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Skin Biopsy, Histo/Path

Important Note

To obtain weekend or holiday results, special arrangements must be made with Pathologist on call, 12-24 hours in advance.  Weekend biopsies and those to R/O Epidermolysis Bullosa (details below) should be discussed beforehand with pathologist on call.

Clinical System Name

Surgical Pathology Final Report



Epidermolysis Bullosa (E.B.)

Sample Requirements

Specimen:  Tissue

Container(s):  see note

Preferred Vol:  see note

Minimum Vol:  see note



Except for Epidermolysis Bullosa (E.B.), tests include light microscopy and possible immunofluorescence, electron microscopy, and fibroblast culture.  A 1 x 0.5 x 0.5 cm skin piece is adequate for all tests; alternatively take a 3 mm punch biopsy for one test or 4 mm punch biopsy for up to two tests. Unfixed tissue should be placed on Saline-moistened telfa in sterile specimen container.


FRESH (no fixative) specimens must be delivered immediately to 8th floor lab CPA or Histology (OC.8.901) and given to someone's personal charge; identify it as a fresh specimen. 


Fixatives for specimens not delivered immediately:  Light microscopy - formalin; immunofluoresence - Michel's or tissue culture transport media (RPMI); electron microscopy - 3% glutaraldehyde; fibroblast culture - tissue culture transport media.


A completed Pathology request form including hospital number, name, date, pre-op diagnosis, clinical history, physician and any other pertinent information must be submitted with the specimen.  For fibroblast culture use Genetics Service Request (See separate listing for fibroblast culture).


After 1700, deliver specimens to the 8th floor lab CPA; notify CPA that it is a fresh specimen. 


For Epidermolysis Bullosa  (

Obtain appropriate media from Histology Lab. It is paramount that diagnostic biopsies are performed on freshly induced blister; two 4mm bunch biopsies should be obtained at edge and contain 1/3 lesion and 2/3 perilesional skin; DO NOT CUT IN HALF; place 1 sample in Zeus or Michel's media and another in gluteraldehyde. No H & E is necessary unless an autoimmune blistering disorder is suspected. In that setting a third biopsy should be submitted in formalin. Deliver to lab with appropriately completed requisition form that includes "Testing for Epidermolysis Bullosa" and name of pathologist who was contacted.


Additional information and specific handling instructions may be obtained from Histology at (206) 987-2580 or Pathology (206) 987-2103.

Processing Instructions

Reject due to: na

Spin:  N

Aliquot:  N

Temp: RT

Note:  For fibroblast culture, deliver to Cytogenetics as per instructions under listing for "Fibroblast Culture".  All other specimens go to Histology.  Notify Histology immediately when specimen arrives in Lab.  Contact on-call pathologist (206) 987-2131 if Histology is unavailable.


Off-site collection:  Specific handling instructions may be obtained from Histology at (206) 987-2580. 

Michel's or tissue culture transport media (RPMI) for immunofluorescence is available in Bellevue Lab (206) 884-9166) prior to procedure.


For Epidermolysis Bullosa:

Zeus/Michel's media sent to Stanford. Gluteraldehyde held at SCH until further notice.


Specimen Type Temperature Time
Tissue Room temp

24 hr (formalin, glutaraldehyde or Michel's)

  Refrigerated N
  Frozen N



STAT Performed TAT
  M-F 8 a.m. - 5 p.m. Varies; 1-3 days w/o EM or IF


Performing Laboratory

Seattle Children's Laboratory  

Stanford University School of Medicine - Dermatopathology (E.B.)


Department:  Histology

Phone Number: (206) 987-2580; for results inquiries call (206) 987-2103.




Method:  Varies; routine formalin fixation with paraffin embedding and standard sectioning; possible addition of frozen section immunofluorescence and/or  electron microscopic examination, as dictated by clinical and pathologic findings

Analytical Volume:  n/a


Surgical pathology requisition required.


For fibroblast culture only (See Fibroblast Culture and storage): order electronically, or submit a Cytogenetics request form.