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Histology

 

 Reporting Guidelines for Histological Specimens Alanna2.jpg

A pathologist examines tissue specimens submitted to Physicians Laboratory. If no microscopic sections are submitted, only a gross description report is issued. If sections are submitted for microscopic examination, both a gross description and microscopic interpretation are reported. It is at the discretion of the pathologist whether a gross only or microscopic exam is performed. All reports are dictated and reviewed by the pathologist responsible for the microscopic interpretation and diagnoses.

Turn-around-time is generally 48 hours from the time the specimen is received into the laboratory for routine surgical specimens. Results are interfaced with the Avera McKennan laboratory information system and can be found in the patient's electronic medical record.  Upon request, they are also faxed or printed directly to a client's printer.

Requirements for Disposition of Fetal Remains

Physicians Laboratory requires that a Disposition of Fetal Remains form be signed by the family before processing any specimen that could be a product of conception. 
The disposition form contains two options for the parents - cremation and burial in a common grave or private burial.  If you as a client or the family have any questions about these options and how they work please contact Miller Funeral Home at 1-800-568-4262.  Personnel there are experienced and will gladly answer questions and provide guidance regarding burial.  If necessary, they will work with other funeral homes in the area to ensure proper burial.  They are also willing to discuss financial arrangements with the family if necessary. 

Physicians Laboratory recognizes that this is a very difficult time for all and it is not easy to have to make these decisions.  However, it is necessary for all involved to be clear about what is desired by the family.  We believe that the easiest way to do this is to obtain the mother's signature when she is on the premises and before any procedure is performed.  Each facility is responsible for obtaining the signature whether it is done at the time of the procedure or later.  Products of Conception (POCs) will NOT be processed until the signed disposition form is received unless there are extenuating circumstances, like a suspected tubal pregnancy. 

If private burial is desired and the funeral home is out of town the fetus will be returned to the facility of origin for pick up by the family.  Locally it can be picked up by Miller Funeral Home at 1-800-568-4262.  Please make arrangements with them for pick up.

If burial in a common grave is desired the fetus will be picked up by Miller Funeral Home and cremated along with other POCs.  Periodically the remains will be taken to St. Michael's Cemetery and placed in a common grave.  A short service is performed at that time by clergy.  No participation is allowed for the service, however the cemetery contains a marker so those who wish to visit the area at some point are able to do so. 

Fetal Chromosome Analysis

Fetal chromosome analysis helps determine any chromosome abnormality present, for example, trisomy 18 and trisomy 13.  Testing detects over 99% of all chromosome abnormalities.  The sex of the fetus is also determined during testing.

Testing can also detect specific inherited diseases such as Tay-Sachs disease or cystic fibrosis.

Due to the sensitivity of the testing, it is very important to get the specimen to Physicians Laboratory as soon as possible to prevent cellular degeneration and keep the specimen optimal for testing.  See the specific procedure for sending specimens in the PL Referral Guide (see corresponding tab on web page).

Samples that contain chorionic villi (from the placenta) have a 90% success rate vs. samples from the internal organs (20% success rate).  Integrated Genetics media is the preferred media for shipment.  If the Integrated Genetics media on hand has expired, it is better to use the expired media than to replace it with some other media as the expired media is preferable to any other types of tissue culture media. 

Providers may want to suggest to their patients that they should check with their insurance carrier as to whether or not specific testing is covered under their plan and/or if it is subject to pre-authorization or a deductible.

The average turn-around-time for testing is about 10 days from the time the specimen is received at the testing facility.

Resource: Integrated Genetics, a business unit of Esoterix Genetic Laboratories LLC, a wholly-owned subsidiary of Laboratory Corporation of America.