Fixation:
Formalin - With the exception of urine/bladder washings for Urovysion, nearly all IHC, ISH and FISH tests offered at Vitro can be performed on deparaffinized, formalin-fixed tissue, including all lymphoid marker studies, thanks to the development of heat induced epitope retrieval techniques (“antigen retrieval”), and the availability of an ever-widening spectrum of monoclonal antibodies. While most antibodies can work on tissues fixed in non-formalin based fixatives, suboptimal tissue antigenic preservation may result and lead to false negative results; please contact the lab if you have questions about a specific fixative.
Decalcification For decalcified tissues, it is recommended that EDTA-based decalcification solutions be employed to preserve optimal tissue immunoreactivity.
Specimen Procurement / Handling / Packaging:
Of note, include as many specimens as possible (without compromising the integrity of the specimen or transporter’s safety) in a single Vitro Box/shipping bag.
Fresh/fixed tissue specimens submitted for Histology/IHC/FISH:
- Adequately fixed, fresh tissue specimens in formalin.
- Vitro’s IHC and FISH studies have been optimized for formalin-fixed specimens. (Specimens must be collected by 3pm for same day processing)
- Put specimen, with appropriate amount of formalin, into specimen container.
- Tightly screw on the lid to the specimen container and seal container shut.
- Label container with the patient’s name, submitter’s accession number, and date the sample was procured. At least two patient identifiers need to be on the container.
- Place labeled container into a re-sealable, biohazard plastic bag.
- Place enough absorbent material (vermiculite, gauze, paper towels) in bio bag adequate to absorb the amount of fluid in the specimen container, should it break open or leak.
- Place requisition and supporting documentation in pouch on outside of bio-bag.
- Place bio-bag, with specimen and absorbent material, in box (provided by Vitro -- “Vitro Box”), with adequate ice packs (if applicable). Tape box closed.
- Appropriately label the Vitro box (or outside shipping box) with any biohazard labels/infectious disease labels that may be required, and complete necessary documentation for the carrier.
Paraffin blocks:
- Ensure block(s) is labeled with the client’s (referring pathology department’s) accession number and all other related accession numbers, and the block sublabel if appropriate, to ensure proper identification of the specimen.
- Wrap each block individually in tissue paper or a Kim wipe or place each block individually in a small plastic bag to prevent cross-contamination, should the block(s) melt in transit.
- Place wrapped/bagged block(s) in box (provided by Vitro -- “Vitro Box”)) with adequate ice packs and tape box closed.
- Place samples, requisition(s) and supporting documentation in outer box (provided by Vitro -- “Vitro Box”).
- Go to Shipping Procedure Below.
- Add 20 ml of fluid (patient sample) to the 10 ml of fixative in the specimen container provided by Vitro.
Stained Microscopic Slides:
- Ensure slide(s) is labeled with the client’s (referring pathology department’s) accession number and all other related accession numbers, and the block sublabel if appropriate, and name of stain on slide to ensure proper identification of the specimen.
- Place slides in a sturdy, top-loading slide holder(s) with enough packing to prevent rattling of the slides in the slide holder.
- Tape the slide holder(s) shut.
- Place slide holder(s), along with requisition(s) and supporting documentation (if necessary) in box (provided by Vitro -- “Vitro Box”), with enough packing materials to prevent the package from rattling.
Urine/Bladder Washings for Urovysion:
- Add 20 ml of fluid (patient sample) to the 10 ml of fixative in the specimen container provided by Vitro.
- Tightly screw on the lid to the specimen container and seal container shut.
- Label container with the patient’s name, submitter’s accession number, and date the sample was procured.
- Place labeled container into a re-sealable, biohazard plastic bag.
- Place enough absorbent material (vermiculite, gauze, paper towels) in bio bag adequate to absorb the amount of fluid in the specimen container, should it break open or leak.
- Place requisition and supporting documentation in pouch on outside of bio-bag.
- Place bio-bag with specimen and absorbent material in foam (provided by Vitro), with adequate ice packs. Clients where a courier is picking up can leave the specimen and requisition in a bio bag and proceed to step 10.
- Place foam in outer box (provided by Vitro -- “Vitro Box”).
- Appropriately label the Vitro box with any biohazard labels/infectious disease labels that may be required, and complete necessary documentation for the carrier.
- Refrigerate sample until it is picked up by the courier/other transporter.
Other Fluids Being Sent for Testing:
- Appropriately preserve fluid.
- Tightly screw on the lid to the specimen container and seal container shut.
- Label container with the patient’s name, submitter’s accession number, and date the sample was procured.
- Place labeled container into a re-sealable, biohazard plastic bag.
- Place enough absorbent material (vermiculite, gauze, paper towels) in bio bag adequate to absorb the amount of fluid in the specimen container, should it break open or leak.
- Place requisition and supporting documentation in pouch on outside of bio-bag.
- Place bio-bag with specimen and absorbent material in foam (provided by Vitro) with adequate ice packs. Clients where a courier is picking up can leave the specimen and requisition in a bio bag and proceed to step 10.
- Place foam in outer box (provided by Vitro -- “Vitro Box”).
- Appropriately label the Vitro box with any biohazard labels/infectious disease labels that may be required, and complete necessary documentation for the carrier.
- Refrigerate sample until it is picked up by the courier/other transporter.
Material/Criteria for IHC/FISH:
Unstained microscopic slide, including smears - IHC and FISH tests are best performed on tissue sections on charged (“plus” slides) or Probe-on Plus slides to keep tissue from falling of the slide during the IHC and FISH analytical processes.
- Ensure slide(s) is labeled with the client’s (referring pathology department’s) accession number and all other related accession numbers, and the block sublabel if appropriate to ensure proper identification of the specimen.
- Ensure slides are not wet to prevent loss of specimen if the slides touch together.
- Place slides in a sturdy, top-loading slide holder(s) with enough packing to prevent rattling of the slides in the slide holder.
- Tape the slide holder(s) shut.
- Place slide holder(s), along with requisition(s) and supporting documentation (if necessary) in box (provided by Vitro -- “Vitro Box”), with enough packing materials to prevent the package from rattling.
