Are you a doctor needing to send in a patient’s biopsy specimen for pathology services? Please review this information for answers to frequently asked questions.
*If a specimen for Immunofluorescence is being taken, please refer to the instructions on this webpage on how to collect and submit this type of specimen. Michel’s solution for specimens that are being collected for immunofluorescent testing is supplied free of charge upon request.
Biopsy reports are communicated to the surgeon via an electronic reporting system called eDossea, which is a third party, HIPAA compliant platform. Biopsy reports are encrypted to ensure patient privacy.
Biopsy reports can be accessed by the contributing surgeon using a passcode chosen by the contributor that is set up in the system. This same passcode will need to be entered for each report that is sent. If more than three attempts are made to try and open the report, or the report has been opened three times, the system will not allow you to open it again. The laboratory must send it again to the contributing office.
Biopsy reports are NOT sent directly to patients. It is the responsibility of the contributing dentist/surgeon receiving the report to share the report with the patient. Any requests for patient reports to be sent to anyone other than the contributing dentist/surgeon must have a patient signed Authorization for the Use and Disclosure of PHI form for release. To obtain this form contact the lab.
Biopsy kits are shipped to contributing dentist’s/surgeon’s offices via FedEx or USPS. Once the biopsy has been taken and placed in the specimen container provided in the kit, follow these steps:
Direct immunofluorescence studies are performed on specimens where additional testing is needed for a definitive diagnosis of a mucocutaneous disorder such as lichen planus, pemphigoid, pemphigus, or erythema multiforme.
IMPORTANT NOTE: Immunofluorescence testing requires the submission of specimens in formalin as well as Michel’s solution in order to obtain the best diagnostic outcome possible. Michel’s solution is available free of charge, upon request.
The diagnosis of bullous/desquamative lesions requires an assessment of where the epithelium is splitting. Clinically, obtaining these biopsies can be challenging due to the tendency for the epithelial layer to slough. It is best to seek a site in the anterior portion of the mouth and take care not to grasp the specimen with forceps. Eight-millimeter punch biopsies work quite well, and one should always biopsy the edge of the lesion to include both potentially pathologic and normal appearing tissues..
Immunoglobulins from rabbits, goats or mice are used as reagents. These immunoglobulins are directed to antigens in the host tissue and many of these antigens are immunoglobulins or autoantibodies (i.e. an antibody to an antibody). Many antigens are damaged by formalin fixation and tissue processing; therefore a special medium is used and the sections are cut from frozen tissue samples.
The anti-human immunoglobulins are tagged with a fluorescent dye that can only be visualized with an ultraviolet light source (fluorescent) microscope.
For collecting the DIF specimen there needs to be both a formalin specimen and a specimen in Michel’s solution submitted.