Histopathology

Introduction

The Anatomic Pathology Unit is located at the Ground Floor, Block D (Ext 7111).

Operating hours:

The Anatomic Pathology Laboratory is open:

• Monday - Friday : 0800 hrs - 1700 hrs

• Saturday/Sunday/Public holidays : Closed.

Services Provided:

1. Histopathological examination (HPE). Included within the service are tests such as histochemical, immunohistochemical, immunofluorescence studies, and in-situ-hybridization (ISH).

2. Intraoperative frozen section.

3. Autopsy specimen examination.

4. Trephine biopsy processing.

Request for test

1. Ensure that all specimens are accompanied with Pathology request form Per.Pat.301

2. Please consult the Anatomic pathologist-on-call for the following sub-speciality tests:

1. Muscle biopsies for evaluation for neuromuscular disorders.

2. Brain tissue resections for epilepsy.

3. Renal biopsies for assessment of transplanted kidneys.

4. Other uncommon requests.

Instruction on filling up form.

1. Please write patient biodata from item 1 to item 11 clearly and completely. Attention should be given to ensuring that the identity card number and patient registration number are correctly and clearly written. This is to assist in tracking of results from the computer by ward staff or doctor at a later date.

2. Please state previous report number in item 12 if relevant.

3. Specify exact site of biopsy and relevant clinical details, including intraoperative findings, radiological findings and drug history.

4. If the report is needed urgently, please write / stamp URGENT clearly at the top right corner of the request form.

5. The form must be signed and stamped with the requesting doctor's name and designation. 

6. It is strongly recommended for the requesting doctor's telephone number to be provided for ease of future communication.

Instruction of sending specimen

1. Please wash the bloody specimens under running tap water before placing into 10% formalin solution.

2. The specimen should be placed into a container, or multiple layered sealable plastic bags containing a sufficient volume of 10% neutral buffered formalin solution.

3. The volume of formalin used must be at least 10 times the volume of specimen to be fixed.

4. Do not place large specimens in small containers as this would prevent proper fixation of the tissue and may distort the specimen.

5. All specimen containers are to be labelled clearly with patient’s name, age, Identification number, type of specimen and date of collection.

6. The patient identifiers on the specimen containers and the request form should be identical and clearly written. 

7. Where possible, specimens from different anatomical sites should be sent in separate containers, properly labelled, and must be clearly itemized in the request form.

8. Label or tag the surgical margins and/or areas of interest on a specimen with an appropriate marker (suture, beads, clips etc.) and elaborate the significance of the marker in the request form (preferably with labelled diagrams).

9. Please label or tag surgical margins of mastectomy specimen, skin biopsy, colonic specimen, thyroid specimen and TAHBSO specimen accordingly (preferably with labeled diagrams).

10. Kindly take care not to soil the request form with formalin / tissue fluid / blood.

11. Kindly cut open colectomy specimens along the antimesenteric border and rinse the content.

12. Specimens for Immunofluorescence study should be sent in a clean container containing phosphate buffered saline (PBS) for skin and renal biopsy. 

13. Important! Specimens should be collected and transported properly. Deviations from best practices can result in pre-analytical errors with the specimens not being suitable for testing or producing results that are confusing or of poor quality. Specimens should be sent to the laboratory as soon as possible after collection. 

Histopathology report

1. Turn-around time for HPE samples is 14 calendar days (at least 70% of specimens).

2. Turn-around time for bone specimen depends on the size of specimen for de-calcification.

3. Verbal report via telephone is not allowed except rendered by Histopathologist.

4. All reports will be available on-line.

Frozen Sections 

1. Frozen Sections must be pre-booked with the Histology Laboratory at least 24-hour before the procedure. The application and relevance of frozen sections must be discussed with a Histopathologist and must be booked in advance. Failure to discuss the case or to book in advance may lead to delays and inaccuracies in the reporting of a frozen section.

2. Frozen sections should be received by the lab before 4pm. Specimens after 4pm will be processed as paraffin section/conventional HPE.

3. Contact the On-call Pathologist directly for the request and fill in the Frozen Section form provided.

4. Frozen Sections will not be processed on patients with TB, Hepatitis B, C or HIV. If a suspicion of such infection exists, clinical staff must inform the laboratory.

5. Samples must be sent in a dry container with no fixative, via porter to the laboratory. 

6. The normal turnaround time for frozen sections is 20-30 minutes after arrival in the laboratory however if multiple specimens are received the turnaround time will be exceeded. 

7. Please write contact number for phoned report.

8. Frozen Section reports will be phoned by the reporting Pathologist to either the Consultant Surgeon or staff at the given contact phone number. 

9. When phoning the report the Pathologist will state the Name and HPE Number of the Patient and the Type and Location of the biopsy and will note the identification of the person receiving the report before dictating the report. 

10. It is important to cancel a frozen section if it is no longer required as Laboratory Staff will be on hold awaiting its arrival.