Lymphoma work-up can only be performed on unfixed (“fresh”) tissue.
The tissue can be taken from any site/organ but most often is lymph node.
Gently blot the freshly cut surface of the tissue, in order to remove blood or saline. Press a clean slide to the cut surface, at least 2-3 times on adjacent areas of the slide. Prepare a total of four slides in this manner. Fix two slides in alcohol and stain with hematoxylin-eosin or other stain as requested by the attending pathologist. Air-dry the other two slides and stain with Diff-Quik stain.
If the imprints are low in cellularity, you may gently scrape the cut surface of the slice with a sharp blade, then smear out the scraped material onto a clean slide and stain as above.
Flow cytometry: submit a portion of tissue in RPMI or other cell culture medium for immunophenotyping. Flow cytometry is generally not helpful in the diagnosis of Hodgkins disease, so consult with the attending pathologist before submitting tissue if Hodgkins disease is suspected.
Immunohistochemistry: consult with the attending pathologist whether to pre-order unstained slides for immunohistochemistry studies.
Gene rearrangement studies: snap freeze a portion and place in the -70°C freezer. This will be held in case it is needed.
Tissue/tumor bank: fill out an information sheet. All remaining tissue will be submitted to the tissue/tumor bank after the case is signed out.
Fix the remainder of the tissue in formalin and submit as indicated for routine histologic sections.
Received without fixative/in formalin, labeled with patient's name, medical number and “_____”, is a __ x __ x __ cm portion of yellow fibroadipose tissue containing __ (number) discrete/matted lymph nodes ranging from __ cm to __ cm. The lymph node capsules are _____ (intact, inapparent). Each lymph node has a _____ (color, fleshy, bulging, soft, firm, multinodular, necrotic, hemorrhagic) cut surface. __ (number) touch preps are prepared and stained with _____ stain. A portion of the specimen is submitted for flow cytometry (and microbiologic culture), and is held for possible gene rearrangement studies. Representatively submitted for routine histology in cassette #__ - #__.