Diagnostic and Molecular Pathology

The Diagnostic and Molecular Pathology department includes Histology, the Molecular Cell Biology Unit and Cytology. Our service is consultant-led with approximately 70 medical, scientific and support staff.

Opening times

Laboratories:

  • Monday to Friday: 08:30 to 17:00

DMP Office:

  • Monday to Friday: 08:30 to 17:00

EUS/EBUS (Endoscopic and endobronchial ultrasound) (ROSE) rapid on site evaluation Fine Needle Aspiration (FNA) service.

Adequacy of the sample is assessed within the clinical setting. Samples include; Bronchial and Mediastinal lymph nodes, adrenal, GI Lesions, liver, pancreatic FNAs and Head and Neck FNAs.

Clinic times Clinic
  • Mondays 14:00 to 17:00
  • Fridays 15:00 to 17:00
EUS
  • Tuesdays 14:00 to 17:00
  • Thursdays 09:00 to 13:00
EBUS
  • Thursday 14:00 to 17:00
Head and Neck (ENT)

Out of hours

There are no provisions for consultant cover out of hours within DMP.

Histology

The Histology service analyses samples to help diagnose, predict and screen, including:

  • Surgical
  • Frozen sections including Mohs
  • Post mortem tissue specimens
  • Special stains
  • Electron microscopy, in conjunction with the University of Plymouth
  • Screening service as part of the NHS Cancer Screening Programmes (Bowel and Breast).

Molecular & Cell Biology Unit

The molecular and cell biology unit provides specialist testing in the following areas:

  • Routine immunohistochemistry
  • Direct immunofluorescence
  • HER2 testing for the Far South West Peninsula
  • Molecular techniques such as in-situ hybridisation (CISH, DDISH and FISH)
  • One Step Nucleic Acid amplification (OSNA)
  • EGFR molecular testing
  • Support for Research, Development and Innovation including clinical trials

Cytology

Cytopathology provides a diagnostic cytology service (non-gynaecological) only as all NHS Cervical Screening programme samples are referred to Exeter Cytology Department.

Cervical Cytology

Cervical Cytology provides cervical screening service for the NHS Cervical Screening Programme. Liquid based Cytopathology is used in conjunction with Microbiology to provide HPV testing for patients from Cornwall and Plymouth.

Diagnostic Cytology

Diagnostic Cytology provides:

  • Fine Needle Aspiration Cytology (FNAC) for head, neck and breast
  • Liquid Based Cytology (LBC) for bronchial, oesophageal and common bile duct samples
  • Body fluid and aspirate cytology
  • EUS/EBUS (Endoscopic and endobronchial ultrasound) FNA service. Adequacy of the sample is assessed within the clinical setting. Samples include; Mediastinal lymph node FNA’s (transbronchial  (EBUS) and transesophageal (EUS)) and Pancreatic FNA’s

Specimen transport for DMP specimens

Histopathology samples must never be delivered from GP’s or hospitals via Public Taxi’s. Only to be transported through NHS Couriers.

Specimen Type Transportation details Information / special handling needs
LBC Cervical Samples Samples from GP’s / Community Clinics – The samples are placed into the courier transportation boxes and delivered daily to the laboratory in accordance with Courier policies and procedures. Samples from Colposcopy are transported to the laboratory by porter. The bags are collected daily and sent to Exeter laboratory. All LBC vials must be sent in orange transportation bags designated for Exeter cytology laboratory

It is vital that they are sent to the laboratory on a daily basis
(excluding weekends)

CSF Specimen degrades quickly and should arrive in the laboratory within one hour of collection.
The sample must arrive at the lab by 4pm to allow for processing time
All specimen containers must be placed into Cellular Pathology specimen bag with the completed request from attached prior to transportation
Breast FNAC’s Mermaid Centre Make sure the slide box is tightly sealed, an elastic band can be used, to prevent the slides from breaking during transportation in the air tube system All specimen containers must be placed into Cellular Pathology specimen bag with the completed request from attached prior to transportation
Bronchoscopy Samples Transported via Porter to the laboratory.
The laboratory is sent a patient list for each clinic. Tuesday’s samples should arrive in the laboratory by 16.30. Thursday’s samples should arrive in the laboratory by 14.00. If samples have not been transported to the lab within the time frame, then a member of cytology staff contacts Endoscopy. To allow for processing time prior to Multi-Disciplinary Team meeting.
Clinic times
Tuesday PM
Thursday AM
If Cytology and Histology samples are taken then samples should be placed into separate specimen bags with a completed request form for each department.
Diagnostic Cytology samples (RCHT) Transported via porter or tube to the laboratory Labelled Glass slides must be placed into a slide carried box.
All specimen containers must be placed into Cellular Pathology specimen bag with the completed request from attached prior to transportation
Diagnostic Cytology samples (External)
Including: Synovial Fluids for Crystal analysis
Via Courier service All specimen containers must be placed into Cellular Pathology specimen bag with the completed request from attached prior to transportation
Head and Neck Clinic FNAC Transported via porter or tube to the laboratory.
(please make sure the slide box is tightly sealed, an elastic band can be used, to prevent the slides from breaking during transportation in the air tube system)
Labelled slides must be placed into plastic slide boxes, placed into a specimen bag accompanied by a completed request form.
Needle washings can be placed into saline. These must be received in the lab within 24 hours to prevent degradation of the sample
EUS/EBUS FNA BMS attendance at the clinic – specimens transported to the laboratory by these staff As directed by staff in attendance at clinic
Routine Histology All histology specimens should be transported in 10% neutral buffered formalin (DO NOT use Saline). 60ml pre-filled biopsy pots are available by calling the Microbiology Consumables Order Line. Telephone 01872 254966, 24hr answer phone service. The information requested will be your name, telephone number, location, items required and quantity. Hospital theatres, RAF St Mawgan, RNAS Culdrose and Bodmin Treatment Centre (BTC) can obtain a range of empty pots in various sizes from the histology department. Volume of 10% formalin must be 5 x the volume of the specimen.
Under no circumstances must specimens containing formalin be sent by the air transport tube or Royal Mail Postal Service.
Histopathology samples must never be delivered from GP’s or hospitals via Public Taxi’s. Only to be transported through NHS Couriers.
Renal specimens Lab staff will deliver the Hanks Medium ready for use on request. They will retrieve the specimen on phone call from the renal physicians. Un-used specimen pots must be collected by laboratory staff and NOT used. Must be booked in advance by phoning ext. 2576. Samples transported in Hanks medium obtained from laboratory.

Products of Conception / Termination of Pregnancy These specimens must be received in 10% buffered formalin Tissue samples less than 14 weeks gestation requiring histology should be sent to the histology department. Outside of working hours these should be stored in the ward’s specimen fridge and delivered to histology on the next working day. These must be accompanied by a histology request form and a ‘Certificate of Medical Practitioner or Midwife in Respect of Fetal Remains’ completed by doctor or midwife where written consent has been obtained for collective cremation or private arrangements.

Tissue samples which are between 14 and 24 weeks gestation should be sent to the mortuary accompanied by the ‘Deceased Baby Care Record’, a unique Typenex ‘Mortuary Identification Band’, and a ‘Certificate of Medical Practitioner or Midwife in Respect of Fetal Remains’ completed by doctor or midwife where written consent has been obtained for collective cremation or private arrangements.

These forms on completion indicate what funeral arrangements are required once the histology has been performed.

These requirements are in accordance with the Human Tissue Authority.

The forms are available on the RCHT document library as appendices of the Policy – Procedure for the Sensitive Disposal of pre-24 week Fetal Tissue.

Termination of Pregnancy These specimens must be received in 10% buffered formalin Termination of Pregnancy specimen’s pre-24 week’s gestation which do not require histology must be sent to the histology department accompanied by a ‘Certificate of Medical Practitioner or Midwife in Respect of Fetal Remains’ completed by doctor or midwife where written consent has been obtained for collective cremation or private arrangements. All specimens must also be listed on a ‘Products of Conception Proforma’.
Such specimen types will not be accepted/processed without the correct accompanying documents.
These requirements are in accordance with the Human Tissue Authority.
The forms are available on the RCHT document library as appendices of the Policy – Procedure for the Sensitive Disposal of pre-24 week Fetal Tissue.
Dental specimens Make arrangements with local GP for specimens to be collected by RCHT courier service. Specimen pots must be contained within sealed bag attached to specimen request card.
Skin Biopsies for Immunofluorescence Transported in Michel’s medium obtainable from laboratory with 24hours notice. Must be kept at room temperature and NOT refrigerated.
Multiple bowel biopsies Acetate strips are available from the histology department. (strips cut 12 squares on the longer edge and 10 on the shorter). The biopsies should be placed along one edge of the strip placing the first biopsy at the diagonal end of the strip. Biopsies should be placed one per square and place acetate strip in labelled biopsy pot
Small Biopsies Cell safes are available from the histology department Biopsies should be placed in the deeper side of a cell safe and clicked shut and then place cell safe in labelled biopsy pot
Needle cores (prostate, breast etc.) Biopsy insert papers are available from the Histology department Needle cores to be placed directly onto cassette insert paper and then place paper in labelled biopsy pot
Frozen sections Must be booked in advance with histology department.
Specimen Must be received dry (not in formalin). Must be delivered immediately to the histology department and handed to a member of staff.
Portering or Theatre staff delivering specimens must hand the sample to a member of staff in Histology. Specimens must not be left in reception areas. Telephone/Pager number must be on request form to enable immediate reporting of results by telephone.

Key Factors affecting Performance or interpretation of histology

  • Insufficient volume of fixative
  • Inappropriate fixation time (24-48hrs optimal)
  • Specimen for frozen section/direct immunofluorescence MUST NOT be placed in formalin.
  • Dry specimens left in reception areas.
  • Renal specimens being placed in formalin or incorrectly stored Hanks.
  • Extreme hot/cold temperatures of formalin.

Key Diagnostic and Molecular Pathology Contacts

Head of Department
Pathology Specialty Director

Dr James Garvican (Consultant Histopathologist)
01872 252655
j.garvican@nhs.net

Head Biomedical Scientist for Diagnostic and Molecular Pathology

Stephen Davison
01872 252798
sdavison1@nhs.net

Lead Biomedical Scientist

Valerie Rodd
01872 25 2549

valerie.rodd@nhs.net

Histology Office Manager

Natalie Blewett
01872 252550
natalie.blewett@nhs.net

Google Translate

Text Size

Change font

Contrast