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Cone biopsy of cervix
MessagePrior to placing the tissue in formalin the surgeon should open the specimen at the anterior midline (twelve o'clock position) of the cervix and indicate such with a suture. After this, pin the specimen flat on the tongue depressor and place in 10 % neutral buffered formalin.
Test Code
Cone biopsy of cervix
Instructions
All specimens will be submitted with either a CHCS order entry document or a Tissue Examination Request
[NAVHOSPPTSVA 6510/44 series
It must be completely filled out with:
1. The providers full name.
2. The patients first and last name.
3. Social security number with FMP.
4. Age.
5. Ward/clinic/MOR.
6. Specimens anatomic site.
7. Two submitting staff initials.
8. Specimen identifier (A, B, C, etc) if more than one container / specimen is to be submitted.
9. Duty station with phone number for active duty personnel.
In addition, pre-operative diagnosis should be included with pertinent clinical data.
Note: All tissue specimens submitted to Histology from internal NMCP sources must have verifying initials on the specimen containers. If they do not, the specimen will not be accepted. This is command policy. In addition, all patient and specimen source information must be on the specimen container and exactly match the specimen source indicated in the order.
When placing the order in CHCS, the ordering provider must verify that the Patient’s name, FMP, social security number, date of birth and specimen source on the specimen container are correct. Specimens from different body sites must be placed in separate, completely labeled, containers.
Surgical Pathology specimens must be labeled and requisitions prepared in the room where the surgical procedure is performed. The ordering provider must ensure that the specimen container(s) are correctly labeled with complete and correct patient information, including full name, FMP, SSN, and date of birth, and with the correct specimen identifier (A, B, C, etc) and specimen source (body site). The provider should verify that the specimen identifier(s) (A, B, C, etc) and body sites in the orders correspond to the identifier(s) and body sites on the specimen container(s.)
Routine specimens should be submitted in adequate fixative (10% neutral buffered formalin). A volume of fixative 10-20 times the volume of the tissue specimen submitted is required for optimal fixation. In cases where fixative has not been added, the histopathology technician or laboratory technician will add fixative to the container after consulting with a pathologist.
For ships and branch clinics that mail surgical specimens to Naval Medical Center, Portsmouth, a leak proof screw top container that seals tightly must be used in addition to some type of absorbent material in order to avoid fixative leaking during shipment. Fixative leakage results in inadequate tissue preservation, and histological detail is destroyed. Tissue submission request chits should be separate from the tissue container to protect from leakage.
Routine specimens should be submitted in adequate fixative (10% neutral buffered formalin). A volume of fixative 10-20 times the volume of the tissue specimen submitted is required for optimal fixation.In cases where fixative has not been added, the histopathology technician will add fixative to the container.
For ships and branch clinics that mail surgical specimens to Naval Medical Center, Portsmouth, a leak proof screw top container that seals tightly must be used in addition to some type of absorbent material in order to avoid fixative leaking during shipment. Fixative leakage results in inadequate tissue preservation, and histological detail is destroyed. Tissue submission request chits should be separate from the tissue container to protect from leakage.
[NAVHOSPPTSVA 6510/44 series
It must be completely filled out with:
1. The providers full name.
2. The patients first and last name.
3. Social security number with FMP.
4. Age.
5. Ward/clinic/MOR.
6. Specimens anatomic site.
7. Two submitting staff initials.
8. Specimen identifier (A, B, C, etc) if more than one container / specimen is to be submitted.
9. Duty station with phone number for active duty personnel.
In addition, pre-operative diagnosis should be included with pertinent clinical data.
Note: All tissue specimens submitted to Histology from internal NMCP sources must have verifying initials on the specimen containers. If they do not, the specimen will not be accepted. This is command policy. In addition, all patient and specimen source information must be on the specimen container and exactly match the specimen source indicated in the order.
When placing the order in CHCS, the ordering provider must verify that the Patient’s name, FMP, social security number, date of birth and specimen source on the specimen container are correct. Specimens from different body sites must be placed in separate, completely labeled, containers.
Surgical Pathology specimens must be labeled and requisitions prepared in the room where the surgical procedure is performed. The ordering provider must ensure that the specimen container(s) are correctly labeled with complete and correct patient information, including full name, FMP, SSN, and date of birth, and with the correct specimen identifier (A, B, C, etc) and specimen source (body site). The provider should verify that the specimen identifier(s) (A, B, C, etc) and body sites in the orders correspond to the identifier(s) and body sites on the specimen container(s.)
Routine specimens should be submitted in adequate fixative (10% neutral buffered formalin). A volume of fixative 10-20 times the volume of the tissue specimen submitted is required for optimal fixation. In cases where fixative has not been added, the histopathology technician or laboratory technician will add fixative to the container after consulting with a pathologist.
For ships and branch clinics that mail surgical specimens to Naval Medical Center, Portsmouth, a leak proof screw top container that seals tightly must be used in addition to some type of absorbent material in order to avoid fixative leaking during shipment. Fixative leakage results in inadequate tissue preservation, and histological detail is destroyed. Tissue submission request chits should be separate from the tissue container to protect from leakage.
Routine specimens should be submitted in adequate fixative (10% neutral buffered formalin). A volume of fixative 10-20 times the volume of the tissue specimen submitted is required for optimal fixation.In cases where fixative has not been added, the histopathology technician will add fixative to the container.
For ships and branch clinics that mail surgical specimens to Naval Medical Center, Portsmouth, a leak proof screw top container that seals tightly must be used in addition to some type of absorbent material in order to avoid fixative leaking during shipment. Fixative leakage results in inadequate tissue preservation, and histological detail is destroyed. Tissue submission request chits should be separate from the tissue container to protect from leakage.
Transport Temperature
Room temperature
Specimen Stability
Specimen stable in formalin indefinitely.
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Missing or incomplete patient FMP and/or social security number on container or lab order form.
Missing or incomplete anatomic site on container or lab order form.
No double initials on container (two staff members from the submitting clinic must initial the specimen container.)
Illegible container label or lab order form.
Patient information on container different from patient information on lab order form.
No lab order form submitted with specimen.
No specimen submitted with lab order form.
Missing or incomplete anatomic site on container or lab order form.
No double initials on container (two staff members from the submitting clinic must initial the specimen container.)
Illegible container label or lab order form.
Patient information on container different from patient information on lab order form.
No lab order form submitted with specimen.
No specimen submitted with lab order form.
Report Available
Interpretation
Clinical Significance
A cone biopsy may be done after a Pap test shows moderate to severe cell changes and:
The abnormal tissue cannot be seen with colposcopy but was found in cells collected from a biopsy of the cervical canal, or the abnormal tissue seen with colposcopy extends high into the cervical canal. A cone biopsy is done to remove and examine the abnormal tissue.
The abnormal cells found on a Pap test cannot be seen with colposcopy or found in cells collected from a cervical biopsy. The cone biopsy may be used to diagnose the cause of the abnormal cell changes and remove the abnormal tissue at the same time.
Cervical cancer is suspected based on Pap test results, colposcopy, and cervical biopsy. A cone biopsy can determine the extent, depth, and severity of the cancerous tissue and can guide treatment decisions.
The abnormal tissue cannot be seen with colposcopy but was found in cells collected from a biopsy of the cervical canal, or the abnormal tissue seen with colposcopy extends high into the cervical canal. A cone biopsy is done to remove and examine the abnormal tissue.
The abnormal cells found on a Pap test cannot be seen with colposcopy or found in cells collected from a cervical biopsy. The cone biopsy may be used to diagnose the cause of the abnormal cell changes and remove the abnormal tissue at the same time.
Cervical cancer is suspected based on Pap test results, colposcopy, and cervical biopsy. A cone biopsy can determine the extent, depth, and severity of the cancerous tissue and can guide treatment decisions.
