Surgical Pathology

Specimens should be delivered without unnecessary delay to the appropriate laboratory. A separate, completed, and signed request form must be submitted with each patient's specimen(s). Specimens will be delayed or rejected if proper paperwork is not completed appropriately.

  • Each specimen container (not lid) must be identified with a label bearing at least the patient's full name, unit number and account number.
  • All specimens are to be placed in 10% neutral buffered formalin in appropriate sized containers. The volume of the formalin should be 10-20 times that of the specimen. See exceptions below.

The Routine Laboratory is open from 7 am to 6 pm Monday-Friday and 7 am to 11 am on Saturday. The OR Lab is open 7:30 am to 3:30 pm, Monday-Friday, and from 7 am to 11 am on Saturday.

Histology lab hours are 5am-9pm Monday-Friday and on call coverage 7am-10am Saturday.

Forty-eight hours is the expected turnaround time for most histopathology reports. (Not including weekends.) Reports on routine specimens are usually available after 4:00 PM the second day following receipt of the specimen.

Materials: Information about the various sized containers and 10% neutral buffered formalin, and ordering information for prefilled formalin containers, is available from the OR Path Lab (336) 716-2686.

Request Forms

Note: For patients not seen at The North Carolina Baptist Hospitals, Inc., the Pathology Laboratory providing the case material will be billed unless patient's billing information is clearly indicated on the request form. Call (336) 716-2628, or consulting pathologist, (336) 716-4311 with questions.

Special Handling Instructions, Histopathology:

Bone Marrow Examination: Procedure is to be scheduled through Hematology Lab, 336-716-2614. Specimen is delivered to and processed in the Hematology Lab. The slides are delivered to the pathologist two days after receipt in the lab. The final diagnosis is usually completed and mailed out from AP Information Center the next day, unless special stains necessitate delay.

Special stains on bone marrow and peripheral smears will be performed at the request of a pathologist or as an automatic part of certain patient protocols. Stains performed are:

  • Butyrate esterase,
  • Immunoperoxidase for various antigens,
  • Iron stain,
  • Myeloperoxidase,
  • PAS, and
  • Tartrate Resistant Acid Phosphatase (TRAP) for Hairy Cells.

Breast Carcinoma Receptor Studies: These are done on almost all primary and metastatic breast carcinomas and require unfixed frozen tumor or paraffin embedded tumor. Generally a frozen section is requested on primaries, however a mastectomy may be done with known diagnosis from a previous biopsy which may not have been assayed. These are to be called to the attention of the resident on duty, or on call after usual hours and not placed in fixative. The resident will obtain the sample and notify the laboratory 336-716-2104 or place the specimen in the proper freezer.

Dermatopathology: Most skin biopsies can be processed in a routine manner with buffered formalin fixation. If an infectious disease is suspected clinically, separate biopsies should be performed, or the specimen must be bisected, and submitted for appropriate microbiology cultures. Read more about the Dermatopathology Lab.

If a panniculitis is suspected, an incisional biopsy of skin through and including subcutaneous fat must be submitted. Punch biopsies of panniculitides are usually unsatisfactory and nondiagnostic.

Note that there is a separate Dermatopathology Request Form for dermatology specimens. 

Immunofluorescence, Direct: If immunologically mediated bullous diseases are a clinical consideration, direct immunofluorescent studies on fresh biopsies must be performed in addition to a routine formalin-fixed specimen. Biopsies should be done at the very edge of a blister, or in the immediate perilesional skin. The specimen must be transported immediately (less than 10 minutes) on wet gauze on ice to the Molecular Diagnostics Lab. Call 336-716-2756 between 7 am and 4 pm to make arrangements.

If the specimen will be delayed more than 10 minutes or if it is collected after laboratory hours (8 am to 5 pm), it must be placed in Michele's Transport Medium 199 and then brought with a Pathology requisition to the Molecular Diagnostics Laboratory. After hours, the specimen should be taken to Lab Central and refrigerated. This holding medium is available on request from the laboratory at 336-716-2756.

Immunofluorescence, Indirect: Serum should be drawn from the patient at the time of the biopsy and submitted to the Molecular Diagnostics Lab for indirect serologic skin immunofluorescence studies. If there are questions about this procedure, call the lab at 336-716-7779.

Lymph Node Biopsies/Lymphoma Tissue Specimens: In order to prepare imprints and divide the biopsy for special procedures, lymph nodes or other tissue suspected to contain lymphoma should be brought to the OR Pathology Laboratory in saline. They should be given to the resident or technician on duty for immediate attention. If neither are present notify the resident on call at beeper 336-806-9627.

Muscle Biopsies are processed by the Neuropathology Laboratory. Special attention is required, as all biopsies must arrive fresh, not fixed to the OR Path or Histology Laboratories to be processed or flash frozen with 24 hours of excision. Biopsies must be received in the Histology Lab by 2:00pm Monday-Friday to ensure adequate time for processing. Outside providers please call the Histology Lab at 336-716-2682 prior to delivery of biopsy.

Neuropathology: Neurosurgical specimens, muscle biopsies, peripheral nerve biopsies and autopsy CNS material are processed by the Neuropathology Laboratory 336-716-2682. Click here for more details about the Neuropathology Lab.

Renal Pathology: A petri dish, saline, and filter paper should be acquired prior to obtaining the biopsy. Once the biopsy has been obtained it should be carefully laid on the saline-moistened filter paper and the latter folded over it with special care given not to crush the specimen. The specimen should then be transported in a biohazard bag to the Molecular Diagnostics Laboratory. Timeliness in transporting the biopsy is essential.

A separate completed Renal Biopsy Request Form must be submitted with each patient's specimen. The specimen must be identified with the patient's full name. Contact Dr. Alexei Mikhailov 336-716-2677 for further details.

T- and B-cell surface markers: Immunocytochemical studies or flow cytometry for T- and B-cell surface markers may be done on the same specimen. Please notify resident or technician that these are needed as they require special handling.