Lymph Node Biopsy
The following advice has been prepared regarding lymph node biopsies as difficulties often arise:
Whole Nodes:. The ad hoc division of fresh material prior to its examination by the anatomical pathologist can lead to confusion, misinterpretation and misdiagnosis. The pathologist, on receipt of the specimen, will divide appropriately and supply specimens in optimum condition to the other laboratories concerned (eg Flow Cytometry, Microbiology). Requests must contain sufficient clinical to enable appropriate triage.
Specimens sent from external sites must be placed in a sterile, dry container and transported on ice immediately to Anatomical Pathology.
Specimens for histopathology not requiring micro and culture or flow cytometry can be placed in 10% Formalin after collection.
Flow Cytometry on nodal tissue – The full investigation of patients with established, or suspected, lymphoma is a necessary preliminary to effective treatment. For optimal examination, whole node specimens should be sent intact, on ice, to the Anatomical Pathology Unit immediately following removal.
It must be emphasised that flow cytometry requires samples be marked "Urgent", must reach the laboratory as soon as possible, and will not normally be accepted after 5 pm Monday - Friday. Please refer to specific requirements for flow cytometery under ‘Leucocyte Immunophenotyping’ elsewhere in this handbook. Note: flow cytometry is of no value in Hodgkin lymphomas.
Core biopsies requiring histology and flow cytometry must be taken as 2 separate passes. Anatomical pathology will not divide smaller specimens such as core biopsies. There should be separate specimens for flow cytometry and histology.
The flow cytometry core should be placed directly into a specimen container containing sterile saline or RPMI. The core for histology should be placed directly into 10% Formalin
Microbiology on nodal tissue – Whole nodes should be sent intact in a sterile container to Anatomical Pathology. Division of the sample for culture and molecular microbiology will be undertaken by the anatomical pathologist.
Core biopsies requiring micro and culture and particularly if fungal and AFB culture are required, cannot easily be shared with other departments. Wherever possible separate cores for histology and microbiology should be taken. |