Lab Test

Kidney Biopsy

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 the reference laboratory.
  • Specimen(s) must be accompanied by a properly completed Pathology Requisition Form, Clinical Data Sheet and Patient Information Sheet provided by Nephropath (Arkana).

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. Dubosq-Brazil Fixative (DB) for in-house biopsy or Zinc formalin for 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: Kidney biopsy tissue. The surgeon or pathologist will separate the specimen for processing. This is the surgeon’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.  OR, if preferred, obtain a renal kit from Histology before the procedure and complete the separation at bedside.

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: A Cytotechnologist or trained Laboratory Assistant 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 zinc formalin, FA buffer, and Glutaraldehyde. The specimen must be delivered to Surgical Pathology immediately by the Cytotechnologist or trained Laboratory Assistant 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 zinc formalin, 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: Electron Microscopy Laboratory technologists 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 DB fixative, 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 zinc formalin, 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.

In-Lab Processing

Specimens in Dubosq-Brazil Fixative (DB) must be transferred to 10% Neutral Buffered Formalin within 4 hours of collection. Outside biopsy specimens should be left in Zinc Formalin for 6 hours before processing.

Farmington Hills

Histology staff will prepare the kit for transport to Nephropath (Arkana) Laboratory.

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 Isopentane).
Tissue for Election Microscopy Studies – Frozen (-20°C/-4°F or below): Indefinitely (Resin Blocks). 

Farmington Hills
Specimen retention time is determined by the policy of the reference laboratory. Contact the Anatomic Pathology Laboratory with any questions.

Laboratory

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

Farmington Hills Anatomic Pathology Laboratory
Specimens are processed and sent to Nephropath (Arkana) Laboratory, Little Rock, AR.

Performed

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.

Test Methodology

Histology testing includes:

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

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

10/23/2019

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This directory currently reflects information only for specimens collected and/or processed at the
Farmington Hills, Grosse Pointe, Royal Oak, and Troy campuses.