Lymph Node Biopsy Collection

NAME OF PROCEDURE

Lymph Node Biopsy Collection

CPT CODE

To be assigned by pathology:

  • 88305 – Level IV:Surgical Pathology, gross and microscopic examination
  • 88312 – Special Stains for microorganisms (if needed), each stain
  • 88342 – Immunohistochemistry (including tissue immunoperoxidase), each stain

NOTE:

Notify the laboratory @Southeastern Pathology Associates (SEPA) in Brunswick, GA. (912-261-2669) in advance, when a specimen for flow cytometry or T-cell gene rearrangement is being collected and transported to via the courier network.

SPECIMEN

Lymph node or other tissue suspected of harboring lymphoma or to “rule-out” lymphoma

CONTAINER

  1. Place specimen in formalin only if diagnosis is metastatic carcinoma.
  2. If diagnosis is unknown, place the specimen in a sterile container within a saline soaked gauze or sponge.  I can also be placed in RPMI media.  If the specimen is sent fresh or in RPMI media, label the specimen with <Refrigerate Specimen> label.
  3. If cultures are needed they are best taken in the operating room where a sterile field exists.  A piece of tissue should be placed in culture tubes or sterile containers for anaerobic and aerobic culture with request for smear, culture, anaerobic culture, acid-fast bacilli (AFB), or fungus as needed.
  4. Label the container(s) with patient’s name, date, time of collection, and type of specimen.

Bring the specimen to the laboratory immediately.  REGFRIGERATE FRESH OR RPMI SPECIMENS PROMPTLY!!!

REQUEST FORM

Complete a <Anatomical Pathology Requisition>.

Complete a culture request form is the specimen is to be cultured for organisms.

CAUSES FOR REJECTION

Specimen container not properly labeled.

Dried specimen

LIMITATIONS

Formalin fixed specimens cannot be used for culture, imprints, flow cytometry, cytogenetics, or T-cell gene rearrangement studies

ADDITIONAL INFORMATION

Correlation with peripheral blood, bone marrow, and other clinical laboratory studies is often desirable and sometimes indispensable.

Flow cytometry on dissociated tissues or body fluid is often utilized instead of immunohistochemistry for cell marker analysis.  This methodology offers a more quantitative approach to cell markers but only at the critical expense of destroying the immunoarchitecture of tissues.

The specimen may be sent as a fresh, entire specimen and the pathologist will divide appropriate samples for flow cytometry or other tests as needed but the specimen must remain refrigerated prior to shipment and a <Refrigerate Specimen> label affixed for transport to the laboratory.

Properly acquired fresh tissue is necessary to document:

  • Monoclonal B-cell proliferation (B-cell lymphoma) by flow cytometry
  • T-cell clonal proliferation (T-cell lymphoma) by T-cell gene rearrangement