Ordering Guidance

If requesting a peripheral blood smear evaluation only, order SPSM / Morphology Evaluation (Special Smear), Blood.

Shipping Instructions

Attach the green "Attention Pathology" address label (T498) in the kit to the outside of the transport container.

Necessary Information

1. The referring pathologist's name and phone number are required.

2. A preliminary pathology report and brief history are required for all Pathology Consultations.

3. If a bone marrow specimen is sent, include results from recently performed complete blood cell count (CBC).

4. A brief explanatory note or consultative letter indicating specialty to review material is also recommended.

5. If pathology material is not in hand, a signed authorization from the patient to be able to request the pathology materials from the outside institution is necessary.

6. An EPIC order for “Pathology Review of Outside Material" submitted from the requesting Mayo provider.

Specimen Required

Specimen Type: Tissue

Supplies: Pathology Packaging Kit (T554)

Container/Tube: Pathology Packaging Kit

Collection Instructions: Submit hematoxylin and eosin (H and E) and all special stains performed on the case. Include unstained slides and/or a formalin-fixed, paraffin-embedded tissue block if it is anticipated that additional stains or ancillary testing may be necessary. Unstained slides for immunohistochemistry should be charged, if possible, as not all immunohistochemical stains can be performed on uncharged slides. If electron microscopy (EM) has been performed, include EM images (via Epic Care Everywhere, Mayo Clinic Image Share, or external storage device). If immunofluorescence (IF) has been performed, include IF slides or IF images on an external storage device.

Specimen Type: Lung biopsy

Supplies: Pathology Packaging Kit (T554)

Collection Instructions:

1. Submit lung tissue with 1 H and E-stained slide.

2. Place tissue in Zeus transport media.

Specimen Type: Enucleated eye

Supplies:

-Pathology Packaging Kit (T554)

-Formalin - 10% Histo Prep, 45 mL (T117)

Specimen Volume: Entire eye specimen

Collection Instructions:

1. Immediately after removal, place specimen in approximately 300 mL of 10% neutral buffered formalin and fix for 48 hours.

2. Enucleated eye should not be opened or punctured.

3. After the 48-hour fixation, the specimen should be transferred from the larger, 300 mL container to a smaller container with fixative (Formalin - 10% Histo Prep, 45 mL) for shipping.

Specimen Type: Iris, conjunctiva, cornea, and other small biopsies from eye

Supplies:

-Pathology Packaging Kit (T554)

-Formalin - 10% Histo Prep, 45 mL (T117)

Specimen Volume: Entire biopsy specimen

Collection Instructions:

1. Place iris, conjunctiva, cornea, and other small biopsies on a paper mount (a piece of filter paper or other porous paper). This helps to keep the specimen from curling when it is fixed.

2. Immediately, gently place paper-mounted specimen into 10% formalin (Formalin - 10% Histo Prep, 45 mL).

3. In cases where margins are important, placing sutures at the margins of resection with accompanying explanatory draft will help orientation of the specimen in the lab.

Specimen Type: Bone marrow aspirate

Slides:5

Preferred: Fresh prep slides made at the time of sample collection

Acceptable: Slides made from EDTA bone marrow specimen, within 2 hours of collection

Submission Container/Tube: Plastic slide holder.

Collection instructions:

1. Prepare slides of bone marrow aspirate.

2. If bone marrow units are sparse/absent or aspirate is a dry tap, make biopsy touch prep slides.

3. Air dry slides. Do not place on hot plate to dry.

4. Send slides unfixed/unstained or stained with Wright-Giemsa stain.

5. Place Parafilm around the slide carriers holding unstained slides to prevent exposure to formalin fumes during transport.

Specimen Type: Bone marrow aspirate (for possible ancillary testing)

Container/Tube: Lavender top (EDTA), yellow top (ACD), green top (heparin)

Specimen Volume:

EDTA or heparin: 3 mL

ACD: 4 mL

Collection instructions:

1. Aspirate per standard bone marrow collection procedure.

2. Send bone marrow specimen in original tube. Do not aliquot.

Specimen Type: Bone marrow core biopsy

Submission Container/Tube: Fixed biopsy core in formalin solution for transport or fixed biopsy core embedded in paraffin block

Collection instructions:

1. Process and embed core in paraffin if desired.

2. If processing at Mayo Clinic is desired, place biopsy core in 10% formalin immediately after collection.

3. Fix in 10% formalin for 1 to 2 hours.

4. Place Parafilm around the formalin container containing the bone marrow core biopsy to prevent exposure.

Specimen Type: Bone marrow aspirate clot

Submission Container/Tube: Bone marrow clot in 10% formalin or fixed clot embedded in paraffin block

Collection instructions:

1. Place 0.5 mL of bone marrow aspirate in clot tube.

2. After clot has formed, place clot in 10% formalin.

3. If embedding in paraffin, process and embed per your standard operating procedures.

4. If submitting to Mayo Clinic for possible processing and embedding, submit in container of 10% formalin.

5. Place Parafilm around the formalin container containing the bone marrow aspirate clot to prevent exposure.

Specimen Type: Blood

Slides: 2

Preferred: 2 Freshly prepared fingerstick slides

Acceptable: 2 Slides made from whole blood in EDTA, within 8 hours of collection

Submission Container/Tube: Plastic slide holder

Collection Instructions:

1. Prepare smears of even thickness.

2. Stain with Wright-Giemsa or submit unstained and unfixed slides.

3. Place Parafilm around the slide carriers holding unstained slides to prevent exposure to formalin fumes during transport.