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Fresh vs Formalin Specimen Guideline - FMC Operating Room

Send the following fresh, IMMEDIATELY, to the Anatomic Pathology Laboratory:
  -
Intraoperative Consultations (frozen sections)
  - Lymphoma Protocol
  - POC or uterine contents for cytogenetic testing
  - Specimens requiring any Ancillary Testing

Neuropathology specimens: Submit in formalin unless directed otherwise by a surgeon.
Cardiac specimens: Submit cardiac transplant biopsy specimens fresh. Submit all other cardiac specimens in formalin.

If you have questions during normal service hours, call the Gross Room at 403-944-1227. After hours, contact the Pathologist on-call.

 BONE and SOFT TISSUES
 FRESH  FORMALIN 
 Amputation  Digits
 Atypical lipomas  Dupuytren's contracture
 Bone resection  Lipoma
 Femoral head  Lymph nodes
 Sarcoma  Sarcoma core biopsies
 Other soft tissue tumors   Skin                                                    

 BREAST SPECIMENS
 FRESH  FORMALIN
 Lumpectomy >3cm  Axillary dissections
 Mastectomy  Breast biopsies/cores
 Segmental/Partialmastectomy        Breast capsules/implants
   Breast reductions
   Lumpectomies ≤3cm
   Lymph nodes
 (including Sentinel nodes if not for frozen section)
   Skin

 GI SPECIMENS 
 FRESH  FORMALIN
 Colon (malignant or benign)  Appendix
 Esophagus  Gallbladder
 Liver resections  Hemorrhoid
 Pancreas  Liver biopsies
 Small intestine (malignant or benign)  Lymph nodes            
 Stomach  Omentum
 Whipples  Polyps
   Spleen
   Stomas                                                          

 GYNECOLOGICAL SPECIMENS
 FRESH  FORMALIN 
 Ovary (malignant or benign)  Biopsies from staging cases 
 Pelvic exenteration  Cervix cone biopsies/LEEPS
 Sarcoma  Endometrial ablation
 Uterus (malignant or benign)  Endometrial/Endocervical currettings 
 Vulva resection                                Fallopian tubes
   Fibroids
   Lymph nodes from staging cases (pelvic,
  para-aortic, obturator, inguinal, etc.)
   Omentum
   Peritoneum
   Polyps
   Vagina resection

 HEAD and NECK SPECIMENS
 FRESH  FORMALIN 
 Larynx  Lymph nodes
 Thyroid                                      Mandible/maxilla
   Neck dissection
   Parathyroid (if not for frozen section)
   Salivary glands
   Tongue
   Tonsils

 THORACIC and PULMONARY SPECIMENS
 FRESH  FORMALIN
 Lobectomy  Lymph nodes
 Lung wedge resections  Pleura
 Mediastinal mass  Ribs                                        
 Pneumonectomy  
 Thymus   

 OTHER SPECIMENS  
 FRESH  FORMALIN   B-PLUS Fixative 
 Adrenals  Hernia sacs  Baseline kidney biopsies
 Bladder  Nasal polyps  
 Kidney resections      Plastic surgery  
   Skin biopsies and resections  
   Vas deferens