Description:
The Core Histology Laboratory processes patient surgical tissue during operations or biopsies from investigatory procedures, including:
• Surgical Pathology and its Specialties
• Breast Pathology
• Dermatopathology
• Endocrine Pathology
• Gastrointestinal Pathology
• Genitourinary Pathology
• Gynaecological Pathology
• Haematopathology
We then either produce a report or send the sample to the Advanced Diagnostics laboratory for further tests.
Post Mortem Examinations and Autopsy examinations are performed at King's, which also has a special room for the examination of ‘high risk’ cases. Hospital post mortem reports are available from the Histopathology Office on (KCH) 33045. Coroner’s post mortem reports are available from The Coroner’s Office on 020 7525 4200.
Turnaround Time (TAT) for Autopsy Reports
• TAT for routine autopsies is 3 weeks
• Autopsies requiring toxicology or specialist tests will take longer
Related condition or disease:
Sample type and Volume required:
Histopathology specimens contained in 10% formal saline should be stored at ambient temperatures (between 15°C - 25°C), these samples should never be refrigerated as this will severely reduce the rate of fixation and preservation by formaldehyde, this will then reduce the morphological quality of the sample. Fresh samples for Histopathology must be delivered to the Histopathology department immediately. These are usually booked in advance so that the department is aware and ready. Any fresh sample that does not come to the Histopathology department directly must be refrigerated before transport to the department.
Exceptions where unfixed tissue must be brought promptly to the laboratory include:
• Frozen sections (except any case known to be or suspected of being an infection risk), which should be pre-booked - for more information please refer to the 'Frozen Section' informaition.
• Renal biopsies
• Lymph nodes (except any case known to be or suspected of being an infection risk)
• Needle localisation biopsies of breast
• Fetuses and placentae
• Bone biopsies (when metabolic disease is suspected)
• Where tissue from gross specimens is required for non-histological investigations
Muscle and nerve biopsies are dealt with in the Department of Clinical Neuropathology ((KCH) 31957).
Specimens must not be squashed into containers inadequate for their size and should be covered by at least 10 to 20 times their volume with fixative.
Call in advance:
Requests for frozen sections should ideally be booked with the laboratory at least 24 hours in advance ((KCH) 34031) to guarantee availability of staff
Turnaround time:
Diagnostic biopsy specimens TAT target is 7 calendar days from date of biopsy to the authorised report being available to the requestor (R.C. Path Key Performance Indicators 2013). Examples of diagnostic biopsies include needle core biopsies, endometrial biopsies/curettings, endoscopic biopsies, colposcopic biopsies and punch biopsies. Samples which require decalcification or additional tests (such as special stains and Immunohistochemistry) will take longer to report. General Histology specimens TAT target is 10 calendar days from date of specimen collection to the authorised report being available to the requestor (R.C. Path Key Performance Indicators 2013). Examples include major cancer resections, integrated reporting of haematological malignancies, and benign therapeutic resections. Samples which require decalcification or additional tests (such as special stains and Immunohistochemistry) will take longer to report.
Special sample instructions:
Michel's medium is used for the transport of skin biopsies that require immunofluorescent staining for the diagnosis of autoimmune blistering diseases. Michel's medium can be obtained from Advanced Diagnostics, Histopathology department. Please call prior to collecting to ensure availability of Michel's Medium transport bottles, tel: 020 3299 9000 ext 34168. Please note: Michel's medium contains N-ethylmaleimide , which is toxic and may cause eye and skin irritation. It should be disposed of by a licensed waste consigner.
Storage and transport:
Specimens must be transported in a plastic kangaroo bag with the form contained in the separate pocket. Please ensure samples are sent as soon as possible post-collection. Histopathology Specimen Reception is located on the 2nd floor of the Bessemer Wing ((KCH) 34038). The specimen reception area is staffed from 8am to 5.30pm. Fresh specimens must be brought to the department by 5pm at the latest. Specimens that are infectious should be clearly labelled with 'Danger of Infection' stickers on the kangaroo bag, on the specimen and on the request form. Fixed specimens can be brought direct to the Histopathology laboratory. Fresh tissue with a known infection risk should be placed in formalin fixative before being sent to the laboratory.
Muscle and nerve biopsies are dealt with in the Department of Clinical Neuropathology ((KCH) 31957).
Specimens must not be squashed into containers inadequate for their size and should be covered by at least 10 to 20 times their volume with fixative.
Time limit for extra tests:
Reflex molecular tests are excluded from this indicator but should have documented and agreed pathways with specified and monitored turnaround times.
Contacts:
For clinical advice or interpretation of results, please contact the laboratory in the first instance.
Prompt fixation is fundamental to good histological technique. In difficult or unusual cases, any query concerning correct tissue preparation should be directed to the Core Laboratory by telephoning (KCH) 33266.
Acceptance Criteria
The laboratory will refuse to process samples/request forms that are not adequately labelled. This is to ensure patient safety. Specimens are checked against request forms to ensure correct identification.
Correct labelling and matching of all diagnostic specimens and request forms is a minimum standard. It is the sender’s responsibility to ensure that the samples and request forms are correctly and adequately labelled. Leaking vials will be processed, if possible, and providing that the specimen labelling is legible.
IF THERE IS A MAJOR DISCREPANCY (ESSENTIAL DEMOGRAPHICS / MISMATCH DETAILS) THE SPECIMEN WILL NOT BE PROCESSED.
