ONCOLOGY TESTING

Every specimen submitted to Histopathology must be labeled with the paraffin block number corresponding to the information on the Test Request Form.

PARAFFIN EMBEDDED TISSUES

Submit formalin fixed, paraffin embedded tumor tissue, an H&E slide which corresponds to the tumor block submitted, and a copy of the pathology report. Complete a separate Test Request Form for each specimen being submitted, noting the fixative used in preparing the specimen (fixatives other than formalin may result in inaccurate test results.) Decalcified specimens are not recommended. When requesting a flow cytometry DNA histogram, select a block with a minimum of 20% malignant cells. All tumor blocks will be returned to the client after test completion. For submission of slides in lieu of paraffin blocks, see slide preparation requirements. Formalin-fixed paraffin-embedded tissue may be stored at room temperature indefinitely.

PARAFFIN BLOCK PREPARATION

Trim tissue free of fat and necrotic tissue. Immediately place tissue pieces no larger than 20 x 20 x 3 mm in a cassette in 10 % neutral buffered formalin. Fix for a minimum of 4 hours (maximum 24 hours). For HER2 testing on breast tissue fix for a minimum of 6 hours (maximum 48 hours). Embed the fixed tissue in paraffin, ensuring the temperature does not exceed 60°C.

SLIDE PREPARATION

For immunohistochemistry assays (IHC) submit 10 slides (minimum 5 slides; with one 4-5 micron thick section on each slide. Ship all slides at ambient temperature. Charged (plus) slides must be used.

BONE MARROW, PERIPHERAL BLOOD, LYMPH NODES, AND BODY FLUIDS FOR LEUKEMIA/LUMPHOMA EVALUATION BY FLOW CYTOMETRY

Please provide a brief clinical summary to accompany these specimens. The summary should include previous diagnoses, CBC results, and other appropriate information.

PROCEDURE FOR COLLECTING AND SHIPPING PERIPHERAL BLOOD AND BONE MARROW FOR LEUKEMIA/LYMPHOMA EVALUATION BY FLOW CYTOMETRY

Peripheral Blood: Submit 5 mL of whole blood in sodium heparin (green top tube). The sample should be stored and shipped at room temperature. DO NOT FREEZE, REFRIGERATE, OR ADD FIXATIVES.
Bone Marrow: Submit 2 mL of bone marrow in sodium heparin (green top tube). The sample should be stored and shipped at room temperature. DO NOT FREEZE, REFRIGERATE, OR ADD FIXATIVES.

PROCEDURE FOR COLLECTING AND SHIPPING TISSUE (OTHER THAN BLOOD AND BONE MARROW) FOR FLOW CYTOMETRIC PHENOTYPING STUDIES

Surgically removed lymphatic tissue, bone marrow biopsy, or other tissue that is suspected to have a hematologic malignancy should be placed in a sterile. leak-proof transport container which contains a small amount of sterile RPMI-1640 tissue culture medium sufficient to cover the tissue. This medium is commercially available from a number of sources, including Sigma Chemical Company, Irvine Scientific Company, and Gibco. This medium should be clear pink or magenta. If the RPMI-1640 turns yellow or cloudy, it should be discarded. DO NOT FREEZE the tissue, fix the tissue, or allow the tissue to dry out at any time. Alternatively, wrap the tissue in a saline-soaked gauze and place in a sterile container. It should be noted that this alternative procedure for shipping tissue may result in decreased viability, especially in high grade lymphomas. The size of the tissue sample required for an adequate cell yield depends on a variety of factors. In general, a sample of at least 3 millimeters in diameter is needed (small peasized is preferred). In some cases, an adequate cell yield can be obtained from even smaller samples or even needle aspirates. The sample should be stored and shipped at 4°C or at room temperature.

PROCEDURE FOR COLLECTING AND SHIPPING BODY FLUIDS (CEREBROSPINAL FLUID, PLEURAL FLUIDS, ETC) FOR FLOW CYTOMETRIC PHENOTYPING STUDIES

Body fluids should be collected and shipped in a sterile, screw cap container. The volume of fluid necessary depends on the cell count. Usually 20 mL of pleural or peritoneal fluid is sufficient. If the body fluids, other than spinal fluid, are bloody, place the fluid in a sodium heparin (green-top) tube. The sample should be stored and shipped at room temperature or 4°C DO NOT FREEZE. Cerebrospinal fluids usually yield too few cells for analysis and are generally not recommended unless there is clear evidence of a high cell count (>100 cells/mL).

BONE MARROW BIOPSIES

Please submit the core biopsy and at least 5 unstained aspirate smears, along with a brief summary of the clinical findings and differential diagnosis. The specimen should also include a peripheral blood smear and the results of the most recent complete blood count and white blood cell differential. If the patient has a previous BM Biopsy evaluated at Quest Diagnostics or any other institution, include a diagnostic smear, core biopsy and the corresponding report.

PROCEDURE FOR COLLECTING AND SHIPPING SAMPLES FOR PLASMA-BASED MOLECULAR ASSAYS

Whole blood is preferred. To avoid contamination, the laboratory will separate the plasma upon arrival. Follow standard whole blood collection procedure. Collect 5-6 mL whole blood in an EDTA tube. Ship at room temperature or 4°C. Do not freeze. Record the draw time an date on the tube and ship immediately to maintain sample stability.

Shipping temperature: Whole blood
Room temp. acceptable, stable 72 hours
Refrigerated preferred, stable 72 hours
Frozen unacceptable