All routine biopsies are to be placed in neutral, buffered 10% formalin (NBF) solution in an approximate volume of 10 parts formalin to 1 part specimen. The container should be large enough to include the specimen and abundant formalin without over filling the container. Over filled containers constitute a safety hazard. An inadequate volume of formalin will adversely affect specimen processing. Formaldehyde warning labels must be affixed to any specimen container with formalin. This is an OSHA requirement.
For other than routine biopsies call histology laboratory 24 hours prior to beginning the procedure for specific instructions. Fresh biopsy specimens must arrive within 1 hour of collection. Biopsies for possible lymphoma lymph nodes, spleen, or any tissue suspected of being a lymphoma will be accepted. Place specimen on a sterile gauze pad moistened with sterile saline in a sterile container. A minimum of 2.0 g of fresh tissue is required. Do Not put In fixative. Maintain sterility and forward promptly.
Kidney Biopsies: See “Kidney Biopsy”
Liver Biopsies: Submit fresh tissue. Do Not put In fixative. Place specimen on a sterile gauze pad moistened with sterile saline in a sterile container. Maintain sterility and forward promptly.
Muscle Biopsies: See “Muscle Biopsy”
Biopsies with culture: Submit fresh, unfixed biopsy specimens for culture. Place specimen on a sterile, gauze pad moistened with sterile saline in a sterile container. Maintain sterility and forward promptly.
Frozen Sections: Notify the histology laboratory prior to collection that a frozen section is coming. If unusual or difficult problems are anticipated before the time of surgery, prior verbal communication with a pathologist can be extremely beneficial and is strongly encouraged. Submit fresh tissue. Do Not put in fixative. Place specimen on a sterile gauze pad moistened with sterile saline in a sterile container. Maintain sterility and forward promptly. Limitations: Bone or heavily calcified tissue and fixed tissues cannot be frozen. Tissues consisting mostly of fat are difficult or impossible to freeze. Small specimens (less than 0.5 mm) in which no sufficient tissue will remain for paraffin sections or small specimens in which preservation of structure and histologic detail are critical, are best examined on permanent section only. These include needle biopsies of tumor, brain biopsies, etc. Certain tissues demand cytologic as well as histologic evaluation for a proper diagnosis and are therefore best examined on permanent section only. These include lymph nodes when lymphoma is suspected, pigmented skin lesions, etc. Tissue is consumed and distorted in the freezing process. Therefore, when only a very limited specimen can be obtained the advisability of doing a frozen section while awaiting the permanent section must be discussed with the pathologist.
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