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HelpTest Code LAB6000 Tissue Exam
Test Overview
Useful For:
Histopathologic evaluation of tissue specimens obtained during biopsy, surgical procedures, excisions, resections, curettage, amputations, and other clinical procedures.
Diagnosis of benign and malignant disease.
Assessment of tumor type, grade, margin status, pathologic stage, treatment effect, and other clinically significant pathologic findings when applicable.
Evaluation of tissue requiring ancillary studies such as special stains, immunohistochemistry, molecular testing, or other pathologist-directed testing when indicated.
Test Descrption:
A tissue examination is the pathologic evaluation of tissue removed during a biopsy, surgical procedure, excision, resection, curettage, amputation, or other clinical procedure.
Depending on the specimen type and clinical indication, evaluation may include gross examination, microscopic examination of routinely stained tissue sections, and ancillary studies selected by the pathologist. The final pathology report may include a diagnosis, tumor classification or grade, margin status, pathologic stage, treatment effect, and other clinically relevant findings when applicable.
Performing Laboratory
Asante Rogue Reginal Medial Center (ARRMC)
Performing Department
Asante Anatomic Pathology
Specimen Collection
Specimen Type:
Tissue obtained by biopsy, excision, resection, curettage, amputation, or other surgical/procedural methods for routine or intraoperative pathologic examination.
Acceptable Container
Routine Tissue
Leak-resistant surgical pathology container containing 10% neutral buffered formalin
Container should be large enough to allow complete immersion of the specimen in fixative.
Fresh Tissue (when specifically requested)
Sterile, leak-resistant container without fixative
Laboratory-approved transport media when directed by Pathology
Special Collection Notes
Place routine tissue into 10% neutral buffered formalin as soon as possible after collection.
Use sufficient formalin to completely surround the specimen (approximately a 10:1 fixative-to-tissue volume ratio when feasible).
Prevent tissue from drying out prior to fixation.
Label each specimen container with two patient identifiers and the exact specimen source.
Submit each separately identified specimen in its own labeled container.
Include laterality, orientation, and margin designation when applicable.
Verify that very small tissue fragments have been placed into the specimen container before submission.
Do NOT place the specimen in formalin if any of the following may be required:
Frozen section
Flow cytometry
Lymphoma workup
Microbiology culture
Renal biopsy studies
Direct immunofluorescence
Electron microscopy
Cytogenetic or molecular studies requiring viable tissue
Contact Pathology before collection whenever fresh tissue or specialized testing may be required.
Frozen Section
Collection Requirements
Notify Pathology before or during the procedure.
Submit tissue fresh in a clean specimen container without fixative.
Do not place tissue in formalin.
Do not freeze tissue prior to submission.
Transport immediately to Pathology.
Clearly identify specimen source and the clinical question to be answered.
Specimen Volume
Entire specimen should be sent to pathology
Transport & Stability
Temperature Requirements:
Routine Formalin-Fixed Tissue
Transport:
Room temperature
Place tissue into 10% neutral buffered formalin as soon as possible after collection.
Cold ischemia time should be minimized and generally should not exceed 1 hour when clinically applicable.
Formalin-fixed specimens may be refrigerated if immediate transport is not possible.
Do not freeze.
Fresh Tissue / Frozen Section
Transport: Immediate delivery to Pathology.
Do not place tissue in formalin unless directed by Pathology.
Do not refrigerate or freeze unless specifically instructed by Pathology.
Notify Pathology prior to collection whenever possible for fresh tissue or specialized studies.
Routine: 2–7 calendar days (most routine cases are completed within 2–4 business days)
STAT/Urgent: Same day or within 24 hours for frozen section/intraoperative consultation only. Routine surgical pathology cases are not performed as STAT unless approved by the pathologist.
Day(s) Performed
Monday–Friday (excluding holidays); frozen section/intraoperative consultation available as scheduled by Pathology.
Test Components
Methodology: Gross examination, tissue processing, paraffin embedding, microtomy, hematoxylin and eosin (H&E) staining, light microscopic examination by a board-certified pathologist. Additional studies (e.g., special stains, immunohistochemistry, molecular testing) may be performed when medically indicated and at the pathologist's discretion.
Reflex Tests : Additional studies may be performed as medically necessary based on the pathologist's evaluation. These may include special stains, immunohistochemistry (IHC), immunofluorescence, molecular testing, cytogenetic/FISH studies, or referral consultation, as appropriate.
Testing Algorithm: Tissue specimen received → Gross examination → Tissue processing and embedding → Microtomy → H&E staining → Microscopic examination by pathologist → Additional ancillary studies performed if indicated → Final pathology report issued.
Rejection Criteria
Specimens may be rejected, delayed, or require clarification/correction prior to processing for the following reasons:
Patient Identification / Labeling
Lacking two patient identifiers:
Patient first and last name
Patient date of birth
(or approved alternate second identifier such as medical record number)
Specimen container identifiers do not match the accompanying requisition/order
Unlabeled specimen container
Mislabeled specimen container
Missing or unclear specimen source/site designation
Specimen Integrity / Submission Requirements
Specimen received leaking or in a compromised container
Specimen submitted in an inappropriate fixative or transport medium
Specimen received without required preservation when special handling was indicated (e.g., fresh tissue required for flow cytometry, microbiology, cytogenetics, renal biopsy studies, etc.)
Specimen submitted in formalin when fresh tissue evaluation or specialized testing was required
Specimen received dried, desiccated, or otherwise compromised and unsuitable for evaluation
Tissue container damaged or unable to maintain specimen integrity
Clinical Information / Documentation
Missing required clinical information needed for appropriate specimen processing or interpretation
Missing laterality, specimen orientation, or site information when clinically significant
Missing physician/provider authorization or required documentation
Special Handling Requirements
Specimens requiring immediate processing or special transport conditions received after stability requirements have been exceeded
Specimens intended for microbiology, flow cytometry, molecular testing, renal biopsy evaluation, or other ancillary studies that cannot be performed due to improper collection or handling
Note:
When possible, Pathology will contact the submitting department/provider to resolve specimen identification, labeling, or handling concerns prior to rejection. Final determination regarding specimen acceptability is made by Anatomic Pathology personnel.
Interpretation
Final interpretation is provided by a board-certified pathologist and is based on gross examination, microscopic evaluation, and additional studies when clinically indicated.
The final pathology report may include:
Histologic diagnosis
Benign or malignant classification when applicable
Tumor type, grade, and staging elements when applicable
Margin status when applicable
Lymph node evaluation when applicable
Presence or absence of specific pathologic features relevant to diagnosis and treatment
Results of ancillary studies, including immunohistochemistry, special stains, molecular testing, or other studies when performed
Results should be interpreted in conjunction with clinical history, imaging findings, laboratory data, and other relevant clinical information.
Clinical Information
Provide relevant clinical information to support accurate specimen evaluation and interpretation. Include, when applicable:
Pertinent clinical history and diagnosis
Reason for procedure or biopsy
Specimen source/site and specific anatomic location
Laterality (right/left) when applicable
Prior history of malignancy or relevant pathology findings
Imaging findings or clinical impressions when relevant
Operative findings when applicable
Lesion location, size, or characteristics when clinically significant
Relevant treatment history (e.g., chemotherapy, radiation, prior excision)
Special testing requests or clinical concern for ancillary studies
For specimens requiring special handling (e.g., frozen section, lymphoma workup/flow cytometry, renal biopsy, molecular testing, or other specialized studies), include the specific clinical question and notify Pathology prior to collection whenever possible.
Forms
Required:
Surgical Pathology Requisition / Electronic Pathology Order
Required information includes:
Two patient identifiers
Specimen source/site designation
Procedure type
Pertinent clinical history
Ordering provider information
Collection date/time when applicable
Special handling requirements or testing requests
Additional forms may be required for specialized specimens:
Frozen Section / Intraoperative Consultation request (when applicable)
Renal Biopsy submission documentation (when applicable)
Muscle Biopsy submission documentation (when applicable)
Flow Cytometry request documentation (when applicable)
Cytogenetics/Molecular testing requisition (when applicable)
Other specialized testing forms as directed by Pathology