Specimen Handling

Specimen handling depends on the type of testing and specimen. Please refer to the links below for more detailed information.

Each specimen must be accompanied by a completed requisition that provides:

  • Patient’s name, date of birth, gender, address, and insurance information
  • Specimen type, time/date of specimen collection, and test desired
  • Clinical indications, history, and therapy
  • Referring physician’s name (not resident’s), phone/fax/pager numbers, and address

Improper specimen collection and an incomplete requisition form could cause delays in processing or unsuccessful analyses

Specimen Collection Instructions

Specific collection instructions are provided to clients, either on the requisition form or as separate collection instructions.

Anatomic pathology & stains

Subspecialty consults

Specimen types accepted include formalin-fixed and paraffin embedded tissue and/or unstained slides (5 micron thick sections). For Ventana IHC, sections should be on Plus(+) charged slides.

Primary diagnosis (renal pathology & dermatopathology)

Renal pathology

Specimen types accepted include native and transplant kidney biopsies. Please refer to the collection instructions below for more detailed information.

standard instructionssimplified instructions

Dermatopathology

Please visit the Dermatopathology website for more information.

Electron microscopy

Tissue should be excised in 1mm x 1mm or less dimension and fixed in modified Karnovsky’s fixative in a 30:1 fixative to tissue ratio.

Histology and immunohistochemistry

Specimen types accepted include formalin-fixed and paraffin embedded tissue and/or unstained slides (5 micron thick sections). For Ventana IHC, sections should be on Plus(+) charged slides.

Cytogenetics

Prenatal

Amniotic Fluid (Amniocentesis)

Notes Note the gestational age in weeks; Uniquely identify twins.
Collection Discard first 2mL of amniotic fluid. Collect 15-25mL in a sterile syringe.
Processing Use sterile technique to transfer to 15mL sterile screw-top plastic conical tubes for transport. Do not centrifuge.
Shipping Maintain at room temperature or refrigerate if sample cannot be delivered within 24 hours. Specimen must be received within three days of collection. Send to North Campus Lab or SLCH Central Receiving for delivery to Lab ASAP.

Chorionic Villi Sampling (CVS)

Notes Note the gestational age in weeks; Uniquely identify twins.
Collection Collect 15-40mg of budding villi in 50mL screw-top plastic conical tubes in sterile transport media (provided by cytogenetics lab)
Processing Do not centrifuge.
Shipping Maintain at room temperature or refrigerate if sample cannot be delivered within 24 hours. Specimen must be received within three days of collection. Send to North Campus Lab or SLCH Central Receiving for delivery to Lab ASAP.

Percutaneous Umbilical Blood Sampling (PUBS)

Notes Cordocentesis; periumbilical blood sampling; or fetal blood.
Collection Collect 1-3mL in sterile, 15mL sodium heparin (green-top) Vacutainer tube. Collect under ultrasound guidance.
Processing Invert tube immediately upon completion of blood collection to prevent formation of clots.
Shipping Maintain at room temperature. Send to North Campus Lab or SLCH Central Receiving for delivery to Lab ASAP.

Products of Conception (POC)

NOTE: Prefer dual specimens (villi and fetal tissues); must specify type of specimen submitted.

Skin

Notes Uniquely identify twins
Collection Collect 3-4mm² skin biopsy (about the size of a pencil eraser) and place in 50ml tube with transport media (provided by the cytogenetics lab).
Shipping Maintain at room temperature or refrigerate if sample cannot be delivered within 24 hours. Specimen must be received within three days of collection. Send to North Campus Lab or SLCH Central Receiving for delivery to Lab ASAP.

Villi

Notes Villi are specimen of choice, but amniotic fluid is acceptable; Uniquely identify twins.
Collection Collect 1 cm² placenta by sterile procedure, and place in 50ml tube with transport media (provided by the cytogenetics lab).
Shipping Maintain at room temperature or refrigerate if sample cannot be delivered within 24 hours. Specimen must be received within three days of collection. Send to North Campus Lab or SLCH Central Receiving for delivery to Lab ASAP.

Constitutional

Peripheral Blood

Notes For CMA studies both sodium heparin (green-top) AND EDTA (purple-top) tubes are required.
Collection Infants, 1-2mL; Children, 3-5mL; Adults, 5-10mL; Collected into a sterile sodium heparin (green-top) Vacutainer tube.
Processing Invert tube immediately upon completion of blood collection to prevent formation of clots.
Shipping Maintain at room temperature or refrigerate if sample cannot be delivered within 24 hours. Samples should be no more than 48 hours old. Send to North Campus Lab or SLCH Central Receiving for delivery to Lab ASAP.

Skin

Collection Collect 3-4mm² skin biopsy (about the size of a pencil eraser) and place in 50ml tube with transport media (provided by the cytogenetics lab).
Shipping Maintain at room temperature or refrigerate if sample cannot be delivered within 24 hours. Send to North Campus Lab or SLCH Central Receiving for delivery to Lab ASAP.

Cancer

Hematologic Specimens

Notes Spicule-rich bone marrow aspirate; peripheral blood; bone core biopsy; lymph node; or effusion. (Bone marrow is specimen of choice for leukemia. Peripheral blood could be the choice for CLL).
Collection Collect 1-2 mL bone marrow; 5-10 mL blood; 0.5-1 cm2 biopsy (bone core; lymph node). Collect bone marrow or blood in a sodium heparin (green-top) Vacutainer.
Processing Invert tube immediately upon completion of blood collection to prevent formation of clots. For bone marrow it is important that a first draw, spicule-rich sample be collected.
Shipping Maintain at room temperature or refrigerate overnight if necessary. Send to North Campus Lab or SLCH Central Receiving for delivery to Lab ASAP.

Solid Tumor, Neoplastic Tissue

Notes Inform the lab prior to surgery or needle aspiration to facilitate optimal specimen collections and culture set up.
Collection Collect 3-4 mmbiopsy (about the size of a pencil eraser) in a sterile, screw-top container filled with transport media (provided by cytogenetics lab).
Processing Ensure the container is tightly sealed to prevent leakage.
Shipping Maintain at room temperature or refrigerate if sample cannot be delivered within 24 hours. Send to North Campus Lab or SLCH Central Receiving for delivery to Lab ASAP.

Paraffin Embedded Tissue (for FFPE FISH)

Notes Solid tumors, biopsies, etc.
Collection Tissue fixed in 10% neutral buffered formalin. Preferred fixation duration of 6-48 hours
Processing Place pieces of 4-5 micron thick fixed tissue sections on positively charged slides. Deliver 4 unstained slides per test ordered plus 1 H&E slide marked with region(s) of interest per case/biopsy.
Shipping Maintain at room temperature. Send directly to lab or to BJC IOH Histology laboratory.

Next-generation sequencing

Cancer

Specimen types accepted include excisional biopsies, core needle biopsies, cell blocks, leukemic blood or bone marrow aspirate.

Acceptable materials for submission include tumor-containing formalin fixed paraffin embedded (FFPE) blocks, unstained slides from tumor-containing FFPE block, or blood/bone marrow in a lavender-top EDTA tube.

Tissue fixation protocols must be compatible with molecular testing; EDTA decalcification is acceptable, acid decalcification is not.

Somatic overgrowth

**Primary specimen type required: tissue from the affected area.  Please call the laboratory for further information. In addition, 2-5 mL of peripheral blood in a lavender-top EDTA tube is requested to allow for comparative study.

Acceptable materials for submission include disease involved tissue in the form of a formalin fixed paraffin embedded (FFPE) tissue block, fresh tissue in transport or tissue culture media or buccal swab.

Tissue fixation protocols must be compatible with molecular testing; EDTA decalcification is acceptable, acid decalcification is not.

Constitutional disease

Specimen types accepted include 2-5 mL peripheral blood in a lavender-top EDTA tube.