These guidelines are provided to ensure both the health and safety of submitting veterinary staff, couriers/postal staff, and those in the laboratory. Following these guidelines will also ensure our laboratory technical team and pathologists have the required information to provide you with as useful a histopathology report as quickly and effectively as possible.

Please do not hesitate to contact the histopathology team with any questions at any time via the [email protected] email address, or by telephone (0808 258 3536).

Pathologists can also be contacted directly by email, with individual email addresses available alongside the pathologist signature on your histopathology reports and in the laboratory brochure.

TURNAROUND TIMES

The vast majority of histopathology reports will be issued within 1-3 working days following receipt of a sample in the laboratory. If samples require additional processing or staining an interim report should be released in this time.

If samples require additional fixation or decalcification this may prolong the reporting time. We will endeavour to notify you if this is the case following receipt of the sample.

SAMPLE LABELLING

All sample pots should be clearly labelled and correspond with information provided on the submission form.
Lesions from separate sites or with clinically distinguishable features should be submitted in separate and individually identified pots.

Minimum details on the sample pot should include the following:

• Patients name and surname and/or a patient identification number
• Date
• The site/source of the sample

COMPLETION OF THE SUBMISSION FORM

A complete and thorough submission form will aid more appropriate interpretation of the sample by our pathologists, enabling us to provide the most relevant and useful information.

Submission forms for histopathology samples can be downloaded at: https://antechdiagnostics.co.uk/resources-and-forms/

The submission form should include the following clinical details where relevant:

• Macroscopic description of the lesion, including duration, progression, distribution
• Any previous relevant pathology results, eg. prior cytological diagnosis/ previous histopathology report
• Any response to treatment
• Appropriate adjunctive findings, eg. imaging characteristics- particularly for bony or oral lesions.
• Any particular clinical questions can be included, or suspected differential diagnoses listed
• If clinical photographs are available, these can be emailed to [email protected], please indicate this on the submission form

TISSUE MARGIN ASSESSMENT

• Tissue margin assessment will be provided when appropriate and does not incur an additional fee.
• Please indicate the nature of the sample submitted (eg. incisional/excisional) to help determine when evaluation of tissue margins is required.
• Tissue ink can be ideally applied to a specimen on the surgical margins prior to fixation. To do this effectively blot the tissue dry, apply ink and blot the tissue again prior to placing in formalin. If possible, please avoid blue and red ink.
• If there are particular areas of concern regarding a tissue margin, these can be indicated by either placement of a suture or application of tissue ink and annotation on the submission form. This will ensure assessment of the tissue in this region.
• Orientation of the tissue can be indicated prior to submission, either by suture application or tissue ink. Please identify two directions on the tissue, eg. cranial and dorsal.
• Please do not incise the tissue through a surgical cut margin to allow for accurate evaluation.

SAMPLE POTS AND FIXATION GUIDELINES

Samples for histopathological evaluation should be placed in 10% neutral buffered formalin as soon as possible after collection in a receptacle appropriate for this purpose and lids securely closed.

The sample pot should be approved for the use of formalin, shatterproof and of adequate size to allow for the appropriate volumes of formalin and tissue. Tissue should be ideally free floating/moveable in the pot.

• Do not use narrow necked pots as tissue may not be easily removed following fixation.
• Please do not use pots with lockable lids (e.g. sharps containers) as it may not be possible to safely remove the sample following receipt in the laboratory.
• Lids should be completely sealed and leakproof to prevent spillage of formalin.

The laboratory can provide 60ml or 120ml containers prefilled with formalin, or can provide larger 1L, 2.5L or 15L containers unfilled. These can be requested via our Customer Service team or your Antech Online account.

Tissue samples in formalin should NOT be refrigerated.

Please note that samples submitted in inappropriate containers or packaging will not be collected by our courier staff due to risks of formalin leakage.

SMALL OR FRAGILE SAMPLES

• Small samples, such as tru-cut biopsies, bone marrow cores or endoscopic biopsies, can be submitted in microcassettes, or cassettes and sponges, to prevent disintegration and loss of the sample(s) during transportation. Please contact the customer service team if you would like these provided.

STANDARD AND LARGE SAMPLES

• Ideally the entire intact lesion, with any adjacent normal tissue, should be submitted for evaluation.
• Larger samples can be partially incised (bread loafing technique), at 1cm intervals, prior to submission, to aid formalin penetration. Ideally ensure the tissue remains in one piece to allow orientation. Avoid incising through surgical margins and instead slice through a serosal or epidermal/skin surface. Photographs can also be taken prior to fixation.
• Hollow or tubular organs should be partially opened to allow for optimum formalin penetration.
• If a limb is submitted this can be disarticulated at a joint, ideally distal to the lesion. Any relevant lymph nodes, eg.popliteal, should be dissected from the specimen and submitted in a separately labelled container.

SAMPLE PACKAGING AND TRANSPORTATION

Diagnostic histopathology samples are typically categorised as Biological Substances, Category B or Exempt Biological Samples.
It is advised that samples sent via Royal Mail are submitted in outer packaging labelled with UN3373, as indicated on our self addressed postage bags and postage labels.

For biological samples being sent via Royal mail or by air travel packaging should comply with IATA P650 packaging instructions.
Samples should be placed in a primary container (eg.sample pot) with 10% neutral buffered formalin. This should be placed alongside suitable absorbent material in a sealable and leakproof secondary packaging such as a sealable biohazard bag. The secondary packaging should be placed, alongside the submission form, in rigid outer packaging such as a cardboard box. Multiple samples can be placed in the same outer packaging if desirable. Delivery address and appropriate labels should be applied to the outer packaging.

TRANSPORTATION OF LARGE SAMPLES (VIA COURIER)

If you have any queries at the time of submitting a large sample please do not hesitate to contact our customer service team who can put you in touch with a pathologist.

The following should apply for any histology sample that will not fit safely into a 60ml or 120ml container pre-filled with formalin.

• The tissue sample, intact, should be wrapped in 1-2 layers of gauze swabs. Free formalin in the container is not required. The area of interest can be incised using the breadslicing technique prior to adding swabs to aid fixation.
• The sample should be placed into a larger, empty, sealable container or sealable waterproof bag and the gauze swabs then moistened with a small amount of formalin.
• Lids should be sealed securely or bags should be double bagged, inserting absorbent material between each bag and the next (eg. inco sheet, paper towel).

If a sample is submitted without prior fixation or with minimal formalin please clearly label the submission form as such to ensure that this can be further fixed in the laboratory without delay.

Large samples can also be pre-fixed for 24 hours in the practice before submitting and packaging as above.