Made with Xara © Arkansas Pathology Associates 2010 Flow Cytometry Specimens Specimen Collection, Preservation, and Transportation Practice aseptic techniques to collect blood from patient’s arm.  Label all specimens with patient’s complete name, collection date and time, and initials of person collecting specimen.  All EDTA samples must contain at least 1mL of whole blood, well mixed to prevent clotting.  Please include all pertinent clinical information. Platelet Antibodies Collect 1-2 purple top tubes and store at room temperature.  Do not add to cytochex.  Send to the laboratory at room temperature. CD4 Panel Collect 1-2 purple top tubes and store at room temperature.  Do not refrigerate.  If specimen is collected on Friday afternoon after flow cytometry is closed, please add 1 mL of well-mixed purple top tube to a vial of cytochex.  Mix and refrigerate.  Send CBC with diff.  Must have WBC and lymph%.  Please make a peripheral blood smear.  Treat the day before a holiday as a Friday and process specimen accordingly. CD4/CD8 Panel (or T4T8 Panel or T lymphocyte subsets or T cell studies, Immunophenotyping of lymphyocytes) Collect 1-2 purple top tubes and store at room temperature.  Do not refrigerate.  If specimen is collected on Friday afternoon after flow cytometry is closed, please add 1 mL of well-mixed purple top tube to a vial of cytochex.  Mix and refrigerate.  Send CBC with diff.  Must have WBC and lymph%.  Please make a peripheral blood smear.  Treat the day before a holiday as a Friday and process specimen accordingly. CLL, HCL, small lymphocytic lymphoma, cell surface markers, flow cytometry on peripheral blood, acute leukemia on peripheral blood Collect 1-2 purple top tubes and store at room temperature.  Do not refrigerate.  If specimen is collected on Friday afternoon after flow cytometry is closed, please add 1 mL of well-mixed purple top tube to a vial of cytochex.  Mix and refrigerate.  Send CBC with diff.  Must have WBC and lymph%.  Please make a peripheral blood smear.  Treat the day before a holiday as a Friday and process specimen accordingly. Bone Marrows for Flow Cytometry Make sure bone marrow aspirate is in an EDTA tube, mix and store at room temperature.  Send a purple top tube peripheral blood if available, peripheral blood smear (unstained), and most recent CBC results. Tissues for Flow Cytometry Fresh tissue should be placed in MEMS soution (stored in refrigerator) as soon as possible.  Label and transport after refrigerated. NOTE:  MEMS solution and cytochex is available in APA Gross Lab or Flow Cytometry.  MEMS solution should be refrigerated. Chromosome Analysis Solid Tissue (Skin, Abortus, Products of Conception) Test Synonym Chromosome Analysis, Cytogenetic Analysis, Karyotyping CPT Code 88233-Cutlure Initiation 88262-Chromosome Analysis 88291-Interpretation and Report Turnaround Time 10-15 Days Methodology Analysis of cultured cells using G-banding Specimen Requirements Products of conception, chorionic villus, fetal tissue, 1 cm skin biopsy or other solid tissue in RPMI Cause of Rejection Specimen exposed to extreme temperature, anticoagulant toxic to cells, insufficient number of cells, specimen exposed to formalin or other fixative. Specimen Stability Specimen stable for 48 hours at 18-25°C Storage and Handling Ship ambient overnight and for Saturday delivery.  Ship Saturday for Monday delivery if sample is protected from temperature extremes. Reference Range 46, XY:  normal male/46, XX:  normal female Bone Marrow Fixation and Handling Materials Needed 1.  Gloves, lab coat, and eye protection. 2.  Tissue container which will hold the specimen. 3.  Acetic Zinc Formalin. 4.  Transport bag. 5.  Frosted end slides for blood smears. 6.  Bone marrow study or differential slide evaluation requisition slip, which includes blood indices, iron levels, etc. 7.  EDTA and Sodium Heparin collection tubes. Bone Marrow Specimen Collection  1.  Wear gloves, lab coat, and eye protection.  2.  Properly label specimen container with patient’s name and source of specimen.  3.  Put core biopsy in Acetic Zinc Formalin (AZF).  4.  Aspirate marrow  5.  Place 1 to 2 mL in EDTA (lavender top) tube and 1 to 2 mL in Sodium Heparin (green top) tube and mix; we can make smears from this.  Allow <0.5 cc of marrow aspirate to clot in syringe.  Remove plunger of syringe and scrape clotted marrow into a vial of AZF.  6.  Transport with wet ice or cool pack in hot summer months.  DO NOT FREEZE.  7.  Always send peripheral blood smear and copy of CBC report (if there are leukemia cells or other abnormal cells in the peripheral blood, 1 mL of fresh blood in cytochex solution would be helpful).  8.  Please send pertinent clinical information.  This will enable us to more rationally and economically select antibodies.  9.  If you have questions, call Dr. Jim Waldron (501) 552-2956 or any other pathologist at (501) 552-2966. 10. Complete the requisition with the following information:  Patient’s name, age, date of birth, SSN, and gender Address Doctor’s office or hospital and phone number Insurance information Relevant clinical history Source of tissue Doctor’s signature Peripheral blood indices, iron levels, etc       11. Collect a peripheral blood smear to be sent along with the aspirate and biopsy. 12. Label all slides with the patient’s name Transport Specimen 1.  Place AZF specimens in one transport bag and all other tubes and slides in a second bag.  Please staple bags together. 2.  Place the requisition in the pouch outside either of the sealed bags. 3.  Transport specimens to the laboratory by courier. 4.  If specimens are to be mailed, contact the laboratory for instructions. Differential Slide for Evaluation Materials Needed 1.  Microscope slides 2.  Requisition 3.  Slide holder 4.  Transport bag Specimen Collection 1.  Make peripheral blood smear on slides.  Please do not stain. 2.  Label slides with patient’s name. 3.  Place slides into slide holder. 4.  Label holder with patient’s name and specimen. 5.  Include a copy of the most recent CBC results and any other pertinent lab results. 6.  Complete the requisition with the following information: Patient’s name, age, date of birth, SSN, and gender Address Doctor’s office or hospital and phone number Diagnosis Brief patient history Comments Transport Specimen 1.  Place slides and EDTA specimen in transport bag and seal. 2.  Place the requisition in the pouch outside the sealed bag. 3.  Transport specimens to the laboratory by courier. 4.  If specimens are to be mailed, contact the laboratory for instructions.