Specimen Collection

Collecting Biopsy Specimens for Direct IF Studies

A. For immunopathologic studies by direct IF, either a 3mm or 4mm punch biopsy, shave biopsy or a surgical biopsy specimen collected by any of the standard methods for histological examinations may be used. The biopsy sites vary for different bullous or connective tissue diseases. Visit selecting biopsy sites for detailed guidelines. Biopsy site diagrams for wall mounting are available from Beutner Laboratories on request.

B. Using the right medium:
Specimens for direct IF studies should be placed into a yellow top tube of modified Michel's transport medium supplied with the specimen kit. Direct IF studies should be performed on specimens placed in such a transport medium tube; they cannot be performed on specimens placed in the blue top tube of buffered formalin. Stopper securely by pressing stopper all of the way into the tube. Place tube(s) in the mailer supplied with the kit.

Biopsies can be placed in physiological saline if they are shipped on the same day for next morning delivery. Also, an alternate method is to quick freeze the specimen in liquid nitrogen and to transport it to our laboratory on dry ice by an overnight carrier service.

C. Complete relevant forms. Fill in the information requested.

  1. The label on tube should include the date, the patient's name and the biopsy site. Also, mark whether biopsies are from normal, lesional or perilesional areas.
  2. On front of Test Request Form fill in data including:
    • Patient's name, address, date of birth, sex, date of specimen
    • Physician's name, address, phone and FAX numbers
    • Billing information, (whom to bill), Medicare number and/or other insurance, including policy numbers and the name of the person insured.
  3. On back of Test Request Form fill in data on biopsy specimen including information on the site of biopsy, transport medium, clinical diagnosis and clinical findings.
  4. In cases of suspected lupus erythematosus (LE), the check list of "ARA Criteria for SLE" on the Test Request Form can serve as a useful guide. Mark findings as [+] or [-] or leave blank [ ] if no data are available.

Collecting Biopsy Specimens for Histological Studies

  1. Collect either a 3mm or 4mm punch biopsy, shave biopsy or a surgical biopsy specimen; use any one of the standard methods. Biopsies should not be cut in half for use in both direct IF and H&E because the pressure of cutting causes artifacts; separate biopsies should be taken for each procedure.
  2. Place biopsy specimen in the blue labeled tube of buffered formalin supplied with the specimen kits. Stopper securely. Place tube in mailer supplied with the kit.
  3. Fill in the information requested both on the tube label and on the front and back of the Test Request Form.

Collecting Serum Specimens

Collect or have a laboratory collect about 5-8 ml of blood in a dry tube or in a red top Vacutainer or serum separator (SST) tube, allow blood to clot, centrifuge and put serum into tube with the red label. Alternatively, if blood cannot be centrifuged, send it to the laboratory as is. However, if such a serum is hemolysed, it cannot be can be used for ELISA.

Fill in the information requested:

  1. On the tube label for serum, enter date and the patient's name.
  2. On front of Test Request Form fill in data including:
    • Patient's name, address, date of birth, sex, date of specimen
    • Physicians name, address, phone and FAX numbers and billing information, (whom to bill), Medicare number and other insurance plus their numbers and the name of the person insured.