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Test ID: ANPAT Anatomic Pathology Consultation, Wet Tissue


Advisory Information


For a pathology consultation on paraffin embedded tissue and slides only (ie, no wet tissue being sent to be processed), order PATHC / Pathology Consultation.



Additional Testing Requirements


Lung biopsy specimens: Immunofluorescence on lung tissue must be ordered in conjunction with this test.

 

Vitreous fluid/aqueous humor specimens: Call 800-533-1710 to request an Expedite on this order since vitreous fluid will have no fixative and needs to reach the laboratory ASAP.



Shipping Instructions


Vitreous fluid/aqueous humor specimens: ship overnight Attention: Ophthalmic Pathology Working Group.

 

Attach the green pathology address label to the outside of the transport container.



Necessary Information


1. Collection date and patient date of birth are required. All specimens must be labeled with specimen type.

2. Although a complete pathology report is not expected to be submitted with the specimen, a preliminary pathology report is required in order to ensure that the specimen is known to a referring pathologist. The name and phone number of the ordering pathologist and a brief history are essential to achieve a consultation fully relevant to the ordering physician's needs.

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

4. All specimens, patient history, and requests should be clearly labeled with correct patient identifiers and pathology accession/case number.



Specimen Required


Specimen Type: Lung biopsy

Supplies:

-Pathology Packaging Kit (T554)

-Formalin, 10% (T118)

-Michel's Transport Media for Immunofluorescent Testing on Tissue (T321)

Specimen Volume: Entire specimen

Collection Instructions:

1. Submit portion of lung tissue in 10% neutral buffered formalin for light microscopy processing. Alternatively, submit a representative hematoxylin and eosin (H and E) slide from the light microscopy sample along with the tissue in Michel's transport media. Pathology Packaging Kit can be used to submit H and E slide.

2. Place a portion of the unfixed lung tissue in Michel's transport media for immunofluorescence.

 

Specimen Type: Cardiac biopsy

Supplies:

-Pathology Packaging Kit (T554)

-Formalin, 10% (T118)

-Michel's Transport Media for Immunofluorescent Testing on Tissue (T321)

-Electron Microscopy Kit (T660)

-Gluta (Trumps) (T130)

Specimen Volume: Entire specimen

Collection Instructions:

1. For ideal analysis, collect 4 to 6 biopsy specimens and submit all in 10% neutral buffered formalin unless electron microscopy (EM) is requested.

2. If EM is needed, submit at least 1 biopsy into 2.5% to 3% buffered glutaraldehyde preservative using the Electron Microscopy Kit along with the formalin biopsy specimens. If formalin biopsy specimens are not available, light microscopic slides would also be acceptable.

Additional Information: If the question is drug toxicity, storage disease, or if the patient is younger than 25 years old, send at least 1 biopsy specimen in 2.5% to 3% buffered glutaraldehyde in case EM is needed for diagnosis.

 

Specimen Type: Cardiac explant

Supplies:

-Pathology Packaging Kit (T554)

-Refrigerate/Ambient Shipping Box, 5 lb (T329)

Specimen Volume: Entire specimen

Collection Instructions:

1. Fix entire explant specimen in formalin for a minimum of 24 hours.

2. Following fixation, lightly wrap specimen in formalin-soaked paper towel, place in a leak-proof sealable bag with a small amount of formalin, seal, and ship ambient in a sturdy shipping container (ie, Refrigerate/Ambient Shipping Box, 5 lb).

Additional Information: Include the last pretransplantation echocardiogram with report and images as well as all other relevant clinical documents.

 

Specimen Type: Enucleated eye

Supplies:

-Pathology Packaging Kit (T554)

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

Specimen Volume: Entire specimen

Collection Instructions:

1. Immediately after removal, place specimen in approximately 300 mL of 10% neutral buffered formalin.

2. Enucleated eye should not be opened or punctured.

3. After 48 hours in the originating laboratory, the specimen should be transferred from the larger, 300-mL container to a smaller container with fixative (Formalin - 10% Histo Prep, 45 mL) to be shipped without risk of leakage.

 

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 specimen

Collection Instructions:

1. Obtain biopsy.

2. 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.

3. Immediately but gently place specimen (on the paper mount) into 10% formalin, approximately 20 times the volume of the biopsy (Formalin - 10% Histo Prep, 45 mL).

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

 

Specimen Type: Vitreous fluid/Aqueous humor

Supplies:

-Pathology Packaging Kit (T554)

-Aliquot Tube, 5 mL (T465)

Specimen Volume: Entire specimen

Collection Instructions:

1. Obtain liquid specimen.

2. Place the liquid (vitreous or aqueous) concentrate into a small tube with a screw-top cap. Seal the tube tightly.

3. Put the specimen immediately on a refrigerated cool pack (not dry ice or frozen cool pack).

4. If a washing (diluted) is available, it can also be sent in similar manner.

Specimen Stability Information: Refrigerated


Forms

If not ordering electronically, complete, print, and send a Cardiovascular Test Request (T724) with the specimen.

Useful For

Obtaining a rapid, expert opinion on unprocessed specimens referred by the pathologist

 

This test is not useful for suspected hematologic disorders

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
LEV1P Level 1 Gross only No, (Bill Only) No
LEV2P Level 2 Gross and microscopic No, (Bill Only) No
LEV3P Level 3 Gross and microscopic No, (Bill Only) No
LEV4P Level 4 Gross and microscopic No, (Bill Only) No
LEV5P Level 5 Gross and microscopic No, (Bill Only) No
LEV6P Level 6 Gross and microscopic No, (Bill Only) No

Testing Algorithm

An interpretation will be provided by Mayo staff pathologists within a formal pathology report that is sent to the referring pathologist.

 

This test should be used when submitting lung tissue for immunofluorescence, cardiac biopsies, enucleated eye specimens, iris, conjunctiva, cornea and other small eye biopsies for Mayo pathology consultation/interpretation.

 

Appropriate stains and other ancillary testing may be performed and charged separately.

 

This test is not intended for suspected hematologic disorders.

 

Note: Tests requested by the referring physician (eg, immunostains, molecular studies, etc.) may not be performed if they are deemed to be unnecessary by the reviewing Mayo Clinic pathologist. For all pathology consultations, ancillary testing is ordered at the discretion of the Mayo pathologist.

 

See Pathology Consultation Ordering Algorithm in Special Instructions.

Reporting Name

Wet Tissue Pathology Consult

Specimen Type

Varies

Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Ambient (preferred)
  Frozen 
  Refrigerated 

Clinical Information

Mayo Clinic Rochester is staffed by pathologists whose expertise and special interests cover the entirety of Pathology, from surgical pathology with all of its respective subspecialty areas, to Hematopathology, Renal Pathology, and Dermatopathology.

 

Consultation services are provided for difficult diagnostic problems. Consultation cases may be sent by a referring pathologist and directed to one of the pathologists who is an expert in the given area or directed more broadly to the subspecialty group. Cases are frequently shared and sometimes transferred between the pathologists, as deemed appropriate for the type of case or diagnostic problem encountered. Emphasis is placed on prompt and accurate results. Materials received are reviewed in conjunction with the clinical history provided, laboratory findings, radiographic findings (if applicable), and sending pathologist's report or letter. If additional special stains or studies are needed, the results are included in the final interpretive report. In some cases, electron microscopy and other special procedures are utilized as required.

 

A variety of ancillary studies are available (eg, cytochemistry, immunohistochemistry, immunofluorescence, electron microscopy, mass spectrometry, cytogenetics, and molecular genetics) to aid in establishing a diagnosis. These ancillary studies are often expensive and labor intensive, and are most efficiently utilized and interpreted in the context of the morphologic features. The goal is to provide the highest possible level of diagnostic consultative service, while trying to balance optimal patient care with a cost-conscious approach to solving difficult diagnostic problems.

Interpretation

Results of the consultation are reported in a formal pathology report, which includes a description of ancillary test results (if applicable) and an interpretive comment. When the case is completed, results may be communicated by a phone call.

 

The formal pathology report is faxed.

Analytic Time

3 days

CPT Code Information

88300 (if appropriate)

88302 (if appropriate)

88304 (if appropriate)

88305 (if appropriate)

88307 (if appropriate)

88309 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ANPAT Wet Tissue Pathology Consult In Process

 

Result ID Test Result Name Result LOINC Value
71043 Interpretation 60570-9
71044 Participated in the Interpretation No LOINC Needed
71045 Report Electronically signed by 19139-5
71046 Addendum 35265-8
71047 Gross Description 22634-0
71048 Material Received 22633-2
71584 Disclaimer 62364-5
71790 Case Number 80398-1

Reference Values

The laboratory will provide a pathology consultation.

Day(s) and Time(s) Performed

Monday through Friday; Varies

Test Classification

Not Applicable

Method Name

Medical Interpretation