Anatomic Pathology

SPECIMEN SUBMISSION FOR GROSS AND MICROSCOPIC EXAMINATION TO THE PATHOLOGY DEPARTMENT

Purpose:

All surgical and procedural specimens removed from Children’s patients (both inpatients and outpatients) must have a pathologic examination in compliance with Children’s Hospitals and Clinics of Minnesota Policies and applicable regulatory requirements. The Department of Pathology in consultation with the professional leadership has approved the following categories for tissue submission.

Excluded From Required Pathology Examination:

• Teeth without soft tissue
• Extra ocular muscles
• PE tubes
• Foreskins (for routine circumcision and hypospadias)
• Orthopedic hardware
• Scars (except as part of tumor resection)
• Devices (i.e. Portacaths, Hickman catheters, ventriculoperitoneal shunts, ureteral stents, etc.) previously placed by surgeons and removed in the perioperative areas are not required to be submitted to the Pathology Laboratory but may be sent at the discretion of the surgeon, unless the device is malfunctioning or otherwise unsafe, or the procedure has resulted in an unanticipated patient outcome (as included in the “Safe Medical Devise Act.”)
• Ingrown toenails
• Foreign bodies are excluded from required pathology examination, unless: a foreign body that has been implanted has a permanent alteration in appearance or function; or is removed unexpectedly or prematurely. (Policy # 900.00 Organizational Policies and Procedures Manual).
• All tissues, devices or foreign bodies are not sent to pathology per this protocol must be appropriately documented by designated personnel.

Tissue Which Must Be Submitted For Gross Examination, Microscopic Examination Optional:

• Extra digits
• Skull flaps (i.e.surgery for craniosynostosis)
• Tonsils and/or adenoids (may be submitted in single container unless microscopic exam requested. If microscopic requested identify “right” and “left”. Tonsils and/or adenoids which meet the following criteria will receive a microscopic examination:

§ Tonsillar asymmetry (size difference of greater than 1 cm between the two tonsils).

§ If tonsils are removed for concurrent acute infection (such as peritonsillar abscess).

§ If the patient has been previously diagnosed with a malignancy, and/or is immunosuppressed.

§ A mass, or area of purulence/necrosis of otherwise unusual appearance observed during grossing.

§ An area of purulence/necrosis observed during grossing.

§ History of organ transplantation.

§ If patient is 12 years of age or older.

§ If only one tonsil is removed.

§ Physician request/order.

Tissue For Both Gross And Microscopic Examination:

• All tissues with the exception of those listed above. Any specimen sent for gross examination only may have a microscopic examination additionally at either the surgeon or pathologist’s request.