Cellular Pathology, QE Hospital Birmingham
The majority but not all of Cellular Pathology tests that are performed and equipment in use are accredited to internationally recognised standards for medical laboratories ISO 15189. This is important for the Department and for service users as it provides assurance on quality and competence. There is increasingly an integrated approach across the different UHB hospital sites e.g. Musculoskeletal Pathology and Heartlands Hospital based Cellular Pathology, where staff, equipment and testing may be shared to deliver the highest possible quality services to our service users. The full range and nature of accredited tests is detailed on the United Kingdom Accreditation Service website. Select this link for the details: http://www.ukas.com - Schedule of accredited tests for Laboratory 10141 . The laboratory is currently modernising H&E, special stains and immunohistochemistry staining platforms to support high quality diagnostic cellular pathology reporting and to ensure full traceability of samples within the laboratory. Consequently not all IHC analysers, special stains and antibodies have been assessed by UKAS. Others have been reviewed by UKAS early in 2020 and so again are not currently covered by UKAS Accreditation to ISO15189. Should the laboratory demonstrate to UKAS that they satisfy ISO 15189 requirements for those new tests and platforms, then the UKAS website is updated to reflect that updated repertoire and further specific test details are also included below:
Specialist Services within Cellular Pathology | Accredited Tests | |
MOHS | Mohs, is microscopically controlled surgery used to treat common types of skin cancer. | Yes |
Neuropathological Smears | The Department provides a rapid diagnostic service for intra-operative brain tissue specimens. | Yes |
Cytopathology | The Department provides the diagnostic cytopathology services for the Trust including fine needle aspirations, endoscopic brushings and washings, EUS-FNAs , serous fluids urines and CSF. | Yes |
Muscle Biopsy Service | Muscle biopsies are performed as part of the investigation of a clinically suspected neuromuscular disorder when other less invasive tests have not provided a firm diagnosis. | Yes |
Electron Microscopy Service | The Electron Microscope Unit is used routinely at magnifications of between 1500 and 70,000 times to examine the ultrastructure of cells and their surroundings. | Yes |
Immunohistochemistry | |||
Assay Code | Diagnostic purpose | Accrediation status | Future progress |
AAT | Alpha-1-Antitrypsin deposits | UKAS Omnis | |
ACTH | Adrenocorticotropin hormone expressing cells |
not on scope | 2020 ETS |
AE1 | Classification of epithelial tumours |
UKAS Omnis | |
AFP | Alpha-1-Fetoprotein expressing cells | not on scope | 2020 ETS |
Alpha Dystroglycan | not on scope | ||
ALPHA-B-CRYST | not on scope | ||
Alpha-SARC | Alpha-Sarcoglycan Staining protein | UKAS AS 48 | |
Assay Code | Diagnostic purpose | Accrediation status | |
AMACR Racemase | Alpha-Methylacyl-CoA Racemase | not on scope | 2020 ETS |
AMYLOID A | Demonstration of Amyloid A |
not on scope | |
AR | adenoca of prostate, breast and ovarian ca | not on scope | 2020 ETS |
ATRX | Glioma identification | not on scope | |
BAPP | Anti-Alzheimer Precursor Protein A4 | UKAS AS 48 | |
B-CAT | Beta -catenin expressing cells | UKAS Omnis | |
BCL2 | B-cells | UKAS Omnis | |
BCL6 | B-Cells | UKAS Omnis | |
BOB1 | B-cells | UKAS AS 48 | |
BSCYTO (MNF116) | Epithelial cells | UKAS Omnis | |
C4d | not on scope | ||
C9 | not on scope | 2020 ETS | |
CA 125 | Identification of serous ovarian cancer |
UKAS Omnis | |
CA19.9 | Epithelial cells, Sialyl Lewis containing glycolipids |
UKAS Omnis | |
Calcitonin | Calcitonin Expressing cells | not on scope | |
CALPONIN | Calponin expressing cells | UKAS Omnis | |
Calretinin | Identification of malignant mesotheliomas |
not on scope | 2020 ETS |
CD10 | CD10 expressing tumours | not on scope | |
CD117 | CD117 expressing cells. Mast Cells. Cajal Cells |
UKAS Omnis | |
CD123 | CD123 expressing cells | UKAS Omnis | |
CD138 | B-cells. Plasma Cells | UKAS Omnis | |
CD14 | CD14 expressing cells | UKAS Omnis | |
CD15 | Hodgkin Cells. Reed-Sternberg Cells. |
UKAS Omnis | |
CD19 | B-Cells | UKAS Omnis | |
CD1a | Lymphoblasts. Langerhans Cells. Thymocytes |
UKAS Omnis | |
CD2 | not on scope | ||
CD20 | B-Cells | UKAS Omnis | |
CD21 | Follicular Dendritic Cells, B-Cells | UKAS Omnis | |
CD23 | Follicular Dendritic Cells, B-Cells | UKAS Omnis | |
AE1 | Classification of epithelial tumours |
UKAS Omnis | |
CD25 | Identification of Interleukin 2 receptor | not on scope | 2020 ETS |
CD3 | T-Cells | UKAS Omnis | |
CD30 | CD30 positive carcinomas such as embryonal carcinoma |
UKAS Omnis | |
CD31 | Endothelial cells | UKAS Omnis | |
CD34 | Vascular and Lymphatic Vessels. Cells of myeloid lineage |
UKAS Omnis | |
CD4 | UKAS Omnis | ||
AFP | Alpha-1-Fetoprotein expressing cells | not on scope | 2020 ETS |
CD43 | T-Cells, B-Cells | UKAS Omnis | |
CD45 LCA | Tumours of lymphoid origin |
UKAS Omnis | |
CD5 4C7 | T-Cells | UKAS Omnis | |
CD56 | NK Cells, T-Cells | UKAS Omnis | |
CD57 | UKAS Omnis | ||
CD68 PG-M1 | Leucocytes macrophages | UKAS Omnis | |
CD68-KP1 | Macrophages and Monocytes | UKAS Omnis | |
CD7 | Macrophages. Monocytes. Cytokeratin 19 expressing cells | UKAS Omnis | |
CD79 | T-Cells | UKAS Omnis | |
CD8 | B-Cells | UKAS Omnis | |
CD99 | CD99 expressing cells | not on scope | |
CDX-2 | Adenoca in GI tract | UKAS Omnis | |
CEA | Carcinoembryonic Antigen positive cells |
UKAS AS 48 | |
CEA POLY | Carcinoembryonic Antigen positive cells |
UKAS AS 48 | |
CG | Neuroendocrine Cells. | UKAS Omnis | |
CK14 (CYTO14) |
not on scope | 2020 ETS | |
CK19 | epithelial tumours with CK19 expression | not on scope | 2020 ETS |
CK8/18 | cyto 8/18 expression | UKAS Omnis | |
CMV | CMV infected cells | UKAS Omnis | |
C-MYC | not on scope | 2020 ETS | |
Collagen IV | not on scope | ||
CRP | not on scope | ||
CRYPTO | not on scope | ||
CyclinD1 | mantle cell lymphoma | UKAS Omnis | |
CYTO 17 | not on scope | ||
CYTO 19 | CK19 positive Epithelial Cells | not on scope | 2020 ETS |
CYTO 20 | Epithelial Cells (colonic type) | UKAS Omnis | |
Alpha-SARC | Alpha-Sarcoglycan Staining protein | UKAS AS 48 | |
CYTO 7 (CK7) | Cytokeratin 7 expressing cells | UKAS Omnis | |
CYTO 8 (CAM5.2) | shows simple epithelium | UKAS Omnis | |
Cytokeratin AE1/AE3 | Classification of | UKAS Omnis | |
D2-40 Podoplanin | epithelial tumours | UKAS Omnis | |
DES | Smooth muscle cells. Striated muscle cells. Reactive mesothelial cells |
UKAS Omnis | |
DOG-1 | GIST | UKAS Omnis | |
DYSFERLIN 1.40 | Dysferlin Protein | UKAS AS 48 | |
DYSTRO C | Dystropin (C-terminus) protein | UKAS AS 48 | |
DYSTRO R | Dystrophin (Rod Zone) protein | UKAS AS 48 | |
EBV | EBV POSITIVE CELLS | UKAS Omnis | |
ECAD | Ductal and lobular breast ca | UKAS Omnis | |
EMA | Epithelial Cells. | UKAS Omnis | |
EMERIN | Emerin Protein | UKAS AS 48 | |
EP4 | UKAS Omnis | ||
ER alpha EP1 | Assessment of oestrogen receptor status | UKAS Omnis | |
ESA | epithelial marker | UKAS Omnis | |
FACTOR 13a | not on scope | 2020 ETS | |
FACTOR8 | not on scope | ||
FSH | Follicular Stimulating Hormone expressing cells |
UKAS Omnis | |
Gastrin | Gastrin producing tumours | not on scope | 2020 ETS |
Amylase | not on scope | ||
GCDFP-15 | Identify breast mets | not on scope | 2020 ETS |
GFAP | Identification of astrocytes | UKAS Omnis | |
GH | Growth Hormone | UKAS Omnis | |
Glucagon | not on scope | ||
GLUT/SYNTH | Glutamine Synthetase expressing cells |
UKAS AS 48 | |
GLYCO C | red cell precursor marker | not on scope | 2020 ETS |
GLYPICAN3 | Glypican-3 expressing cells | UKAS Omnis | |
GRANZ | Lymphocytes. NK cells. T-cells | not on scope | 2020 ETS |
HAIRY CELL | Hairy Cell Leukemia | UKAS AS 48 | |
HBCAG | not on scope | ||
HBSAG | UKAS Omnis | ||
HCG | not on scope | 2020 ETS | |
HEPATOCYTE | Hepatocyte Cells | not on scope | 2020 ETS |
HSV | HSV positivity | UKAS Omnis | |
HHV8 | Human Herpes viris (type 8) latent nuclear antigen | UKAS Omnis | |
HIV | HIV + | not on scope | 2020 ETS |
HMWCK | basal cells and squamous epithelium |
UKAS Omnis | |
HSP 70 | not on scope | ||
IDH | astrocytoma | UKAS Omnis | |
IgA | not on scope | ||
IgD | not on scope | ||
IgG | not on scope | ||
IgG4 | Ig4 expressing cells | UKAS Omnis | |
IgM | not on scope | ||
Arginase | Hepatobiliary Pathology | not on scope | |
INSULIN | Insulin producing cells | UKAS Omnis | |
KAPPA | plasma cells | not on scope | 2020 ETS |
Ki-67 | Proliferating cells | UKAS Omnis | |
Lambda | plasma cells | not on scope | 2020 ETS |
LH | Luteinizing Hormone expressing cells |
UKAS Omnis | |
MAP2 | not on scope | ||
MAST CELL Tryptase | Mast Cells | not on scope | |
MDM2 | not on scope | ||
Melan-A | Melan-A expressing cells | UKAS Omnis | |
Melanosome HMB45 | Melanocytes | UKAS Omnis | |
Merkel Cell | not on scope | 2020 ETS | |
MESO | Mesothelial Cells | UKAS AS 48 | |
MHCf | Skeletal Muscle fast fibres | UKAS AS 48 | |
MHCs | Skeletal muscle slow fibres | UKAS AS 48 | |
MITO | not on scope | ||
MLH1 | MutL Protein Homlog1 Expressing cells |
not on scope | 2020 ETS |
MSH2 FE11 | MutL Protein Homlog2 Expressing cells |
not on scope | 2020 ETS |
MSH-6 | MutL Protein Homlog6 Expressing Cells |
not on scope | 2020 ETS |
MUC 1 | UKAS Omnis | ||
BAPP | Anti-Alzheimer Precursor Protein A4 | UKAS AS 48 | |
Mum-1 | B-cells in the light Zone of germinal centre / plasma cells | UKAS Omnis | |
MYELIN PLP | Myelin PLP protein | not on scope | |
MYELOPX | Myeloid cells | UKAS Omnis | |
MYO-D1 | Myosin | not on scope | |
MYOGENIN | rhabdomyosarc | not on scope | |
Myoglobin | not on scope | ||
NAPSIN A | not on scope | 2020 ETS | |
NEU-N | Neurones | UKAS Omnis | |
Neurofilament Protein | Neurones. Axonal processes | UKAS Omnis | |
NSE | not on scope | 2020 ETS | |
OCT 2 | not on scope | ||
OCT 3/4 Octamer/binding Transcription factor OCT3/4 |
OCT3/4 expressing cells | not on scope | 2020 ETS |
MHC smooth muscle | UKAS AS 48 | ||
P16 | Heart and Neck/Gyane | UKAS Omnis | |
p53 | P53 protein | UKAS Omnis | |
P62 | P62 Protein | not on scope | |
#REF! | #REF! | ||
BCL2 | UKAS Omnis | ||
PAX-5 (BSAP) | B-Cells | UKAS Omnis | |
Pax-8 | UKAS Omnis | ||
PERFORIN | not on scope | ||
PGP 9.5 | not on scope | ||
PGR | Assessment of progesterone receptor status. Meningioma Cell |
UKAS Omnis | |
PLA2R 1/300 | not on scope | ||
PLAP | Placental Alkaline Phosphatase (PLAP) Expressing cells |
not on scope | 2020 ETS |
BCL6 | B-Cells | UKAS Omnis | |
PROLACTIN | Prolactin expressing cells | UKAS Omnis | |
PRP1/10000 | not on scope | ||
PSA | Prostate luminal epithelial cells. | UKAS Omnis | |
PSAP | UKAS Omnis | ||
S100 | S100 protein expressing cells | UKAS Omnis | |
SDHA 1/100 | SDHA expressing cells | not on scope | 2020 ETS |
SDHB | SDHB expressing cells | not on scope | 2020 ETS |
SMA | Smooth Muscle myosin / Myoepithelial cells | UKAS Omnis | |
SMMYO | UKAS Omnis | ||
SNF5 | not on scope | ||
SPECTRIN PARAFFIN | UKAS AS 48 | ||
STAT 6 1/1000 | not on scope | ||
BOB1 | UKAS AS 48 | ||
SV40 | not on scope | 2020 ETS | |
Synapto | Neuroendocrine Cells. | UKAS Omnis | |
TAU | not on scope | ||
TDT | Thymocytes | not on scope | 2020 ETS |
THYROG | Thyroglobulin expressing cells | not on scope | 2020 ETS |
B-SARC | not on scope | ||
TOXO | not on scope | ||
TSH | Thyroid Stimulating hormone expressing cells |
UKAS Omnis | |
TTF | Already using same Ab as HGS | UKAS Omnis | |
UBIQ | not on scope | ||
VIMENTIN | Mesenchymal Cells | not on scope | 2020 ETS |
WT1 | Wilms’ Tumour 1 Protein (WT1) expressing cells. |
not on scope | 2020 ETS |
Special stain and Eynzme Histochemistry | |||
Protocol | Diagnostic purpose | Accredited | Future progress |
Alcian Blue | acid mucins | Yes | |
Alcian Blue/PAS/d | Acid and Neutral mucins | Yes | |
Congo Red | Amyloid | Yes | |
Elastic van Gieson | Elastin Fibres | Yes | |
Gram/Gram Twort | Gram positive and Gram negative organisms/Fungi, Pneumocystis |
Yes | |
Grocott's Methenamine Silver | Haematopoietic Tissue | Yes | |
Haematoxylin van Gieson | Collagen, connective tissue | Yes | |
Long Giemsa | Haematopoietic Tissue | Yes | |
Long Ziehl-Neelsen | Lipofuscin | No | |
Martius Scarlet Blue | Fibrin | Yes | |
Masson's Trichrome | Collagen, connective tissue | Yes | |
Modified Giemsa | Helicobacter-type organisms | Yes | |
Modified Masson Fontana | Melanin | Yes | |
Modified Ziehl-Neelsen | Mycobacterium Leprae | No | |
Mucicarmine | Mucin | No | |
Orcein | Hepatitis B Surface antigen Copper associated protein |
Yes | |
Periodic Acid Methenamine Silver | Glomerular Basement Membranes | Yes | |
Periodic Acid-Schiff | Glycogen, neutral mucins, fungi, glomerular Basement Membranes |
Yes | |
Periodic Acid-Schiff - Diastase | Carbohydrate, fungal organisms/ glomerular basement menbranes | Yes | |
Perls | Iron | Yes | |
Reticulin | Reticulin fibres at 3µm and 2µm | Yes | |
Rhodanine | Copper | Yes | |
Toluidine Blue | Mast Cell | Yes | |
Von Kossa | Calcium | Yes | |
Warthin-Starry | Spirochetes, Helicobacter pylori | Yes | |
Ziehl-Neelsen (Acid Fast Bacillius) | Acid-Fast Bacilli (Mycobacterium) | Yes | |
Cytochrome C Oxidase staining PMU_S010 |
Marker of mitochondrial activity | Yes | |
Gomori Trichrome staining PMU_S005 |
Abnormal Mitochondria | Yes | |
Haematoxylin and Eosin staining PMU_S004 |
Basophilic and eosinophilic | Yes | |
Muscle Acid Phosphatase staining PMU_S013 |
structures | Yes | |
Myosin Adenosine Triphosphatase Staining pH 9.4 & pH 4.6 PMU_S012 |
Demonstration of lysosomes | Yes | |
Major Histocompatibility Complex PMU_S055 |
Demonstration of fibre typing | Yes | |
NADH Staining PMU_S009 | Upregulation indication of inflammatory response. | Yes | |
Periodic Acid – Schiffs (PAS) Staining PMU_S007 |
Demonstrate abnormal mitochondria and fibre typing. | Yes | |
Phosphorylas staining | Demonstrate muscle glycogen | Yes | |
Succinate Dehydrogenase staining | Phosphorylase activity | Yes | |
Sudan Black staining | Marker of mitochondrial activity | Yes |
Minimum Dataset required for Cellular Pathology Requests
In order to process specimens it is essential that request forms are fully completed in a clear and legible format. The use of patient ID stickers is permitted however please ensure you use the full patient sticker NOT the smaller blood tube sticker. All specimens received into Cellular Pathology must meet the agreed laboratory minimum dataset; any specimens not meeting the criteria will be returned to the requesting department.Please ensure that any important information (e.g. clinical history, bleep number etc.) is clearly indicated on the form and ensure that any priority or urgent cases are marked as such.
- Trust cases can be requested via a theatre book or by completing an internal UHB histopathology / cytopathology request form.
- GP and dental practices should complete the external request form which can be supplied on request from the Department and for internal service users this link http://www.uhb.nhs.uk/laboratory-request-forms.htm shows this request form together with specific request forms used within the Trust (QE site) for liver and breast biopsy cases.
Specimen Labelling and Multi-Part Cases
If more than one specimen from the same patient attributed to a case is sent they should be clearly indicated as part 1, 2, 3 etc. with an note on the request form detailing the site of the specimen.
Hazardous Specimens
Specimens arising from patients with known or suspected transmissible diseases (e.g. tuberculosis, viral hepatitis, HIV) must be clearly labelled as such to prevent unnecessary risk to laboratory staff.
Specimen Containers
When requesting stock a member of staff from the Cellular Pathology department will inform the requestor when they will be ready for collection by the portering staff. Consumables provided by the lab should be transported via the porters so please allow time for preparation and transport. Please note specimens must be despatched to the Department within a secondary bag or secure transport box with sufficient absorbent material to absorb/contain any potential spillage.
Transportation of Specimens
Specimens are collected at regular intervals from theatres and all relevant departments via portering services. Urgent and unfixed (dry/not in formalin) specimens should NOT be left until the next routine collection – telephone portering services and arrange for a member of staff to bring the sample(s) to the laboratory without delay.
Urgent Reporting
Occasionally it may be necessary for a requesting clinician to highlight a specimen as clinically urgent. If an urgent report is required it should be clearly identified or indicated on the request form. Urgent requests should be sent to Cellular Pathology via the porters without delay.
To ensure that cases are not delayed within the laboratory please make sure that the request form is correctly completed and all sections are filled in properly. Once received urgent cases will be highlighted by the specimen reception and prioritised appropriately in the departmental workload.
UHB, Department of Cellular Pathology
- Last updated on .
- Hits: 1264