Ordering Guidance

This test is intended for use with dry tissue - blocks and/or slides - only. For test ordering guidance for other specimen types, see Pathology Consultation Ordering Algorithm.

If requesting only a peripheral blood smear evaluation, order SPSM / Morphology Evaluation (Special Smear), Blood.

Note: Send only those case specimens for which a Mayo Clinic pathologist interpretation is needed to guide patient care. This test is not intended for quality assurance/control (QA/QC) or medico-legal reviews. If Pathology QA/QC or medico-legal review is needed, contact your Mayo Clinic Laboratories account team or call 800-533-1710.

Shipping Instructions

Attach the green "Attention Pathology" address label (T498) to the outside of the transport container before putting into the courier mailer.

Necessary Information

For assistance gathering required documentation and specimens for this test, see Pathology Consultation order submission guide.

All requisition and supporting information must be submitted in English.

Each of the following items is required:

1. All requisitions must be labeled with:

-Patient name, date of birth, and medical record number

-Name and phone number of the referring healthcare professional

-Anatomic site and collection date

2. A preliminary or final pathology report and brief patient history are essential to achieve a consultation fully relevant to the ordering healthcare professional's needs.

3. A specific diagnostic question is required for each specimen/part submitted. Include diagnostic question in a cover letter or in the requisition notes/comments. For ease of submission, the Pathology Consultation Cover Letter form can be completed and sent with the specimen.

4. Additional required information by case type:

Note: Imaging studies should be submitted for the request via Mayo Clinic ImageShare (preferred) or external storage device. Be aware that ImageShare does not support the upload of Pathology whole slide images.

-Bone soft tissue consults: Preoperative imaging studies must be provided; the consultation will not proceed without radiology films, as a diagnosis cannot be definitively determined.

-Liver/kidney consults: Corresponding ancillary laboratory test results

-Neuropathology consults: Clinical and/or radiology imaging should be included if available.

-Placenta consults: Labor and delivery notes, patient history, operation notes, and imaging reports should be included if available.

-Bone marrow consults:

1. A recent Hematology/Oncology clinical note; print and submit with the case.

2. Complete blood cell count (CBC) result from testing performed within 14 days of bone marrow collection

3. Indicate clinical reason/context for submitting this case.

4. All pending and final reports for ancillary testing on submitted specimens.

Specimen Required

Additional Information:

All specimens and additional paperwork must be labeled with:

-Two patient identifiers (first and last name, date of birth, or medical record number)

-Specimen type and anatomic site

Supplies: Pathology Packaging Kit (T554)

Specimen Type: Tissue

Container/Tube: Formalin-fixed paraffin-embedded blocks, stained slides, and/or unstained slides

Note: Submit only pertinent hematoxylin and eosin (H and E) and all special stains relevant to the diagnostic questions for the case. Include positively charged unstained slides and/or a formalin-fixed, paraffin-embedded tissue block if it is anticipated that additional stains or ancillary testing may be necessary.

Bone Marrow Case Specimen Requirements

For information on collecting specimens, see Bone Marrow Core Biopsy, Clot, and Aspirate Collection Guideline.

Specimen Type: Bone marrow aspirate

Slides: 5

Preferred: Freshly prepared slides made at the time of specimen collection

Acceptable: Slides made from EDTA specimen, within 2 hours of collection

Submission Container/Tube: Plastic slide holder

Specimen Type: Bone marrow aspirate clot

Container/Tube: Bone marrow aspirate clot embedded in paraffin block

Collection Instructions: Process and embed clot in paraffin

Specimen Type: Bone marrow core biopsy

Container/Tube: Fixed biopsy core embedded in paraffin block

Collection Instructions: Process and embed core in paraffin.

Specimen Type: Blood

Slides: 2

Preferred: 2 Freshly prepared fingerstick slides

Acceptable: 2 Slides made from whole blood in EDTA, made within 8 hours of collection

Submission Container/Tube: Plastic slide holder