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Consultant Haematopathologists
Dr Lívia Rásó-Barnett (Specialty Lead) (01223 217791)
Dr Caoimhe Egan (01223 217017)
Dr John Grant (01223 216744)
Dr Elizabeth Soilleux (Honorary) (01223 254842)
Dr Joy Staniforth (01223 348274)
About our haematopathology service
HODS provides an integrated haematopathology diagnostic service. This includes:
Histopathology
Diagnostic cytology
Immunohistochemistry
Molecular pathology
Specimen requirements
| Specimen | Sample type | Specimen requirements |
|---|---|---|
| Bone marrow trephine | In formalin | - Send in formalin - Immerse in 6 to 10 times the volume of neutral buffered formalin (10%) - Use an appropriately sized container with a secure lid - Label container with a formalin hazard label |
| Slides/tissue blocks* | Submit either: - Fixed and stained sections with 10 unstained sections or - Block(s) or - Block(s) plus 20 consecutive serial sections (2–4 micrometres thin) with minimal trimming. Submitted as 3 H&E stained slides at level 1, 10 and 20 with the remaining 17 unstained slides for further IHC/retic | |
| Lymph node sample for flow cytometry | - Refer to Immunophenotyping section for detailed requirements - Contact Immunophenotyping service in advance: 01223 586546 | |
| Lymph node sample for histomorphology (core biopsy, excisional biopsy or cell block from aspiration cytology/EBUS-FNA) | Slides/tissue blocks | Submit either: - Single H&E stained slide from each block plus the block(s) or - Single H&E stained slide from each block plus 20 unstained slides from each block Also include: - Original request form (or a copy) - Local report - Information about work-up performed - Details of material retained in the referring hospital Important: - HODS does not accept unprocessed non-trephine samples (except fresh samples for flow cytometry) - These will be returned to the referring centre for tissue processing |
| Splenic biopsy | Slides/tissue blocks | - Block(s) plus 20 consecutive serial sections (2–4 micrometres thick) with minimal trimming - Submitted as 3 H&E stained slides at level 1, 10 and 20 with the remaining 17 unstained slides for further IHC/retic |
*For bone marrow trephine biopsy: Follow your local decalcification protocol if available. If no local protocol exists, then the current protocol at department of Histopathology (Cambridge University Hospitals) can be followed: fix in 10% formalin for 24 hours, then decalcify in EDTA for 24 hours (pH 6.5-7, at room temperature) before processing and sectioning.
Storage and return of samples
Solid tissue samples are stored in the CUH histopathology laboratory
Slides cut or stained at CUH remain with CUH
After testing, we return the submitting centre's blocks and original slides through the CUH Histopathology Archive Team
Contact HODS directly if you need material urgently
The East genomics laboratory may store additional fixed material for a period
Workflow of bone marrow trephine biopsies
Fresh bone marrow trephine biopsy samples should be sent to HODS (Level 3, Pathology Block) in purple HODS specimen bags alongside the liquid samples for morphology, flow cytometry, cytogenetic and molecular studies. They are booked in and linked via the specimen (SP) number in HODS.
After booking in, bone marrow trephines are transferred to the Department of Histopathology (LMB Cut-up room) for processing.
Fresh bone marrow trephine biopsy samples need to be fixed in six to ten times the volume of neutral buffered formalin (10%) in an appropriately-sized container for 24 hours. It is therefore of paramount importance that the referring clinical team clearly labels sampling time on the container.
Once 24 hours of fixation is complete, samples will be placed into EDTA (molecular decal solution) for 24 hours each evening, Monday–Thursday and Friday–Saturday AM.
After 24 hours of decalcification is complete, specimens are processed overnight, then embedded and transferred back to the Immunohistochemistry Laboratory (Level 1, Pathology Block) the next morning for section cutting.
Once sections are cut, they are stained for HE in the Department of Histopathology (LMB – Main Laboratory) and transferred back to HODS for allocation to the Consultants in HODS.
Consultants request appropriate immunopanels and report cases once immunostained slides are available. For example, if a trephine sample is taken on a Tuesday before 3pm and reaches HODS by midday Wednesday, H&E stained slides should be available by Friday or Monday morning at the latest.
Factors that may delay histopathology reports
Limited clinical information
Providing comprehensive clinical details is crucial. Include:
Responsible clinician's email address and/or phone number
Relevant clinical, radiological, and laboratory findings
For non-marrow histological samples:
Biopsy site (including laterality if applicable)
Current or previous haematological malignancies (if known, include WHO diagnostic entity or lineage)
Known immune deficiency or dysregulation (including underlying aetiology if ascertained)
Limited sample size
Small samples, such as EBUS-FNA, require stepwise analysis rather than a single diagnostic panel. Consider submitting a separate sample for flow cytometry to aid diagnostic yield.
Sample quality issues
Interpretation can be challenging with significant crush or cautery artefact, and with small diameter tissue cores from higher gauge needles.