Hi - I Think I can help. We have a policy and I've provided it here. Also, we have a separate policy in our autopsy manual concerning the handling of radioactive cadavers, which is rather extensive. We also participate in an annual Radiation Accident Drill which is county wide and covers emergency response teams, hospital emergency, laboratory, and morgue services. Its quite a big deal to witness and lots of fun to participate in. Here is our tissue procedure. Please let me know if you need a copy of the other.
PURPOSE: To provide guidelines for the handling of sentinel lymph nodes and other tissue with possible radioactivity. PRINCIPLE: The technique of sentinel lymph node biopsy (SLN) attempts to detect regional node metastases by identification of the "sentinel" lymph node(s) using a combination of radiolabeled colloid (99m Technetium labeled sulfur or Human Serum Albumin) and isosulfuran blue dye. The premise is that lymph node metastases will initially travel by lymphatic drainage to the "sentinel" node. Other tissues that might contain radioactive substances are identified and handled according to the Radiation Safety Officer's recommendations. PROCEDURE: 1. During the validation phase of the SLN biopsy technique, the sentinel lymph node(s) and the completion lymph node dissection will be submitted to Pathology in separately labeled containers. For mapping with a radiolabeled colloid, an injected dose of technetium (99mTc) in the range of 0.1 to 1.0 mCi (3.7 to 37 MBq) is approximately 4% of that administered for a conventional bone scan. No isolation, precautions, or special radiation monitoring are required. 2. Specimens should be submitted in 10% neutral buffered formalin unless an intraoperative consultation is requested. 3. Gross examination will identify the number and the size of the sentinel lymph node(s). Nodes should be sectioned into 2-3 mm slices. Grossly evident metastatic disease should be noted. 4. Following tissue processing, at the pathologist's instruction, the SLN block will be sectioned at 3 levels at 4 microns. All levels will be stained with hematoxylin and eosin. Immunostaining will also be performed when appropriate. Lymph nodes demonstrating metastatic disease on Frozen Section are routinely cut at one level only. 5. If the pathologist does not ask for the protocol procedure, then the lymph node is to be sectioned as regular tissue. 6. For any other tissue sent to the Histology, suspected or labeled as containing radioactive substances, the Histology Tech is to immediately call the Hospital Radiation Safety Officer for radiation measurement and instructions for the handling of the tissue. 7. The tech will immediately notify the pathologist on call that tissue with suspect radiation has been received and the Radiation Safety Officer has been called 8. The Radiation Safety Officer's handling instructions will supersede any further processing of the tissue. Documentation of the Radiation Safety Officer's tissue handling recommendations will be included on the requisition. Reference: JCO October 20, 2005 vol. 23 no. 30 7703-7720 Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 -----Original Message----- Today's Topics: 1. Re: Radioactive specimens policy (Bob Richmond) 6. RE: Re: Radioactive specimens policy (Joelle Weaver) --------------------------------------------------------------------------------- CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. _______________________________________________ Histonet mailing list [email protected] http://lists.utsouthwestern.edu/mailman/listinfo/histonet
