The request form is checked for the date a sample is taken, to ensure that it has been received within time. Michel’s fixative is available from the pathology department upon request. The fixative should be stored between 2-250c and not be used after it has reached its expiry date.

COVID-19

Fresh samples are being processed routinely for immunofluorescence analysis. However, if the patient is known to be COVID Positive, please can this be indicated clearly on the form so the laboratory will be able to take the appropriate precaution when processing these samples.

Danger of Infection

Specimens that are suspected or are known to contain blood borne viruses (e.g. HIV, Hep B, and Hep C) are classified as Category 2 and can be dealt with using the appropriate safety precautions.

Specimens suspected or known to have Category 3 organisms (e.g. TB, Leprosy, and Anthrax) or Category 4 organisms (e.g. Ebola, Lassa Fever and Haemorrhagic Fever) or CJD are not suitable for analysis via immunofluorescence.

For further information regarding immunofluorescence or danger of infection samples, please contact the Immunocytochemistry Department of the pathology laboratory (0141 354 9518/89518).

All specimens must be accompanied by an appropriately completed NHSGGC Pathology request form (available through PECOS – product code 100509) or speciality request form (placenta, HPV cytology, muscle etc.) with an accompanying Trakcare form.

Please see the departmental specimen transport policy and user manual for further information.

Specimens should be sent to:

Specimen Reception (L3/B/021),

NHSGGC Pathology Department

Level 3, Laboratory Medicine and Facilities Management Building

Queen Elizabeth University Hospital

Tel:  0141 354 9513 (89513)/0141 354 9514 (89514)

Please use a purple bag for histopathology specimens and a white bag for cervical cytology specimens

Minimum Sample Acceptance Criteria

CHI/Unique identifier, Surname & Forename or if no CHI/unique identifier, the Surname, Forename & DOB must be provided.

A minimum of THREE matching patient identifiers across both the specimen pot labels and forms are required to accept a specimen and meet legislative requirements.

Only Specimen containers and Forms that satisfy the essential criteria listed below can be accepted into the department.

Request Form:

Essential:-

  • CHI Number or a temporary unique identifier (e.g. ZP number)
  • Patient’s Full Name or unique coded identifier
  • DOB
  • Nature of Specimen including qualifying details (Any Danger of Infection information is essential)

Desirable:-

  • Patient’s Address including Postcode (essential if no CHI number)
  • Clinical Information/history including risk/danger of infection (essential for fresh tissue and frozen section)
  • Date and time of sampling
  • Practitioner’s contact number (bleep or extn)
  • Gender
  • Location and destination of report
  • Requesting Practitioner
  • Investigation Required

Sample Container:

Essential:-

  • CHI number or a temporary unique identifier (e.g. ZP number)
  • Patient’s Full name or unique coded identifier
  • Date of Birth
  • Nature of Specimen or identifier including qualifying details
  • Labelling to indicate if there is a risk/danger of infection

Desirable:-

  • Date and Time of Sampling

The full address to which the report should be sent must also be included.

N.B: Pre-printed labels do not indicate the address to which the report should be sent.

A short clinical history must also be provided.

A brief clinical history is invaluable in the interpretation of the histological findings and should be given in every case.

As many pathology cases require considerable clinico-pathological discussion before a diagnosis can be reached, it is essential that the name of the patient’s consultant, the name of the requesting doctor and the contact telephone or page numbers are put on the request form where asked.

If the report is required urgently this should be stated on the request form along with a contact telephone number or page number.

The laboratory cannot supply a report on unlabelled specimens or specimens received without request forms.

Failure to provide the required information may result in delays in processing specimens and/or in the provision of a Pathology report to the appropriate location.

Fixation (Tissue Preservation)

Normally, specimens should be transferred in a sealed container with 10% neutral buffered formalin, which prevents tissue decay, ideally the volume of formalin should be at least 10 times the volume of the specimen, but for major resections this may not be possible. Please ensure that containers are properly sealed before dispatch as leaking specimens will not be picked up by Transport/ Facilities staff. If you have a Formalin spill, follow your own spill procedures. 

No fixative should be added if:

  • a frozen section is requested (including: brain biopsies taken mid surgery for smear analysis, muscle biopsies and paediatric rectal biopsies – see individual sections for more information)
  • the specimen is thought to be a lymphoma – whole lymph nodes only
  • there is a need to collect and process fresh surplus tissue for medical research purposes
  • The sample is for Cytology
  • The sample is for Immunofluorescence 

All fresh tissue must be delivered to the Pathology Department immediately and Pathology Specimen Reception should be notified that fresh tissue has been sent.

Tel:  0141 354 9513 (89513)/0141 354 9514 (89514)

If you are unsure of the correct procedure, contact Pathology Specimen Reception for advice on the telephone numbers above.

Delay in receipt of a “fresh” specimen may make diagnosis impossible.

Fixatives and specimen jars are available from:

Specimen Reception (L3/B/021),

NHSGGC Pathology Department

Level 3, Laboratory Medicine and Facilities Management Building

Queen Elizabeth University Hospital

Tel:  0141 354 9513 (89513)/0141 354 9514 (89514)

Urgent Specimens for Pathology

Requests for urgent results should be clearly marked on the request form and contact telephone or page number provided.

The consultant pathologist should be notified before the specimen is sent if an urgent result is required.

It is the responsibility of the clinical team to ensure that emergency/urgent specimens are transported urgently to the Pathology Laboratory.

Precautions for “Danger of Infection” (DOI)

In practice, these are specimens that carry the risk of transmitting Hepatitis B virus, Hepatitis C virus, HIV, M. tuberculosis and other category III pathogens.

The Clinical Microbiology Department should be contacted where there is any uncertainty.

Such specimens, include those from confirmed or suspected cases of the disease, known carriers (e.g. those known to be hepatitis antibody or antigen positive), as well as patients from an ‘at risk’ group (e.g. drug abusers).

‘Danger of infection’ (DOI) stickers MUST be put on the specimen bag, the request form and the specimen container.

If the nature of the DOI is known please include this in the clinical details.

Specimen bags should be sealed so that they can be opened without the use of sharp or pointed instruments.

For large specimens, containers should be enclosed in individual plastic sacks tied at the neck. The request form should be placed in a plastic envelope which is then securely tied to the neck of the sack.

“Danger of Infection” specimens should always be sent in an adequate volume of buffered formalin.

Pathology Non-Conformances (Unable to Accept Specimen)

If a specimen is received in Pathology and the specimen and/or request form has been mislabelled, is unlabelled or there are discrepancies between the request form and specimen container, the Laboratory staff will make every attempt to contact the sender to clarify the error, including telephoning the source and contacting requesting clinician etc. identified from any information that has been supplied.

If the Laboratory staff are unable to rectify the problem by telephone, a “Non-conformance letter” will be sent to the requesting clinician.

This letter is accompanied by the request form and identifies the nature of the non-conformance with a request that this is rectified and the requesting clinician takes responsibility for the changes.

Specimens are NOT returned but will be kept in Pathology Specimen Reception labelled with the appropriate non-conformance number, until the non-conformance has been resolved.

Cytology Non-Conformances

The laboratory cannot supply a report on unlabelled specimens or specimens received without request forms. Failure to provide the required information may result in delays in processing specimens and/or in the provision of a pathology report to the appropriate location.

In the event of an urgent specimen being received in diagnostic cytology, where the specimen and/or request form has been mislabelled, the technical staff in the lab will make every attempt to contact the sender and clarify the mislabelling error, including telephoning the source and contacting the requesting clinician etc. identified from any information that has been supplied.

In the event of there being insufficient information to allow cytology to contact the sender, the specimen will be kept refrigerated for one week, in the hope that the lab will be contacted. If no contact has been made at the end of this period, the specimen will be discarded.