Pathology Specimen Handbook

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology by cytogenetics when requested by a pathologist.

Concurrent LOH testing is undertaken by the Genetics and Molecular pathology laboratory

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology by cytogenetics when requested by a pathologist.

Please note recent change in test code to ATS13A (and ATS13AU for urgent requests) 16.10.23.

Attached form to accompany all ADAMTS-13 activity requests.

https://handbook.monashpathology.org/downloads/haem/FOR-HE-147.pdf

Non CMBS test

Please note recent change in test code to ATS13A (and ATS13AU for urgent requests) 16.10.23.

Attached form to accompany all ADAMTS-13 activity requests.

https://monashpathology.org/wp-content/uploads/2024/01/FOR-HE-147.pdf

Non CMBS test

Collect convalescent bleed 14 days after acute sample

Retesting is not required within 7 days.

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology by cytogenetics when requested by a pathologist if indicated following ALK IHC testing.

If IHC is 3+, ALK FISH testing will be performed concurrently with EGFR testing by the Genetics and Molecular pathology laboratory. If IHC is less than 3, ALK FISH testing will only be undertaken if EGFR result is negative.

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology by cytogenetics when requested by a pathologist if indicated following ALK IHC testing.

CSF: minimum volume of 0.5mL

Please note CSF testing for GQ1b autoantibodies is not currently available in Australia.

Please collect via butterflies instead of a vacutainer as there is a possible backflow of the liquid inside the PAXgene if vacutainer is used. Samples can be collected at any time.(Monday-Sunday).

Please ensure that blood for molecular testing for BCRABL is collected in a separate dedicated sterile tube. Molecular specimens must NOT be put through any analysers. If unsure please call the Genetics and Molecular Pathology laboratory.

Tube handling must be minimized to prevent contamination.

Please collect an additional 9mL EDTA whole blood sample. Register as "spare" and send to GMP.

Folloing instructions are only for EDTA collections:

For EDTA tubes collections between Friday 2:30pm and Sunday 12pm must be avoided.

EDTA specimens collected after 12pm on Sundays must be stored at room temperature.

EDTA specimens more than 24 hours old cannot be tested and a recollection will be requested. Sample in Paxgene tube is viable for 3 days at room temparature.  

For EDTA collections that occur externally to the Clayton site, please ensure that specimens reach the Clayton laboratory by 3pm if collected on Fridays.

PAXgene collections: collect via butterflies instead of a vacutainer due to the possible backflow of liquid inside the PAXgene if a vacutainer is used. 

Collections for BCR ABL testing must be collected in a separate dedicated sterile tube and must NOT be put through any analysers. 

Tube handling must be minimized to prevent contamination.

If using a PAXgene tube also collect an additional 9mL EDTA whole blood sample. If PAXgene tubes are not available then collect 1 x 9mL EDTA tube.

Test must be performed within 48 hours of specimen collection. Do not collect blood for this test on days preceding public holidays. Collections on Fridays must arrive at the Clayton laboratory by 2pm and samples collected after this or on a Saturday will not be accepted.

Test requests for rare translocations are referred to SA Pathology and these samples must be accompanied by a completed referral form, link below:

https://www.sapathology.sa.gov.au/testcatfiles/PUB-0556.pdf

Samples must be collected in a separate dedicated sterile tube and must NOT be put through any analysers.

Tube handling must be minimized to prevent contamination.

Sample processing must be commenced within 48 hours of specimen collection. Do not collect blood or bone marrow for this test on days preceding public holidays. Collections on Fridays must arrive at the Clayton laboratory by 2pm and samples collected after this or on a Saturday will not be accepted. 

Samples must be accompained by a completed referral form, link below:

https://www.sapathology.sa.gov.au/testcatfiles/PUB-0556.pdf

Note this test is for BIOTINIDASE not BIOTIN and requires by Chemical Pathologist - please call 9594 4551 for approval.

At least 2 filled blood spot circles.

EDTA whole blood may be used to fill the Guthrie card spots as an alternative collection.

Biotinidase CANNOT share a Guthrie card. Collect separate cards for Acylcarnitine or Amino Acids if required.

Note this test is not for BIOTIN. Biotinidase and Biotin are two different tests. Biotinidase is a Send-away test. 

Both tests require approval by Chemical Pathologist/Registrar - please call 9594 4551. 

Please fill at least 2 blood spot circles on the Guthrie card. 

EDTA whole blood may be used to fill the Guthrie card spots as an alternative collection.

Biotinidase CANNOT share a Guthrie card with any other tests. If acylcarnitine or Amino Acids are also requested,  collect separate cards. 

Other specimen type: 0.5 mL CSF or Brain tissue.

Blood samples requires a dedicated blood tube

Retesting is not required within 7 days.

BKV PCR is performed in-house on PPT plasma only

All other specimen types are referred to VIDRL under send-away procedure 'BKDNA1'

JC PCR is also referred to VIDRL under send-away code 'BKDNA1'

Retesting is not required within 7 days.

Tuesdays early mornings only.

Specimen must be collected by 8.30am and sent immediately to Pathology Reception for courier to reach The Royal Children's Hospital before 11am on Tuesdays only.

Tuesdays early mornings only.

Specimen must be collected by 8.30am and sent immediately to Pathology Reception for courier to reach The Royal Children's Hospital before 11am on Tuesdays only. 

Specimen requirements for gene testing are listed under PRION PROTEIN GENE testing.

Obtain a National Dementia Diagnostics Laboratory (NDDL)
Cerebrospinal Fluid (CSF) Specimen Data Sheet form and CJD tube from Microbiology Clayton.

A miminum volume of 2.5ml is required. 

CSF must be clear and colourless and NOT spun

Specimen requirements for gene testing are listed under PRION PROTEIN GENE testing.

Collect blood in a PPT tube (in separate sterile tube) for adults and in an EDTA paediatric tube for neonates, Urine, Saliva Swab (under tongue), Eye Swab, Amniotic Fluid. 200ul of CSF(neat sample preferred as supernatant fluid is less sensitive).

Collect blood in a dedicated PPT tube  for adults and in an EDTA paediatric tube for neonates

200ul of CSF(neat sample preferred as supernatant fluid is less sensitive).

Collect Saliva Swab under tongue

Random specimen

A deceased foetus is taken to the cool room in the mortuary.

Paperwork required is:

1) Notification of Death

2) SIGNED Death Certificate.

3) Request for non-Coronial Post Mortem Examination form

4) Referral for Post Mortem form

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology by cytogenetics when requested by a pathologist.

Testing is performed in cases where IHC is 2+.

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology by cytogenetics when requested by a pathologist.

Sample must be collected on Mon-Thurs only.  (Not on a public holiday or public holiday eve).

Sample must be received at the Royal Children's Hospital within 24 hours of collection.

Please collect an EDTA (2mL minimum) sample if no FBE tube is collected at the same time.

A single Heparin Whole Blood (no gel) tube (5mL adult / 2mL minimum) is sufficient to cover the following tests sent to RCH:

- High Sensitivity B cells

- HLA-DR expression

- Th17 cells

- T follicular helper cells (Tfh)

A separate Heparin Whole Blood (no gel) tube is required for the following tests:

- Lymphocyte Subsets (CD4 count) (collect Mon-Sat) - Performed in-house

- Double Negative T-cells (DNT)  (collect Mon-Sat) - Performed in-house

- Memory B-cells (collect Mon-Sat) - Performed in-house

- Naive T-cells  (collect Mon-Sat) - Performed in-house

- T-regulatory cells  (collect Mon-Sat) - Performed in-house

- T cell proliferation (collect between 3pm on Mon to 830am on Tues) - Sent to RCH on Tuesdays only.

Sample must be collected after midday on Mon-Thurs only (avoid collection on a public holiday or public holiday eve).

Sample must be received at the Royal Children's Hospital within 24 hours of collection.

Please collect an EDTA (2mL minimum) sample if no FBE tube is collected at the same time.

A single Heparin Whole Blood (no gel) tube (5mL adult / 2mL minimum) is sufficient to cover the following tests sent to RCH:

- High Sensitivity B cells

- HLA-DR expression

- Th17 cells

- T follicular helper cells (Tfh)

A separate Heparin Whole Blood (no gel) tube is required for the following tests:

- Lymphocyte Subsets (CD4 count) (collect Mon-Sat) - Performed in-house

- Double Negative T-cells (DNT)  (collect Mon-Sat) - Performed in-house

- Memory B-cells (collect Mon-Sat) - Performed in-house

- Naive T-cells  (collect Mon-Sat) - Performed in-house

- T-regulatory cells  (collect Mon-Sat) - Performed in-house

- T cell proliferation (collect between 3pm on Mon to 830am on Tues) - Sent to RCH on Tuesdays only.

Please collect 2x3mL EDTA tubes for adults and children for HLA-B27.  This test requires separate tubes and cannot be added onto an FBE tube.

Note that the Lithium Heparin tube indicated in EMR and in Medipath is out of date (as of 01/01/2023).  A request for these to be updated has been logged.  If a lithium heparin tube has been collected, please send to Immunology.  For further clarification, please contact the Immunology lab on 9594 3587 (x43587).

For Coeliac Disease HLA typing (HLADQ2 / HLADQ8), refer to COELIAC GENETIC TEST.

For HLA Tissue Typing (Transplant patients), refer to entry HLA TISSUE TYPING (TRANSPLANT PATIENTS)

For other HLA typing (including HLA B57), refer to entry HLA TYPING.

For Coeliac Disease HLA typing (HLADQ2 / HLADQ8), refer to COELIAC GENETIC TEST.

For HLA Tissue Typing (Transplant patients), refer to entry HLA TISSUE TYPING (TRANSPLANT PATIENTS)

For other HLA typing (including HLA B57), refer to entry HLA TYPING.

Please collect the specimen in a separate tube. The specimen must not be used for other testing. This is a DNA test and removal of specimen for other tests may cause the specimen to become contaminated. The same tube can be used for the JAK2 ex 12 test.

Please collect the specimen in a separate tube. The specimen must not be used for other testing. This is a DNA test and removal of specimen for other tests may cause the specimen to become contaminated. The same tube can be used for the JAK2 exon 12 test.

Please phone Chemical Pathology Registrar on (03) 9594 4551 for test request approval.

Samples collected close of business Friday or prior to public holidays, store 4C.

Samples collected close of business Friday or prior to public holidays, store at 4C.

Do NOT spin (centrifuge) or separate.

Specimen must be collected in a separate tube and must not be passed through an analyser. 

Slip must state LNMP, H X, DOWNS NTD, DIABETES, RACE

Ist Trimester Testing: 11 - 13 weeks (13 weeks + 6 days cutoff)

2nd Trimester Testing: 14 - 20 weeks (20 + 6 days cutoff).

                                            15 - 17 weeks preferred

NOTE: If only PE Biochemistry is requested then refer to pre-eclampsia in the handbook. QUAD will not need to be registered in this instance.

Non-CMBS test

Slip must state LNMP, H X, DOWNS NTD, DIABETES, RACE

Ist Trimester Testing: 11 - 13 weeks (13 weeks + 6 days cutoff)

2nd Trimester Testing: 14 - 20 weeks (20 + 6 days cutoff).

                                            15 - 17 weeks preferred

Non-CMBS test

Slip must state LNMP, H X, DOWNS NTD, DIABETES, RACE

Ist Trimester Testing: 11 - 13 weeks (13 weeks + 6 days cutoff)

2nd Trimester Testing: 14 - 20 weeks (20 + 6 days cutoff).

                                            15 - 17 weeks preferred

Non-CMBS test

Slip must state LNMP, H X, DOWNS NTD, DIABETES, RACE

Ist Trimester Testing: 11 - 13 weeks (13 weeks + 6 days cutoff)

2nd Trimester Testing: 14 - 20 weeks (20 + 6 days cutoff).

                                            15 - 17 weeks preferred

NOTE: If only PE Biochemistry is requested then refer to pre-eclampsia in the handbook. QUAD will not need to be registered in this instance.

Non-CMBS test

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology when requested.

Fresh tissue is not acceptable for this test. Testing will only be performed on FFPE slides.

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology when requested.

Fresh tissue is not acceptable for this test. Testing will only be performed on FFPE slides by the external laboratory performing the test.

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology when requested by a pathologist.

Fresh tissue is not acceptable for this test. Testing will only be performed on FFPE slides.

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology when requested.

Fresh tissue is not acceptable for this test. Testing will only be performed on FFPE slides.

No fresh tissue is required for this request. Histopathology staff will cut spare sections of the paraffin embedded tissue and send for testing to cytogenetics.

This is a FISH test which must be ordered by a pathologist. Testing is performed on FFPE tissue sections organised through histopathology when requested by a pathologist.

Fresh tissue is not acceptable for this test. Testing will only be performed on FFPE slides.

This is a send away test for tumour cytogenetics on paediatric patients. A fresh specimen in RPMI medium is required for this request.

This is a send away test for tumour cytogenetics on paediatric patients. A fresh specimen in RPMI medium or normal saline is required for this request.

Frozen sample via the tissue bank are also accepted.