Paediatric rectal biopsies for diagnosis of Hirschsprung’s disease do not need to be sent fresh. These specimens may be sent in formalin. There is no requirement to discuss these cases with the duty pathologist.
Paediatric tonsils do not need to be sent fresh unless there is a high clinical suspicion of malignancy. These specimens may be sent in formalin. There is no requirement to discuss these cases with the duty pathologist unless there is a high clinical suspicion of malignancy.
Please ensure that for all specimens indicative of paediatric neoplasia/cancer/tumour that the day duty pathologist is notified in advance of submission and the specimens are submitted unfixed as specified by the day duty pathologist’s instructions. ALL fresh specimens including frozen sections must be discussed directly with the day duty pathologist in advance of submission.
The following procedures must be followed for all urgent paediatric fresh specimens including frozen sections, fresh tumour biopsies and fresh tumour resections.
Any queries regarding urgent specimens should be directed to the duty Paediatric pathologist by telephoning the paediatric office on 89478 and asking to speak to the duty paediatric pathologist. Any out-of-hours queries should be directed to the on-call pathologist who can be contacted via hospital switchboard. The paediatric laboratory team may be contacted on 89531.
DISCUSSION WITH THE DUTY PATHOLOGIST – ALL CASES
All cases must be booked in advance (ideally the day before) by telephoning 89478 and discussing the case and your requirements with the duty paediatric pathologist. Please provide patient details, including name and CHI number, date of surgery, approximate time of surgery and a contact number for theatre.
The surgeon or interventionalist performing the biopsy / resection must speak directly to the duty Paediatric pathologist prior to the procedure in every case to establish the specimen requirements. Failure to follow this procedure may render the biopsy un-interpretable.
Any patients requiring frozen sections on fresh tissue need to have had a negative COVID test taken within 72 hours before the procedure.
Any patients for whom fresh tissue is to be frozen/biobanked also need to have had a negative COVID test taken no more than 72 hours prior to the sample being collected. Any patients for whom fresh tumour tissue is to be taken for genetic only (not biobanking or freezing) do not need a recent COVID test for pathology.
The instructions below are general instructions and must not replace a case by case discussion with the duty pathologist.
TRANSPORT TO THE LABORATORY – ALL CASES
All fresh paediatric specimens must be conveyed immediately in person or by porter to pathology (3rd floor, Laboratory Medicine Building). It is the responsibility of the surgical team to arrange urgent transport of the specimen to pathology. The sample must not be sent via the POD system and must be taken directly to pathology specimen reception on the 3rd floor. The specimen should be marked as “Urgent. Frozen section.” Staff transporting the specimen must inform specimen reception staff that it is an urgent fresh specimen for frozen section.
When the specimen leaves theatre, theatre staff must inform the laboratory by telephoning 89531.
The following procedures must be followed for all paediatric renal biopsies:
DISCUSSIONS WITH THE DUTY PATHOLOGIST AND THE LABORATORY
All Renal biopsies must be discussed with the Duty Paediatric Pathologist on 89478 as well as with laboratory staff on 89531 (see below).
These specimens will be collected in theatre by a biomedical scientist who will separate the sample for immunofluorescence and electron microscopy. Notification of such biopsies to the laboratory must be done as far in advance of the biopsy as possible by telephoning 89531. Failure to do so may result in delay since staff will have to be available to attend theatre to undertake this procedure.
Any Patients requiring immunofluorescence need to have a negative COVID test result available, taken up to 72 hours before sample collection.