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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