Clinical Pathology Laboratory Hematology and Transfusion Medicine Clinical

. • Clinical Pathology Laboratory: Hematology and Transfusion Medicine Clinical Chemistry Clinical Microbiology Anatomical Pathology • Surgical Pathology • Cytopathology • Autopsy Pathology • Molecular Pathology and Cytogenetics – Current state in North zone – –

. • Tissues usually exempt from pathological examination: – – – – – Amputations Bone fragments & ligaments Foreign bodies Hernia sacs Nasal septum Optic lens Teeth Tonsils and adenoids Placentas When in doubt!

. • Transporting to the Lab: – – – Presume contaminated Formalin (15 – 20 X tissue volume) Clean leak-proof containers Label fixative used (with warning) Refrigerate if expect delay Special considerations: • Items with medico legal implications • Send unfixed if – Frozen section, lymphoma work-up or Cytogenetics – Nerve or muscle biopsies – Skin or kidney biopsies for IF

. • Formalin fixation: – Prevents autolysis – Inactivates infectious agents – Hardens the tissue – Has to be exposed to the tissues • After hours – neoplastic vs non-neoplastic – Lower GI – Ischemia and Fixation times and duration may be important

. • Handling breast specimen – Orientation sentinel lymph nodes – Radiology specimen – Ischemia and fixation times

. • Cytopathology specimen: – No formalin! – Fluids – Washouts / rinses – Smears / slides • Air dried or fixed

. • Autopsies: – Adults – Neonates (cut of is 20 weeks)

. • Intraoperative consultations – Indications – Specimen transport – Turnaround time – limitations

. • Pathology turnaround times: – Calculated from the time received in the lab – Depends on the complexity of the specimen • • Small specimen: 4 working days Large complex cases: 6 working days Cytology specimen: 2 working days Pap smears: 6 working days

. • Retention of clinical material – Wet tissue: 4 weeks – Slides and blocks: 20 years – Normal pap smears: 5 years

. • Major discrepancy / deficiency: – Unlabeled specimen (without name & unique identifier) – Name identifier incomplete – Discrepancy between sample label and the test request form – Specimen site on both container and request form