How the Specimen Is Processed

When a specimen arrives at University Pathologists, we take great care to process it efficiently and according to the needs of each physician in the following manner ...

Registration and accessioning

  • Histology clerks register each patient’s data in our computer system and assign a unique number to each case and the specimen container.
  • Once the data is entered, it remains in our patients’ database indefinitely, allowing expeditious demographic and diagnosis retrieval for future specimen accessioning and comparison analysis.

Specimen grossing

  • The tissue is examined macroscopically by highly experienced pathologists’ assistants, who record the specimen type, size, the presence of abnormal lesions and their relation to the resection margins.
  • Skin specimens are inked for more accurate evaluation of the surgical margins.
  • The large surgical specimens (mammary tissue, lung, hollow organs such as esophagus, stomach, colon, urinary bladder) are routinely fixed overnight in formalin and grossly examined the next day.
  • All surgical resection specimens are grossly examined according to standard procedures, sectioned following the most recent guidelines published by College of American Pathologists and representative 2-3 mm thick tissue samples are placed in plastic cassettes that are labeled with the same identifying number.
  • All biopsies are submitted entirely with specific orientation instructions.

Tissue processing

  • The samples are placed in an automated tissue processor that runs overnight. The cassetted tissue is subjected to different solutions of alcohol for optimal microscopic examination.
  • The run cycle is completed the following morning.

Tissue embedding and cutting

  • After being removed from the tissue processor, the tissue sections are placed in metal cassettes filled with molten paraffin. At this stage, the tissue orientation in the paraffin blocks is of paramount importance to ensure accurate microscopic examination.
  • After the paraffin blocks are cooled, the tissue is ready to be cut into 5 micrometers thin transparent histologic sections using specialized microtomes.
  • The sections are floated on a water bath and then placed on glass slides.
  • This entire process is manually performed by our licensed and highly experienced histotechnologists.

Staining and coverslipping

  • All slides are routinely stained with hematoxylin and eosin (H&E) using an automated stainer.
  • After staining, the slides are automatically covered with thin glass coverslips, to prevent tissue damage and to provide the optical quality necessary for microscopic examination.

Microscopic examination

  • The histological sections are interpreted by highly skilled, board-certified pathologists.
  • Additional ancillary studies are performed if deemed necessary.

Turnaround time for specimen results is 24 to 72 hours. We provide same-day diagnosis with rapid evaluation of tumors via frozen section. Verbal reporting of all new malignant diagnoses, with the exception of basal cell or squamous cell carcinoma of the skin, are provided on the day of the readout. For our partnering physicians, we offer expert review of their most complex cases, comprehensive reports accompanied by photomicrographs (upon request) and immediate access to our pathologists by phone. A physician liaison manages the needs of each physician — just one more way we ensure that nothing is overlooked.