The following is a brief outline. If there are any queries concerning specimen handling, please contact the laboratory (details below) and discuss these with a Histopathologist or pathology registrar.
ROUTINE SPECIMENS
Include Small Biopsies, Larger Specimens.
NON - ROUTINE SPECIMENS
The following require rapid transport to the laboratory and/or special protocols (click on the links below for more information)
SPECIMENS REQUIRING RAPID TRANSPORT
(a) Skeletal muscle biopsies
(b) Lymph node biopsies
(c) ALL childhood and SOME adult tumours
(d) Rectal biopsies
(e) Any fresh specimens
(f) Any transplant biopsies (cardiac, lung, renal, liver)
(g) any biopsy for rapid paraffin section/ slow Moh's
NB: These specimens must be received by the Histology lab no later then 1600 hrs from Monday to Friday and the Lab must be notified on extn 22090, before sending.
SPECIMENS REQURING SPECIAL PROTOCOLS
(a) Renal biopsies
(b) Liver biopsies with fresh tissue (e.g. for metabolic diseases)
(c) Direct Immunofluorescence (DIFL)
FRESH SPECIMENS
With the increasing diversity of diagnostic techniques there is a growing number of specimens which need to be sent fresh to the laboratory. All fresh specimens sent to the laboratory must be accompanied by a Frozen section/Fresh tissue ORANGE form and it is essential that the Histology Laboratory is notified when a procedure is planned, and when the specimen is sent. Phone extn 22090.
Special fixatives other than formalin are supplied to departments regularly obtaining specialised biopsies. Any queries or requests for special fixatives should be made via extn 22090.
FROZEN SECTIONS
Frozen sections must be booked in with the Histology Lab on ext. 22090 (Monday to Friday 8am-5pm) prior to carrying out the procedure. The specimen be sent to the laboratory fresh. They must be accompanied with a Fresh Tissue Orange form . The contact number for the result must be written on the form.
The Histology lab must be contacted when the specimen leaves theatre on ext.22090.
CHILDHOOD AND SOME ADULT TUMOURS
ALL childhood and SOME adult tumours, where cytogenetic studies, EM or lymphoid cell marker studies are anticipated
LARGE SPECIMENS
Large specimens should be submitted fresh and transferred to the laboratory as soon as possible. These MUST be accompanied by an orange form to indicate urgency.
LIVER BIOPSIES
Biopsy specimens should be submitted in formalin (unless otherwise requested)
Routine
These biopsies are processed daily (except weekends and statutory holidays) on the routine cycle if submitted before 1530hrs
Urgent
If required urgently please contact the Histology Laboratory on extn 22090 giving relevant details and the reason for the urgency
Transplant
These biopsies are handled by:
Dr Kai Yin Chau extn 22092 mob 021 053 8958
Dr Amanda Charlton extn 22085 mob 027 201 0646
They will not be processed urgently until one of the above Pathologists has been consulted and the Technical staff notified on extn 22090.
These specimens should then be delivered to the laboratory accompanied by an orange request form showing an Urgent Sticker. Please inform Specimen Reception that the specimen is urgent, or phone ext 22090 to say that it's on its way to the laboratory.
LYMPH NODE BIOPSIES
Lymph Node Biopsies and all other tissue biopsies where the diagnosis of either lymphoproliferative disorder or infection is suspected must be submitted fresh with an orange request form.
The Histology Lab must be contacted on extn 22090 prior to sending, to notify them of the specimen.
NB: These specimens must be received by the Histology lab no later than 1600 hrs from Monday to Friday.
RECTAL BIOPSIES
Rectal Biopsies for Hirschprung's or Batten's disease must be sent fresh together with an orange request form - please refer to Starship Rectal Protocol.
The Histology Lab must be notified on extn 22090, before the specimen is sent.
NB: These specimens must be received by the Histology lab no later than 1600 hrs from Monday to Friday
RENAL BIOPSIES - also see DIFL below
These are all handled by:
Dr Jonathan Zwi extn 23103 mob 0274 824 811
Dr Logan Carpenter extn 22085
Dr Nicola Kingston extn 22097 mob 021 245 9119
Dr Jeannette McFarlane extn 23271 mob 021 432 501
Dr Boomi Kwon extn 24337
Dr Hiba Hameed extn 23065
Native biopsies should be submitted before 1530hrs Monday to Friday. One core in Michels Transport Medium (MTM) and one core in formalin.
Please contact the Histology Laboratory on extn 22090 if the 1530hrs deadline cannot be met. Transplant biopsies should be submitted in formalin (unless otherwise requested).
Send all specimens by direct urgent delivery. These specimens should be accompanied by a green renal request form.
Urgent Specimens will be processed on the same day, but only after consultation with one of the above renal Pathologists.
MTM is available from the laboratory on request.
SKELETAL MUSCLE BIOPSIES
It is necessary to discuss the case prior to biopsy with one of the below Consultant Pathologists, on all patients.
If unavailable contact the Histopathology laboratory on ext 22090 before proceeding.
Dr Clinton Turner extn 23103 mob 0274 824 811
Dr Amanda Charlton mob 027 201 0646
Dr Komal Srinivasa mob 020 4028 1972
NB: These specimens must be received by the Auckland city Hospital, LabPlus, Histology Lab 0800-1600 hrs Monday to Friday. For details on specimen collection, handling and transportation click
Download: Skeletal Muscle Biopsies - 2021 MUSCLE BIOPSY information for lab test guides.doc
IRIS BIOPSY
For histopathological examination for suspected neoplasia, particularly pigmented lesions.
1. Thin flimsy iris specimens need to be fixed flat before being sent to the laboratory.
2 Use the Sandwich Press method demonstrated in this 3 minute video https://youtu.be/Fr2i1kVPDnc
3. Summarised in this infographic:
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| Sandwich Press |
4. This method is also suitable for other thin flimsy ophthalmic specimens such as conjunctiva, choroid and DMEK excisions.
Contact Information
For further information contact the Histopathology laboratory (contact via Lablink: 22000 or (09) 307-8995 ) ,or ext 22090
Dr Amanda Charlton acharlton@adhb.govt.nz or 09 307-4949 ext. 22085
Immunohistochemistry Antibody Stains Availableplease click the link below for the Immunohistochemistry antibody list |
SKIN BIOPSIES FOR IMMUNOFLUORESCENCE - also see DIFL below
Skin biopsies may be for paraffin processing and/or for immunofluorescence only. Submit tissue for immunofluorescence in Michels Transport Medium (MTM) with a separate biopsy in formalin for routine Histology. Please telephone the laboratory on extn 22090 and inform the staff that a specimen for immunoflourescence has been sent.
MTM is available from the laboratory on request.
SMALL BIOPSIES
Immerse immediately in at least a ten-fold volume of 10% formalin in an adequately sizes and tightly sealed container.
DIRECT IMMUNOFLUORESCENCE (DIFL)
Send all specimens either in Michel's Transport Medium OR urgently, fresh on saline soaked gauze.
If sending fresh (from within the ADHB or other DHB's/medical centre's/laboratories) - The specimen MUST be received by the lab no later than 4pm Monday - Friday. DO NOT send fresh specimens over the weekend.
All fresh specimens must be accompanied by an orange request form and the Histology Lab must be notified on extn 22090, before sending.
Specimens for DIFL sent together with tissue for paraffin processing, are placed on hold until requested by the Pathologist reviewing the paraffin block material. Specimens for DIFL only investigations are usually processed the following day after receipt in the lab.
Whether sending fresh or in transport medium and regardless from where the specimen has been sent, please phone the lab and inform them that a specimen for DIFL is on the way. This allows the lab to track the specimen and get in touch with the sender should the specimen not arrive in the lab in a timely fashion
MTM is available from the laboratory on request.
LABELLING
In addition to the requirements of the Company Policy regarding specimen labelling, please include the following information:
Specimen Type
Pertinent Clinical / Operative details
Legible signature and printed name
- Endometrial samples require menstrual and hormonal data on the request form to enable an informed interpretation of the histological appearance.
- Specimens AND request forms from patients with communicable infectious diseases must be adequately labelled
- Failure to provide the above information may result in a delayed turn-around-time of results.
The Examination of Body Parts and Tissues
A comprehensive explanation is available for all patients, whose body part/tissue may require histological investigation in the booklet "The Examination and Return of Body Parts and Tissues" - CC5074
Turnaround Time Varies
Please note that all TAT's are working days i.e. Monday - Friday and exclude weekends and statutory holidays.
Histology reports
TAT for urgents is 3-5 working days.
TAT for non-urgent is 90% of cases reported in 10 working days. However it should be noted that TAT is governed by the complexity of the specimen and any additional testing may extend the TAT to greater than 10 working days.
Urgent Reports
Results may be available earlier if the clinical situation warrants this, through consultation with the on-call Histopathologist. Clinical staff to whom the results are to be communicated should be specified with locator, mobile and/or extension numbers.
Rapid Paraffin Sections/Slow Mohs
Typically for 'slow Mohs' staged surgical excision of skin tumours requiring margins before reconstruction 2-3 days later. Paraffin sections require overnight processing and provide superior quality sections compared to frozen sections. Specimens need to arrive at LabPlus, Grafton before 4pm to enable accession, dissection and overnight processing. For specimens sent from Greenlane or Waitakere be aware transport can be slow on Friday afternoons and may miss the 4pm cut off. The lab does not process specimens on weekends or public holidays.
For specimens processed overnight, the result can be available the next day, but if immunohistochemistry or levels are required, another day is needed. Immunohistochemistry is often required for melanotic lesions.
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Notify the laboratory before sending ext 22090
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Activate the the rapid specimen transport pathway
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The reconstructing surgeon should ensure they have the result before commencing surgery. If the result is not on RCP, phone the lab ext 22090 and speak to the on call pathologist for a verbal report.
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Fill in an Orange form, and attach an Urgent sticker. Use the following template.
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Laboratory Hours are Monday to Friday between the hours of 0800 and 1700. During this time Histology offers a full service.
During normal working hours
The laboratory can be contacted on extn 22091 and the Cut-Up room on ext 22090. The Histopathologists can be contacted via LabLink on extn 22000 or directly by following the link below.
For all Office enquiries please contact the clerical team on extn 22089
Information regarding surgical pathology reports is available through LabLink on extn 22000. Cases requiring further discussion, preliminary reports and frozen section results will be communicated by telephone from laboratory medical staff (Pathologist or Registrar) to clinical medical staff.
Outside of normal working hours (weekends and statutory holidays)
Histopathologist on call - contact switchboard
Scientist on call: Ph 021 522 298
For urgent liver and renal biopsies, please contact the on-call liver or renal pathologist. Do not call the Histotechnologist unless you have contacted the pathologist first.
For paediatric, please contact the department.
For ENQUIRIES and RESULTS Phone Lablink: 22000 or (09) 307-8995 or 0800 522 758.
PLEASE NOTE: Technical and clerical staff are NOT authroised to give out results.