-1

:Histopathology

Comment: Histopathologic diagnosis; distinguish benign from malignant entities when possible; evaluate extent of lesions, adequacy of resection, provision of classification and, when appropriate, grading in the case of tumors

Sample: Fresh tissue, tissue fixed in formalin or other appropriate fixative. Each specimen from a different anatomic site must be placed in separate, correctly labeled container

-2

:(Bone marrow (aspiration +biopsy

Comment: Evaluation of cellularity, morphology of erythroid, myeloid, lymphoid monocytic /macrophage precursors and Megakaryocytes; maturation of the precursors of each of these cell lines; and erythroid: myeloid ratio. Establish decrease or increase in any of these cell lines. Abnormal representation /infiltration of the bone marrow by any of these cell lines or cells foreign to Quantify iron status by Perl’s stain and establish presence /absence of ring sideroblasts. Examine for the presence of infectious organisms in the bone marrow (e.g., histoplasmosis, various mycobacterial species, Cytomegalovirus, Parvovirus inclusions involving erythroid precursors). In general, a bone marrow examination can be omitted in uncomplicated iron deficiency anemiawhen serum ferritin levels are reduced below 20 mg/L, serum transferrin receptor levels are raised above normal, or the transferrin level/TIBC is raised along with concomitant reduction in the fasting serum iron level < 55mg/dL and resultant transferrin saturation is reduced to < 18%. Repetitive bone marrow examination are valuable for assessment of response to therapy in cases of hematologyical malignancies (e.g., acute leukemias, lymphomas, multiple myeloma, as well as nonhematological malignancies, e.g., Ewing sarcoma, carcinoma. Evaluation of response to therapy may include examination of cytogenetic abnormalities and quantification of abnormal metaphases (e.g., chronic myeloid leukemia). The number of Philadelphia positive metaphases or the number of bcr-abl transcrips noted on performing FISH or PCR are invaluable markers of response to therapy. Similarly, FISH and PCR are invaluable in determining minimal disease in acute progranulocytic leukemia

-3

:(Cytology (body fluid

Comment: Cytopathology is the study of a alterations with individual cells reflective of changes within their environment. Examination of such alterations at the cellular, as well as molecular +level, allows the diagnosis of a wide range of benign preneoplastic and malignant conditions. Like all morphologic studies, clinical and radiologic findings are of inestimable value in the accurate diagnosis of cytologic specimens. In addition, proper specimen procurement is absolutely essential for reliable interpretation

Sample: body fluid in plain tube or on slide

-4

:Frozen

Comment: Establish rapid histopathologic diagnosis of the presence and nature of a pathologic process, provision rapid intra operative diagnosis to support immediate intra operative decisions

Sample: Fresh tissue with no added fixative or fluid rapidly brought to the pathology laboratory

 -5

:(Imunofluorescence test on the skin biopsy (IgG, IgA, IgM, C3, C4

:Comment

(Sample: Tissue sections, (Paraffin blocks

-6

:(Kidney biopsy (+ IF

Comment: For glomerulonephritis. Ig can be performed on paraffin

Sample: Formalin + saline

-7

:Muscle biopsy + enzymes

Comment: To detect myopathies, dystrophies and neuropathies

Sample: Pad of Gauze moistened with normal saline in petri dish

-8

:PAP smear

Comment: Screen for dysplasia or infections

Sample: cells on Slide

-9

:(Skin biopsy (+IF

Comment: For different bullous lesion and autoimmune conditions

Sample: specimen in Formalin + saline

-10

 :FNA of testis

Comment: Detect sperms in 10 sites. More sensitive and specific than open biopsies

Sample: on slides

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