Site Distribution: SB
Copy Location: / Division of Laboratory Medicine
Anatomic Pathology
Specimen Collection Instructions / SCI-5.7.20.10.3
Version: 3.2
Page 1 of 4
Effective:2017/01/12
E-Authorized by: Director of Lab Medicine / Medical Director

Submission of Renal Biopsies – External Client

This procedure is for use by external clients when submitting renal biopsies for diagnostic evaluation to Sunnybrook.

A completed requisition must accompany the labelled specimen container.

The patients' BRADMA label or a complete, handwritten label must be affixed to all specimen containers before transporting. Clinical Data must accompany the specimen.

Refer toSCI-5.7.20.8 Specimen Identification and Requisitions.

  1. Notify

Contact the Histology Laboratory at (416) 480-4019 providing the patient name, and the name of referring institution as soon as the biopsy has been procured, prepared for submission and is ready for transport.

The operational hours of the laboratory are:

Monday to Friday (except statutory holidays)0800-1700 hrs

Weekendsclosed

Statutory holidaysclosed

Specimens must be received between 0800 – 1400 hours. If you obtain specimens after this time, please call the Sunnybrook Histology Lab for advice on submission and handling.

B.Specimen Submission

Specimen

Renal specimen: The pieces submitted should be representative of each tissue type area. More than 1 core may be submitted for each application. Obvious medulla, fat or capsule should only be submitted for histologic light microscopy.

Preparing the specimen for submission

Materials

Applicator sticks

Scalpel blade (sterile)

Dissecting microscope

Specimen containers

Michele’s Transport Medium (MTM)

Brazil’s fixative

10% Neutral Buffered formalin (NBF)

Brazil’s fixative

Stock solution:

Ethanol, 80% 150mL

Formaldehyde, 37% 60mL

Picric acid 1g

Working solution:

Add 1mL of glacial acetic acid to 14mL stock solution before use.

Note: It is critical to add the glacial acetic acid just prior to procuring the renal specimen.

Procedure

• Transfer cores into the appropriate fixative/medium using the applicator stick (see below).

  1. The needle biopsy material should be divided under a dissecting microscope.
  2. As a rule 70% of the material should go to light microscopy, 20% to Immunofluorescence, and 10% for Electron Microscopy.
  3. Cut the specimen with a sterile dissection blade and submit as follows:
  4. Tissue for Electron Microscopy: a minimum of 3mm in length, a minimum of 2 glomeruli optimal. Place in a vial containing universal fixative. Universal fixative must be colourless.
  5. Tissue for Immunofluorescence: a minimum of 4mm in length, >5 glomeruli optimal. Place in a vial containing Michel's Transport Medium. Michel’s Transport Medium must be colourless and without crystals. Refer to SCI-5.7.20.10.4 Submission of Specimens for Immunofluorescencefor instructions on the preparation of Michel’s Transport Media.
  6. Tissue for Light Microscopy: a minimum of 4mm in length, 10 to 12 glomeruli optimal. Place in a vial ofBrazil’s Fixative. Note: 10%NBFcan be used if Brazil’s fixative not available.

4. Label the specimen container and requisition.

5. Record the fixation start time on the requisition.

6. Transport immediately.

Note:

  • If specimens are not fixed immediately upon procurement, artifactual effects may affect pathologic diagnosis. The specimen for Immunofluorescence, must not be stored at room temperature for longer than 4 hours, longer storage requires refrigeration.
  • Sunnybrook does not supply or Michel’s Transport Media. We will provide Universal Fixative for EM specimens upon request. Please contact the Department of Anatomic Pathology at 416-480-4019 for supplies. Store in the refrigerator and observe the indicated expiry date for storage limitations.

C. Transporting the specimen

Send immediately by courier, for receipt at the laboratory by 1400 hoursto:

Sunnybrook Health Sciences Centre

Department of Anatomic Pathology, Room E410

2075 Bayview Avenue

Toronto, Ontario

M4N 3M5

ATTENTION: RENAL BIOPSY

Note: Transportation and expenses thereof shall be the obligation of the referring institution.

Reference:

Richmond B. Dubosq-Brazil fixative. 2002; [1 screen]. Available at:

Accessed Dec 22, 2016.

Uncontrolled When Printed \ Printed document valid on this date2018-11-14