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Kidney Biopsy

Renal Biopsy

Department

Histology

Instructions

Farmington Hills

• The Anatomic Pathology Laboratory must be notified at least 12 hours before the planned procedure 248-471-8247.
•  The specimen must arrive in the Anatomic Pathology Laboratory by 12:00 p.m. to allow for clerical processing and shipment to Royal Oak.

• Specimen(s) must be accompanied by a properly completed Pathology Requisition Form, Clinical Data Sheet and Patient Information Sheet. 

Dearborn

• Notify the laboratory at least 1 hour in advance 313-593-7911 between the hours of 7:00 am and 12:00 pm.
• The specimen MUST arrive in the Laboratory by 12 pm to allow for proper handling/fixation and shipment to Royal Oak for processing.

Taylor, Trenton & Wayne

• The Anatomic Pathology Laboratory must be notified at least 24 hours before the planned procedure.  See Site Contact numbers below.

• The specimen MUST arrive in the Laboratory by 12 p.m. to allow for proper handling/fixation and shipment to Dearborn/Royal Oak for processing.

Specimen Collection Criteria

Collect: A minimum of 3 portions of tissue are required to complete all kidney biopsy procedures. One portion should be placed in each of the following solutions:

1. 10% NBF for in-house and outside biopsy, for light microscopy studies.

2. FA Buffer for immunofluorescence studies.

3. Glutaraldehyde for Electron Microscopy studies. 

Collection Notes

• Specimen container must be labeled properly with the patient's full name (first and last), date of birth, hospital number including visit, and specimen source. 
• Each specimen must be accompanied by a Beaumont Laboratory Form #6624, Progress Notes Operative Form #5113 and/or Anatomic Pathology Form, including the patient's full name, date of birth, patient's social security number (only last 4 of SSN), hospital number including visit number, surgeon and/or clinician name, specimen source (including the size), pre-op diagnosis, and a brief pertinent clinical information. 
• The time specimen was placed into fixative must be written on container and requisition. The specimen must be delivered to Surgical Pathology immediately since the timing of fixation must be controlled. 

Farmington Hills
Collect: Trained laboratory personnel will go to radiology to assist in specimen collection.

Taylor, Trenton & Wayne
Collect: Kidney biopsy tissue. The surgeon, physician, pathologist or PA will separate the specimen for processing. This is the surgeon’s/physician's choice:

1. If the pathologist is performing the separation, the specimen is to be submitted fresh, in a properly labeled container, on a saline dampened Telfa.

2. If the surgeon is performing the separation, bring a fresh specimen in a properly labeled container, on a saline dampened Telfa, to Histology where a pathologist or pathology assistant will assist the alloquation.

Specimens must be delivered fresh (without fixative), STAT, to the Anatomic Pathology Laboratory.

Physician Office/Draw Specimen Preparation

• Arrange for transportation to the Laboratory prior to specimen collection. Specimen must be sent to the Laboratory immediately after collection in appropriate containers, as described above. 
• Specimens can be picked up by a Beaumont Laboratory courier and may also be sent via a courier/transportation service chosen by the facility sending the specimen. Please contact Surgical Pathology prior to sending the kidney biopsy at 248-898-9042. 

Preparation for Courier Transport

Transport: Biopsy specimens prepared as described above, at room temperature (20-26°C or 68-78.8°F). Specimens are hand delivered to Surgical Pathology.

Rejection Criteria

• Any missing information will delay processing and final diagnosis. 

Farmington Hills

• Specimens placed in fixative and/or an improper solution.
• Specimens not accompanied with required paperwork described in Instructions above.

Inpatient Specimen Preparation

• Farmington Hills: Trained laboratory personnel is called to the procedure site with a microscope cart to assist a pathologist to view the specimen under microscopic examination to determine whether there is sufficient renal cortex in the specimen for further examination. The pathologist records his/her initial impression and guides the radiologists as to the necessity of additional core biopsies to ensure an adequate specimen is obtained. The pathologist divides up the core biopsies according to the instructions in the kit. A minimum of one piece is submitted into each 10% NBF, FA buffer, and Glutaraldehyde. The specimen must be delivered to Surgical Pathology immediately by the trained laboratory personnel along with paperwork where arrangements for courier transport to Royal Oak are handled.
• Grosse Pointe: Pathologist's Assistant is called to Ultrasound to assist in placing specimens in correct containers/fixatives as instructed in the biopsy kit. A minimum of one piece is submitted into each 10% NBF, FA buffer, and Glutaraldehyde. The specimen must be delivered to Surgical Pathology immediately by the Pathologist's Assistant. Paperwork and the specimens are taken to Specimen Reception where arrangements for courier transport to Royal Oak are handled.
• Royal Oak: Histotechnologist assist doctors during a kidney biopsy by dividing the biopsy into 3 sections according to instructions provided in the biopsy kit. A minimum of one piece is submitted into each 10%NBF, FA buffer, and Glutaraldehyde. The specimen must be delivered to Surgical Pathology immediately.
• Troy: A Cytotechnologist is called to Ultrasound to assist in placing specimens in correct containers/fixatives as instructed in the biopsy kit. A minimum of one piece is submitted into each 10% NBF, FA buffer, and Glutaraldehyde. The specimen must be delivered to Specimen Reception immediately by the Cytotechnologist along with paperwork where arrangements for courier transport to Royal Oak are handled.
• Dearborn: Trained laboratory personnel are called to radiology to assist in placing the specimen cores into the correct specimen containers/fixatives as instructed in the biopsy kit received from Royal Oak. There must be a minimum of three cores collected. Extra cores are placed into FA buffer. The specimen is delivered to histology immediately for accessioning and then packing/shipping via STAT courier to Royal Oak with the required paperwork / patient history.
• Trenton & Wayne: Histology Lab provides the collection kit to radiology. Radiology puts the collected specimen cores into the correct specimen containers/fixatives as instructed in the biopsy kit received from Royal Oak. There must be a minimum of three cores collected. Extra cores are placed into FA buffer. The specimen is delivered to histology immediately for accessioning and then packing/shipping via STAT courier to Royal Oak with the required paperwork / patient history.
• Taylor: Does not perform this collection outside of the OR. 

In-Lab Processing

Specimens must fix in 10% Neutral Buffered for minimum of 2 hours.

Farmington Hills
Pathologist Assistant will prepare the kit for transport to Royal Oak. 

Storage

Specimen Stability for Testing:
Specimens are processed immediately upon receipt in the Laboratory.

Specimen Storage in Department Prior to Disposal:
Tissue for Light Microscopy – Minimum of 10 years (Paraffin Block).
Tissue for Immunofluorescence – Frozen (-20°C/-4°F or below): 1 year (In cassette).
Tissue for Election Microscopy Studies – 21 years (Resin Blocks). 

Laboratory

Royal Oak Surgical Pathology/Histology Laboratory
All specimens are processed at Royal Oak, however specimens may be procured at Troy, Grosse Pointe, Farmington Hills, Dearborn, Taylor, Trenton, and Wayne.  

Performed

Royal Oak
Monday – Saturday, 6:00 am – 6:00 pm.
Results available generally within 2 business days for light microscopy and immunofluorescence studies.

Farmington Hills
Monday – Friday, 7:00 am – 12:00 pm.
Results available within 7 days.

Dearborn
Monday – Friday, 7:00 am – 12:00 pm.
Results available within 7 days.

Taylor, Trenton & Wayne
Monday – Friday, 7:00 am – 12:00 pm.

Grosse Pointe
Monday – Friday, 7:00 am – 12:00 pm.

Troy
Monday – Friday, 7:00 am – 3:00 pm.

Test Methodology

Histology testing includes:

• Hematoxylin and Eosin Staining
• Masson's Trichrome Stain
• Periodic Acid Schiff Stain
• Jones Silver Stain.

Immunohistochemical testing includes:

• Native kidney biopsies are stained with IgA, IgG, IgM, C3, C1q, Kappa and Lambda antibodies
• Transplant kidney biopsies are stained with IgA, IgG, IgM, C3, C1q, Fibrinogen, Kappa, Lambda, and C4d antibodies

Electron Microscopy Diagnostic Studies.

Farmington Hills
Varies dependent on testing performed.

Interpretation

Microscopic diagnosis of prepared slides.

Farmington Hills
By report.

CPT Codes

Varies dependent on testing performed. Please contact the Laboratory with questions.

Contacts

Last Updated

5/30/2023