Tips for getting the most out of your histopathology submission

histopathology submission tips

 

Our veterinary pathologists aim to provide a timely report on biopsy and postmortem samples, and by integrating clinical information supplied by practitioners, can help to formulate a diagnosis and where appropriate, a prognosis. 

In order to help practitioners gain the most out of our histopathology service we have compiled the following list of tips that can increase the chances of obtaining a clinically useful histopathological diagnosis.

●  A good, but concise, clinical history (i.e. not a printout of the entire patient’s record) is essential and should include:

o  Species, breed, age, and sex (all these affect the types and likelihood of certain disease processes)

o  A description of the lesion, including size, site and numbers of samples submitted (these can help to formulate a diagnosis as some diseases are site specific, and this data is also checked against the samples received to ensure that the correct samples have been received)

o  Any relevant clinical pathology data

o  Any particular questions that the clinician would like addressed such as ruling in or out certain differential diagnoses, the appropriateness of margins (you can mark important margins with sutures or ink and describe these on the submission form), or the presence of infectious, including zoonotic, disease.

 

This is an extract from an article by Paul C. Stromberg DVM, PhD, Professor of Veterinary Pathology, Ohio State University, which says it all!

“…As incredible as it may seem, I frequently get surgical biopsies in which I am not even told the species or the location of the sample much less the other mentioned information.

Some clinicians mistakenly believe you should not “bias” pathologists by sharing information with them.

Nothing could be further from the truth.  I have often said that if the object of the autopsy/biopsy is to fool me, I will tell you right now, “You can fool me”.  Easily!

If, on the other hand, the object is to acquire a rapid, accurate, specific diagnosis, share what you have observed and what you think with the pathologist." 

 

●  Suitable samples should be representative, well fixed and minimally affected by collection or packaging

o  Samples generally require to be fixed in 10x their volume of formalin, so larger samples may need pre- fixing before posting, or representative samples of larger tissues may need to be taken, in which case a photograph (hard copy or by e mail) and/or diagram of the whole lesion or organ is invaluable. Complex samples may require discussion with a pathologist before sending and we are always more than happy to advise.

o  Avoid using non-standard containers such as pill pots, bottles or jars- whilst samples are soft when put in the container they can be difficult to get out through a narrower neck once fixed (and therefore firm) and can be damaged.  Additionally, leakage of formalin is more likely.

o  Where multiple samples from the same case are sent, and cannot be clearly differentiated by, for example, size or sutures, please put in separate, labelled containers.

Communication with the pathologists is crucial if you are to get the most from the service.  We have a range of frequently asked questions on the website here, but we are more than happy to provide telephone advice; please call the Diagnostic Pathology office on 0117 394 0510, where our reception may be able to help you or will direct you to someone who can!