GENERAL
INFORMATION:
1.1 STAFF
DIRECTOR:
Assoc. Prof. A Morey
STAFF SPECIALISTS:
Dr. A. Field
Dr. J. Turner
Dr. S. Rainer
Dr. K. Oliver
Dr. W. Barrett
Dr N. Kumaradevan
CHIEF HOSPITAL SCIENTIST
Mrs. L. Thornell
SENIOR HOSPITAL SCIENTIST HISTOLOGY
Ms. S. von Richter
SENIOR HOSPITAL SCIENTIST CYTOLOGY
Ms. S. Carbone
1.2 LOCATION:
Level 6, Xavier Building
1.3 TELEPHONE:
General Enquiries 8382 2319
1.4 LABORATORY HOURS:
Monday to Friday: 0730 to 1800 hours
All other times: Contact the Central Specimen Reception (CSR) Ext 9100
for the pathologist on call.
1.5 PATIENT RESULTS:
Results can be obtained in the wards via the hospital computer using the pathology enquiry
facility
(Mediweb). Any other enquiries or consultations should be referred to the relevant staff
specialist via the Anatomical Pathology Office between the hours of 0800 to 1800. Outside
these hours, a duty staff specialist Anatomical Pathologist is always available & can
be contacted through the CSR ( 8382 9100).
2.0 SURGICAL PATHOLOGY:
To provide a prompt evaluation of specimens received by histology/cytology laboratories, a
properly completed
request form must accompany each case.
A properly completed request form should possess -
2.1 Patient identification (name, address, medical record no. age, DOB,
ward, financial class.
2.2 Date and time of collection.
2.3 Type of specimen.
2.4 Relevant clinical history.
2.5 AMO and requesting medical officer (with page number).
2.6 A clear indication of contact details if an urgent result is
required
3.0 SPECIMEN LABELLING:
The specimen should be labelled with the patient’s identification (see above). If
there is more than one specimen it should be indicated as Specimen I, Specimen 2 etc. and
coincide with the request form.
4.0 GENERAL INSTRUCTIONS:
4.1 Tissue removed at operation must be submitted for
histopathological / cytological examination except those tissues specifically exempted.
This is a mandatory requirement for accreditation. ( ACHS Accreditation Guide 13th Edition
1995)
At St Vincent’s hospital, the tissues specifically exempted are:
* Tonsils from patients less than 14 years of age
* Varicose veins
* Bone chips
* Skin trimmings
Notwithstanding this exemption, these tissues also may be submitted if so directed by the
patient’s
attending medical officer.
Disposal of tissue: Refer to St Vincent’s Hospital Policies and Procedures Manual
Section 5 Policy No 2
4.2 The sister in charge of the case is personally responsible for :
4.2.1 Checking the label on the specimen container.
4.2.2 Placing the specimen with the request form into the appropriate
bio-hazard bag and ensuring that the specimens are left in the appropriate area for pick
up by the Sydpath courier.
4.3 AMO may request that a specimen be treated in a specific manner, in
which case his instructions are followed.
4.4 If in doubt as to what to do with a specimen ask the AMO in charge
of the case for instructions. If doubt remains contact the duty pathologist.
5.0 ROUTINE SPECIMENS:
5.1 Place the tissue immediately or as soon as possible in at least five
times its own volume of 10% buffered formalin in a sealed labelled container. Formalin can
be obtained from the histology
laboratory Level 6 Xavier Building.
5.2 Specimen must be placed into biohazard bag. The request form must be
placed in the separate compartment provided and should reach the Anatomical Pathology Dept
no later than 1800 hours on the same day whenever possible. In cases where it is
impossible, the specimen should be despatched at the earliest practicable opportunity.
5.3 Large unopened specimens such as bowel, stomach, spleen should
always be sent to Anatomical Pathology as soon as possible as they will not be fixed
adequately if left unopened overnight. Outside routine hours these specimens should be
opened by the surgical registrar on duty.
6.0 SPECIMENS NOT IN FIXATIVE:
6.1 Specimens NOT in fixative must NEVER be left in Anatomical Pathology
without informing a medical or technical member of the pathology staff.
6.2 Any specimens submitted for microbiological examinations as well as
histology should be in a DRY, sterile container which has NOT contained formalin.
6.3 Frozen sections (see below)
7.0 SPECIMENS for FROZEN SECTION or ANY
SPECIMEN NOT in FORMALIN for
ANATOMICAL PATHOLOGY (HISTOLOGY or CYTOLOGY)
7.1 Place tissue in a DRY, sealed container PROPERLY labelled and
identified.
Public Theatres
Take IMMEDIATELY with request form, completed and marked with the
number
of the theatre, to the Department of Anatomical Pathology, Level 6
Xavier Building.
DO NOT DELIVER TO CENTRAL SPECIMEN RECEPTION.
7.2 On arriving in the laboratory, ring the bell (located directly
in front of the main door) and hand the biopsy and the request form to a member of the
medical or technical staff.
Private Theatres.
The theatres are to ring the clinic Ext. 6590 when the frozen section
specimen is ready to be picked up.
7.3 If any queries arise concerning Frozen Sections, contact the
Director of Anatomical Pathology or her Deputy IMMEDIATELY.
Specimens to be brought direct to Anatomical Pathology include:
7.3 1 Frozen Sections except those from Private
Hospital
7.3 2 Sperm samples for immediate intra operative
assessment.
7.3 3 Any unfixed tissue requiring histology plus
other tests eg. lymphoma investigations, crystal examination, culture, immunofluorescence,
electron microscopy, research.
7.3.4 For cytological examination of fluids (ie
ascites or pleural fluid, a volume of up to 50ml in an appropriate sterile container is
more than adequate; large drainage bags are INAPPROPRIATE.
8.0 SPECIFIC TISSUES
8.1 SKIN BIOPSY
Place in 10% formalin and treat as routine specimen.
8.2 LIVER BIOPSY
Place in 10% formalin and treat as routine specimen. This includes additional cores for
iron estimation
(separate jar required).
8.3 RENAL BIOPSY
Contact the department of Anatomical Pathology to book technician attendance BEFORE taking
the biopsy.
8.4 MUSCLE BIOPSY
Contact the Anatomical Pathology laboratory in advance, at least 2 hours before the biopsy
is to be taken. Wrap tissue in gauze slightly dampened in saline. Place into a container
properly labelled and identified. Take immediately with request form to the Department of
Anatomical Pathology Level 6 Xavier Building
8.5 PERIPHERAL NERVE
Arranged by the medical staff in theatres to be sent to the University of Sydney
Neuropathology
Department. Dr Fern
Room 417 Blackburn Bldg
Sydney University
8.6 LYMPH NODE, SPLEEN
Deliver IMMEDIATELY in DRY container to Department of Anatomical Pathology.
Outside normal hours seek instruction from the doctor in charge of the case.
8.7 IMMUNOFLUORESCENCE (ANY TISSUE)
Treat as a frozen section.
8.8 ELECTRON MICROSCOPY (ANY TISSUE)
Contact a medical officer of the department before beginning the procedure to take the
specimen.
8.9 INTRA-OPERATIVE FNAB’S FOR CYTOLOGY
Cytology staff are available to come to theatres and assist
in the preparation of slides for assessment.
Generally, staff members will set up at the theatres front
desk. We ask that you bring the needle and syringe out to us in a biohazard bag.
If cytology staff are needed in theatre, notice of 15
minutes will be required in order to organise equipment and change into theatre attire.
A number of questions will be asked when you call for
assistance, it would be appreciated if the answers could be ready. These questions are as
follows:
1. Does the surgeon want to know if there is adequate material for
diagnosis, and if so,
will further passes be done if there is insufficient material ?
2. Does the surgeon want an URGENT result (if so, how quickly)?
3. Is the patient immunocompromised / infectious?
4. Name of the patient; name of the surgeon and site of the FNAB.
A fully completed, signed request form is required with each
patient’s specimen. If results are to be called through to theatre write the
extension on the request form.
8.10 FLUIDS
All fluids MUST be collected into 50 ml screw top specimen containers and placed in a
biohazard bag. SPECIMENS in DRAINAGE BAGS are UNACCEPTABLE
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