Histopathology
The histology department is based on the Cheltenham General Hospital site.
The Histology Department
The histology department is based on the Cheltenham General Hospital site. The department is accredited to ISO 15189:2012. (Please note: our accreditation is limited to those activities described on our UKAS schedule of accreditation found at UKAS.com) It provides a fully comprehensive diagnostic service, handling around 40,000 requests per annum, sent from a variety of locations within the region; including hospital theatres, clinics, GP surgeries and private hospitals. The vast majority of these are sent as routine histopathology specimens, for which no prior arrangements need be made.
Technical staff are on site Monday to Friday, 08:00 to 16.30, with the office manned under normal circumstances until 17:00. To contact the laboratory please see the Contacts and advice service page.
If an emergency arises outside these hours then please refer to the Out of hours services section.
Death advice
A death advice service is available, please contact the histopathology office on 0300 422 4075/3316/3313
Example of a completed Histology request form
Guidance and an example on a completed Histology request form is available here.
Specimens
Histopathology specimen requirements:
The majority of specimens for histopathological analysis require fixation by formalin. Please be aware that this is a hazardous chemical and requires the correct personal protective equipment. If you require any COSHH or risk assessment data please contact the laboratory, or read this formalin health and safety data sheet. We are happy to discuss any training requirements with you or your team. Please contact the laboratory for further information.
For smaller specimens, pre-filled orange pots containing formalin can be obtained from pathology stores. A selection of larger pots and buckets, which are not pre-filled, are available for larger specimens; these can be obtained by contacting histology reception.
To ensure adequate fixation and to avoid any delays, please ensure that the pot is big enough for the specimen. Allow enough room for the specimen and an adequate amount of formalin to cover the specimen and store at room temperature. Once received in the laboratory, fixation times will vary depending on the specimen type and size of the specimen, but in most instances, requires a minimum of 24 hours prior to analysis. This can affect turnaround times.
We aim to have a turnaround time of 14 days for routine histology specimens. If you will need a report urgently please contact the laboratory.
For instructions on correct sample labelling please refer to the sample labelling and request form. Please note that inadequately/insufficiently labelled specimens will not be accepted. This will cause delays in obtaining a patient result.
For instructions on the correct use of cell safe capsules for small biopsies please refer to the Cell Safe SOPcell safe SOP
For information on transport of Histology specimens please refer to Specimen storage and transport to laboratories
If you require information regarding the uncertainty of measurement please contact the laboratory.
Please note: If we need to carry out the decalcification process on a specimen, this may impact subsequent results that we provide, such as immunohistochemistry. For further information please telephone the histology office.
Frozen sections
A service for frozen sections is provided on the Cheltenham General site. In order to book a frozen section, please telephone the histology office with patient and specimen details. (NB – high risk biohazardous tissues are not suitable for frozen sections. These include tuberculous lesions, specimens from patients with viral hepatitis and patients who are known HIV positive). Please contact the laboratory if there is uncertainty regarding this procedure.
It is realised, however, that occasions will arise when the request is unforeseen. In these cases the laboratory must be informed before the specimen is sent, and if outside normal laboratory working hours an “out of hours” consultant must be contacted via switchboard prior to taking and sending the sample
Tissue must be sent fresh and unfixed: DO NOT PLACE IN FORMALIN.
Specimens must be delivered into the hands of a member of the histopathology staff. Do not leave frozen sections at pathology reception as delay may ensue.
A verbal report will normally be given within 30 minutes of the arrival of the specimen, although complex cases may take longer.
Immunofluorescence
Please note: this test is not currently included in the ISO 15189:2012 accreditation.
The department provides an immunofluorescence service for skin and renal specimens. The laboratory will provide the transport containers for these specimens – please contact histology reception to request these prior to taking the specimen.
DO NOT PLACE THE SPECIMEN INTO FORMALIN
Special Techniques
The histopathology department offers a special techniques service to enhance and assist in the diagnosis of disease.
For further information please contact the laboratory.
Immunocytochemistry
The department has an expansive repertoire of antibodies for routine testing to aid the diagnosis of disease. Any tests not offered in-house are sent away to an external ISO accredited laboratory for testing; this can therefore impact turnaround times.
For further information please contact the laboratory.
HER 2
Please note: this test is not currently included in the ISO 15189:2012 accreditation.
The department offers a HER 2 immunocytochemistry service for breast cancer, performing in excess of 700 tests per annum. All testing is performed in accordance with national guidelines. Reflex testing by FISH and HER 2 testing in gastric cancer is currently outsourced to an external ISO accredited laboratory for testing.
For further information please contact the laboratory.
ISH
Please note: this test is not currently included in the ISO 15189:2012 accreditation.
The department offers testing to detect the presence of Epstein Barr Infection (EBV) to aid in the diagnosis of some cancers. Testing is performed by in situ hybridisation (ISH).
For further information please contact the laboratory.
Non-gynaecological
The department offers a non-gynaecological service. This service involves processing and analysing samples taken from any body site (other than cervical) to provide a diagnosis for patients with suspected disease.
Rapid on-site evaluation of fine needle aspiration (FNA) cytology samples
The Histology department provides a rapid on-site evaluation of fine needle aspiration (FNA) non-gynaecological samples for the ear nose and throat (ENT) clinic. This is held at the ENT outpatient department at Gloucestershire Royal Hospital every Tuesday between 14:00pm and 17:00pm and at Cheltenham General Hospital every Friday between 8:30am and 12:30pm.
The ENT Clinic is responsible for the management of this service. If the clinic is cancelled, the Histology department must be informed on 0300 422 4219/3314.
The clinic is attended by qualified biomedical scientist staff. Stained smears from FNA samples are assessed by the biomedical scientist for adequacy while the patient is in the clinic (minimum of 6 groups of 10 cells in thyroid and salivary gland FNA’s, or lymphocytes present in lymph node FNA’s). This enables the clinician to repeat the FNA if the sample is assessed as inadequate.
Adequate samples are taken to the Histology department by a member of staff from the clinic, to be assessed by a pathologist. A preliminary diagnosis is then given to the clinician over the phone if possible. This should enable the patient management to be planned the same day with the patient and clinician.
Reporting of routine non-gynaecological samples
Routine non-gynaecological samples will be reported within 5 working days.
In cases when more complex pathology requires further laboratory investigations or referral for expert opinion, a provisional report will be issued within the above time scale to be followed by a further complete supplementary report.
Reporting of urgent non gynaecological samples will be reported within one working day of receipt.
For a sample to be treated as urgent, the laboratory must be notified on 0300 422 4219/3314.
Non-gynaecological (general) tests and samples
All samples must be accompanied by a yellow non-gynaecological cytology request form. The completion of the form and the labelling of the sample must conform to the pathology policy on specimen labelling. For full details please see Policy for Specimen and Request Form Labelling for Pathology Users.
Useful links
The following links will take you to non-gynaecological sample-specific information. If you do not think your sample falls into any of these groups or are otherwise unsure, please contact non-gynaecological lead Richard Butt on 0300 422 3850.
Breast Fine Needle Aspiration Cytology
Bronchial Lavage/Washing/Trap Cytology
Cerebrospinal Fluid (CSF) Cytology
Fine Needle Aspiration of Thyroid, Head and Neck and All Other Sites Except Breast