PROTOCOL FOR BIOPSY TAKING, FIXATION AND SHIPPING
.1. When a doctor has decided to take a sample of blood or tissue for examination by the laboratory, the laboratory request form represents the only link between the patient and the laboratory, so it should supply all required documentation about the patient.in order to make the consultation successful. Therefore clinician needs to take a minute or two to carefully write the patient particulars, a summary of clinical complaints and physical findings, key investigation results like X-rays, CT or MRI, the clinical diagnosis and what investigation is being ordered by writing on the request form in a legible manner.
An example of an appropriate laboratory investigation form is attached. You may adopt this one or make one with similar features.
2. During removal of the sample from the patient, tissue degradation by autolytic enzymes starts immediately the blood supply is severed. Therefore, prompt fixation is imperative. Take the sample for examination with normal tissue margins on all sides, taking care not to pull, crush, clamp, fragment or tear the tissue as this distorts the microanatomy on which microscopic diagnosis depends.
3. Choose an appropriate container with a wide mouth and place an adequate amount of formalin fixative constituted in following proportion: 100 mls of stock formaldehyde (usually 37 to 40%) added to 900 mls distilled water and 9g sodium chloride. This is called 10% Formal Saline fixative. The volume of the fixative in any one tissue should be about 10 times the volume of the tissue. So use adequate amounts of fixative. Place the tissue in the container with fixative.
4. The specimen and fixative should be securely closed then plastered over on the lid by plaster to prevent spillage of fixative during transportation. A wide mouth of the container ensures the specimen can be taken out easily after fixation because it becomes stiff after fixation.
5. For a large specimen such as a uterus, mastectomy etc, the clinician should make an incision down to the endometrial cavity or to the center of a pathological lesion before immersion in the fixative to allow proper fixation in the middle of the sample.
6. We shall send to you the results within 7 Working days by e mail or you can download the results from our website which is now under construction.
7. We shall keep all fixed organs for 3 months after a diagnosis has been made after which it may be sent for incineration. However, all microscopic slides and tissue blocks will be kept in our archives. These will be available for further study such as research or review purposes. Electronic copies of all reports will also be kept indefinitely.