PASADENA CYTO-PATHOLOGY LABORATORY, INC.

A MEDICAL CORPORATION 1OO W. CALIFORNIA BLVD PASADENA, CA 91105

Billing Inquiries: (626)397-3448 S. S. Murakami, M.D., Director (CLIA) Tissue Information: (626)397-8616 H. D. Slosser, M. D., Director Cytology Information: (626)397-8618 X. Wang, M.D., Ph.D., Director Fax Number : (626)397-2931 D. Lu, M.D., Director L. Wang, M.D., Director

HISTOLOGY SPECIMENS

Tissue specimens may be dropped off in Surgical Pathology Monday through Friday between 0700 and 1800. At all other times – including weekends and holidays - specimens should be taken to the Clinical Laboratory Processing area on the ground floor of the West Tower.

I. Routine Pathology specimens should be submitted in an appropriately-sized, leak proof container and covered with 10% buffered formalin. Large specimens (colons, placentas, etc) may be submitted fresh but must be refrigerated after hours.

A. The container must be labeled legibly with the following information: 1. Patient’s full name 2. MR number and/or Visit Number 3. Age/date of birth 4. Sex of patient 5. Source of tissue

B. A completed “Pathology Tissue and Microbiology Requisition” form must accompany each specimen and contain the following: 1. Patient’s full name 2. MR number and/or Visit Number 3. Age/date of birth 4. Sex of patient 5. Date specimen was collected 6. Source of tissue / specimen description 7. Name of submitting physician/surgeon (and other pertinent clinicians) 8. Clinical information including pre- and post-operative clinical impressions. 9. Signature of surgeon 10. Signature/name of person completing the form

C. If more than one specimen is submitted, each must be numbered and identified on a tissue requisition form and on the container label.

D. All specimens must be placed in a secondary, leak proof container or biohazard bag for transport.

Refer to following page(s) for the most common specimen handling requirements.

Any other special testing requests or tissues requiring special handling need to be communicated to Surgical Pathology prior to delivery of the specimen.

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Result availability from time received HISTOLOGY in the Lab

SPECIAL TEST NAME SPECIMEN REQUIREMENTS INSTRUCTIONS/STORAGE ROUTINE STAT ROUTINE Ideally, specimen should be Deliver specimen and SPECIMENS placed in ten times its requisition to Pathology volume of 10% neutral processing area as soon as buffered formalin; at the possible after collection. very least, specimen should be completely covered Refrigerate the specimen if it 24 to 48 hrs N/A is delivered after Pathology Large specimens may be hours of coverage sent fresh in an appropriately-sized leak proof container

COMPLEX Ideally, specimen should be Deliver specimen and SPECIMENS placed in ten times its requisition to Pathology volume of 10% neutral processing area as soon as buffered formalin; at the possible after collection. very least, specimen should be completely covered Refrigerate the specimen if it 24 to 48 hrs N/A is delivered after Pathology Large specimens should be hours of coverage sent fresh in an appropriately-sized leak proof container

LIMBS Double-bag specimen in a Deliver specimen and plastic bag other than a red requisition to pathology biohazard bag; specimens processing as soon as in red bags will require possible after collection. Surgery personnel to come to Pathology to properly After hours, leave in contain them refrigerator in Surgery – do not deliver to Processing in 24 to 48 hours N/A Refrigerate fresh specimen the Clinical Lab.

If the limb is too big for the refrigerator, place in limb storage box in the Morgue and log in specimen in Pathology stating that limb is in the Morgue FROZEN Fresh, unfixed specimen Deliver to Pathology SECTIONS / should be delivered to Grossing Room and hand to OPERATIVE Pathology STAT personnel. Never leave a CONSULTA- specimen on an TIONS unattended counter. N/A 15 minutes After hours, the on-call pathologist should be notified in advance of pending procedure

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Result availability from time received HISTOLOGY in the Lab

TEST NAME SPECIMEN REQUIREMENTS SPECIAL ROUTINE STAT INSTRUCTIONS/STORAGE RENAL Two to three cores of fresh, Deliver to Pathology BIOPSY unfixed renal tissue should Grossing Room and hand to Send Out – be delivered to Pathology personnel. Never leave a STAT. specimen on an preliminary unattended counter. results available N/A Submit specimen on damp in 1-2 days; saline-soaked gauze After hours, the on-call pathologist should be Final results notified in advance of available in 1-2 pending procedure weeks

BONE Cores in B-5 fixative (or Deliver specimen and MARROW 10% formalin if B-5 not requisition to Pathology available) processing area as soon as possible after collection. Aspirate in purple top tube Refrigerate the specimen if it 24-72 hours N/A Peripheral blood in purple is delivered after Pathology top tube hours of coverage

Cytogenetics, flow studies in green top tube(s)

QUANTITA- Liver tissue at least 1 cm Submit tissue for routine TIVE IRON long obtained with an 18 pathology and quantitative gauge needle. iron separately in labeled containers. Tissue less than 2 mg is Send Out – unacceptable. Deliver specimen and N/A requisition to Pathology 10 Days Submit in 10% formalin in a processing area as soon as metal-free container possible after collection.

Refrigerate the specimen if it is delivered after Pathology hours of coverage

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Result availability from time received HISTOLOGY in the Lab

TEST NAME SPECIMEN REQUIREMENTS SPECIAL ROUTINE STAT INSTRUCTIONS/STORAGE NERVE Specimen requirements are Notify Pathology at least 4 BIOPSY different depending on working days in advance of where specimen is sent: the procedure in case a nerve bx kit has to be Long Beach Memorial – obtained. fresh sural nerve 3-4 cm in Send Out – N/A length should be placed on Clinician should specify stiff porous paper or entirely where specimen is to be 1 month frosted slide, straightened sent. and slightly stretched and then placed in fixative Procedure should be provided in kit scheduled before 12:00 pm to ensure specimen reaches UCLA – sural nerve at least reference hospital before 2.5 cm in length sent fresh afternoon cut-off time. to Pathology History and physical (H&P) and patient billing information must accompany specimen

MUSCLE Specimen requirements are Notify Pathology at least 4 BIOPSY different depending on working days in advance of where specimen is sent: the procedure in case a muscle bx kit has to be Long Beach Memorial – obtained. ideally 3 muscle specimens (10-15 mm x 5mm) on Clinician should specify

clamps; place in fixatives where specimen is to be

provided in kit sent.

UCLA 5-10 mm square of Procedure should be – fresh muscle sent fresh to scheduled before 12:00 PM Send Out – Pathology to ensure specimen reaches N/A reference hospital before 1 Month Children’s Hospital – ideally afternoon cut-off time. 4 fragments of muscle measuring 3 x 4 mm each History and physical (H&P) sent fresh to Pathology and patient billing information must accompany specimen

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Result availability from time received HISTOLOGY in the Lab

TEST NAME SPECIMEN REQUIREMENTS SPECIAL ROUTINE STAT INSTRUCTIONS/STORAGE PRODUCTS OF 3-4 mm or 50-100 mg of Submit tissue for routine CONCEPTION tissue. Pathology separately from FOR If possible, always include tissue for chromosome KARYOTYPING chorionic villi. analysis in labeled (CHROMO- containers. Send Out – SOME Submit in sterile saline. N/A

ANALYSIS) Deliver specimen for 7 - 21 days DO NOT PLACE IN chromosome analysis (Avg. 10 days) FORMALIN. directly to Processing on the Ground Floor - DO NOT deliver to Pathology.

ELECTRON Fresh, unfixed specimen Deliver to Pathology MICROSCOPY should be delivered to Grossing Room and hand to (EM) Pathology STAT or personnel. Never leave a specimen may be placed specimen on an unattended and held in 3% counter.

glutaraldehyde in Surgery

Send Out –

N/A 2 weeks

CLONOGENIC Fresh, sterile tumor (at least Deliver to Pathology ASSAY 1 mg) should be delivered to Grossing Room and hand to (EXTREME Pathology STAT personnel. Never leave a DRUG specimen on an unattended RESISTANCE counter. After hours, the on- ASSAY) call pathologist should be notified in advance of pending procedure.

In addition to the standard information required on the tissue requisition form, the Send Out – following information must N/A also be included: Histologic 3 to 4 weeks diagnosis, whether or not the patient received prior chemotherapy, cancer type, the specific tests requested, and patient billing information

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