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Histopathology and cytology

Our services A-Z

The Histopathology Department Cambridge University Hospitals NHS Foundation Trust (CUH) provides a comprehensive range of histological and cytological pathological services. These services include the routine and specialised examination of tissue samples (including immunocytochemistry and electron microscopy), diagnostic screening of body fluids and aspirates, and coroner's autopsies.

These services are fully supported and led by Royal College of Pathologists (RCPath) registered consultant clinical staff and Health and Care Professions Council (HCPC) registered senior biomedical scientists.

Opening hours

The Histopathology Department is open for the routine examination of specimens from 08:30 to 17:30 Monday to Friday and on Saturday for deliveries from 09:00 to 12:00. It also provides an on-call service for renal and liver transplant and out of hours intra-operative frozen section.

Contact details

Departmental Clinical Lead: Dr Michael Eden

Histopathology Manager: Zahrah Rosun

Contact Histopathology and cytology via its Enquiries line

Telephone: 01223 217163

Email the enquiries line.

Packaging, Labelling and Transport of Specimens to Histopathology and Diagnostic Cytology

External specimens

Always ensure that the specimen container is:

  • appropriate to the specimen
  • properly closed
  • correctly labelled
  • not externally contaminated by the contents
  • placed in an individual clear, plastic, marsupial transport bag
  • correctly labelled
  • properly sealed at the top to contain any leakage

There must be three points of patient identification on the specimen and where appropriate the paper request form:

  • FULL legal first and last name (no abbreviations or preferred names)
  • DOB
  • MRN or NHS number

These may be handwritten or an electronically requested label.

Muscle samples (external cases)

Some external centres freeze their own biopsies (dry ice) and send directly to Addenbrooke’s via a courier or taxi. Centres that send fresh muscle tissue, must send the specimen cooled (on wet ice), and it should be received at Addenbrooke’s with 1.5 hours. This is only recommended for cases that are not query metabolic in nature.

When dry ice (solid carbon dioxide) or ice are used as coolant/conditioner to keep specimens cold the following requirements must be met:

  • for ice, the outside packaging or over-pack must be leak-proof.
  • the coolant must be placed outside the secondary packaging or in the outer packaging or over-pack.
  • secondary packaging must be secured in position to prevent movement after the coolant has dissipated.
  • for dry ice, the packaging must be designed and constructed to permit the release of carbon dioxide gas to prevent a build-up of pressure that could rupture the packaging.
  • Primary receptacle and secondary packaging must maintain their integrity at the temperature of the coolant as well as the temperature and pressures which could result if coolant is lost.

Packages containing dry ice for cooling must be marked as “DRY ICE, AS COOLANT” or “CARBON DIOXIDE, SOLID, AS COOLANT”. Where dry ice is used for the cooling purposes of another dangerous good, then all the relevant markings and labelling for that dangerous good must be displayed on the package also, e.g. UN3373 diamond and Biological substance, category B wording.

Histopathology service update

The Histopathology and Diagnostic Cytology laboratory has relocated to 1000 Discovery Drive on the Cambridge Biomedical Campus.

UKAS Accreditation Scope

Histopathology department, including 1000 Discovery Drive location is accredited to ISO 15189:2022 standards. Schedule of accreditation can be found here. (opens in a new tab)

Tests outside scope of UKAS accreditation

While the department is accredited by UKAS to ISO 15189:2022 standards, there are some tests which are not currently within our accredited scope. The department continues to verify and monitor all testing processes in line with established quality assurance standards. Please see below:

Tests and their purpose

Dystrophy panel (Fresh Muscle)

  • Dystrophin I: Muscle membrane marker, used in analysis of Dystrophic muscle disease.
  • Dystrophin II: Muscle membrane marker, used in analysis of Dystrophic muscle disease.
  • Dystrophin III: Muscle membrane marker, used in analysis of Dystrophic muscle disease.
  • Alpha Sacroglycan (Adhalin): Muscle membrane marker, used in analysis of Dystrophic muscle disease.
  • Beta Sarcoglycan: Muscle membrane marker, used in analysis of Dystrophic muscle disease.
  • Gamma Sarcoglycan: Muscle membrane marker, used in analysis of Dystrophic muscle disease.
  • Merosin: Muscle membrane marker, used in analysis of Dystrophic muscle disease.
  • Dysferlin: Muscle membrane marker, used in analysis of Dystrophic muscle disease.
  • Emerin: Stains muscle cell nuclei.

Inflammatory Panel (Fresh muscle)

  • CD3: T - Cell marker used for inflammatory myopathy.
  • CD4: T - Cell marker used for inflammatory myopathy.
  • CD8: T - Cell marker used for inflammatory myopathy.
  • CD68P: Macrophage marker used for inflammatory myopathy
  • CD79A: B- Cell marker used for inflammatory myopathy
  • HLA-DR: MHC II protein, up regulation in inflammatory myopathy.
  • P62: Protein found in rims vacuole inclusions in Inclusion Body Myositis.
  • Complement C5B9: Part of complement pathway in complement mediated cell death. Inflammatory myopathy.

Myofibrillary Panel (Muscle Fresh)

  • Vimentin: Intermediate filament. Disruption in Myofibrillary Myopathy
  • Desmin: Intermediate filament. Disruption in Myofibrillary Myopathy
  • Myotilin: Intermediate filament. Disruption in Myofibrillary Myopathy
  • Developemental Myosin: Intermediate filament. Disruption in Myofibrillary Myopathy
  • Actin (Skeletal muscle): Intermediate filament. Disruption in Myofibrillary Myopathy

Routine Enzyme Histochemistry (Muscle Fresh)

  • Neonatal Myosin IHC: Regenerating muscle fibres
  • Cytochrome Oxidase/ Succinic Double stain: Used to highlight effected fibres in mitochondrial myopathy.

Metabolic Histochemistry (Muscle Fresh)

  • Phosphofructokinase (PFK): Metabolic myopathy marker
  • Buffer Control: Endogenous PFK activity to be compared with test slide.
  • Phosphorylase (PHRY): Metabolic myopathy marker
  • Aldolase (ALD): Metabolic myopathy marker
  • Alcoholic PAS: Demonstration of soluble glycogen.
  • Myodenylate Deaminase: Metabolic myopathy marker

Dementia Markers (Paraffin Brain tissue)

  • Alpha Synuclein: Protein seen in intra nuclear neuronal inclusions in Pakinsons disease.
  • TDP43p: Inclusions seen in Amyotrophic Lateral Sclerosis.
  • P62: Autophagic mediator seen in protein aggregations of Dementia suffers.

Additional Neuro tests

  • Toxoplasma IHC: Demonstrate Toxoplasma Tachizoites on formalin fixed paraffin embedded tissue.
  • Teased Nerve Preparation: Myelin figures in peripheral nerve biopsies.
  • T-pit: Identify the lineage of PitNETs corticotroph tumours
  • Pit1: Identify the lineage of PitNETs somatotroph, Mammosomatotrophs, lactototrophs and thyrotroph tumours

Special Stains

  • Non-specific Esterase: Cells of Monocytic Lineage
  • Melanin Bleach (with H&E stain): Melanin Bleach
  • Bone morphometry: Primarily used to diagnose metabolic bone disorders

Microtomy

  • AT-192 autotrimmer: To trim paraffin blocks ahead of sectioning as part of automated microtomy

Immunohistochemistry

  • HER2 F-ISH on Leica BOND-III platform: Identification of Her2 amplification/ over expression

Diagnostic Cytology

  • Thyroid FNA clinic: Preparation of fine need aspirates
  • Confoccal microscopy: One-Stop Renal Clinic for renal biopsy assessment
  • Infrared lymph node scanner: To aid in identification of lymph nodes at dissection
Immunohistochemistry tests

Leica BOND-III

  • Alpha-1-Fetoprotein
  • ATRX
  • BAF47 (INI1)
  • BAP1
  • Bcl-2 (E17)
  • BOB-1
  • C1q
  • C3c
  • CD11c
  • CD123
  • CD25
  • CD33
  • CD57
  • Collagen IV
  • CYP11B1
  • CYP11B2
  • DNAJB9
  • FH
  • Fibrinogen
  • FSH
  • Galectin-3
  • GLUT-1
  • Granzyme B
  • HHV8
  • Histone H3 (mutated K27M)
  • Histone H3 (tri-methyl K27)
  • HSV
  • IDH1
  • IgA
  • IgG Poly
  • KCNJ5
  • LEF1
  • LMO2
  • Muc-1
  • Muc-2
  • Muc-4
  • Muc-5ac
  • MyoD1
  • Parvovirus
  • PAX8
  • Phox2B
  • Prostein
  • PTEN
  • RCC
  • SDHB
  • STAT6
  • Stathmin

Ventana BenchMark Ultra Plus

  • Arginase-1
  • ERG

Immunohistochemistry service update

As part of our ongoing commitment to service improvement and innovation, the Histopathology Department is progressively transferring selected immunohistochemistry (IHC) tests from the Leica BOND-III staining platform to the Leica BOND PRIME platform. This transition is being implemented in phases to ensure continuity and quality of service.

During this period, any antibodies that have been transferred to the BOND PRIME platform will temporarily fall outside the scope of UKAS accreditation until an Extension to Scope assessment has been completed and accreditation has been formally granted. The department will continue to verify and monitor all testing processes in line with established quality assurance standards.

Please see below list of antibodies that are now being carried out on the BOND PRIME platform.

BOND PRIME - Antibodies
  • (Smooth Muscle) Actin
  • 2SC
  • 34βE12 (CK HMW)
  • Adipophilin
  • ALK-1 (CD246)
  • Amyloid-P
  • Androgen Receptor
  • Bcl-2 Oncoprotein
  • c-myc
  • C-Reactive Protein
  • CA125
  • CA19-9
  • Caldesmon
  • Calponin (Basic)
  • Carbonic Anhydrase IX
  • Cathepsin-K
  • CD10
  • CD117 (Monoclonal)
  • CD138
  • CD15
  • CD163
  • CD19
  • CD1a
  • CD2
  • CD20
  • CD21
  • CD23
  • CD3
  • CD31
  • CD34
  • CD4
  • CD43
  • CD5
  • CD61
  • CD7
  • CD79a
  • CD8
  • CD99
  • CDX2
  • CEA (Monoclonal)
  • CEA (Polyclonal)
  • Chromogranin A
  • CK AE1/3
  • CK MNF
  • CK14
  • CK17
  • CK19
  • CK20
  • CK7
  • CK8/18
  • CMV
  • CMV CISH
  • Cyclin D1
  • D2-40 (Podoplanin)
  • Desmin
  • DOG-1
  • E-CAD
  • EBER CISH
  • EP1 (oestrogen receptor)
  • Factor XIIIa
  • Gastrin
  • GATA-3
  • GCDFP
  • Glucagon
  • Glutamine Synthetase
  • Glypican-3
  • H. Pylori
  • HBME-1
  • HCG
  • Hepatocyte
  • HMB45
  • HSP70
  • Inhibin
  • INSM1
  • Insulin
  • Kappa CISH
  • Lambda CISH
  • Langerin
  • LFABP
  • Mammaglobin
  • Melan-A
  • Mesothelin
  • MLH1
  • MSH2
  • MSH6
  • MTAP
  • MUM1
  • NeuN
  • NKX3.1
  • OCT2
  • OCT3/4
  • p53
  • p63
  • PAX5
  • PD-1
  • PLAP
  • PMS2
  • Progesterone
  • Prolactin
  • PSA
  • PSAP
  • Racemase (AMACR)
  • RNA Negative
  • S100
  • SALL4
  • SF-1
  • SMARCA4
  • SMMHC
  • SV40
  • TdT
  • TTF-1
  • Vimentin
  • WT-1 (Monoclonal)

Histopathology turnaround time

Due to a significant increase in the number Histopathology investigations since the end of the COVID pandemic the Cambridge Histopathology laboratory has not been meeting the turnaround time reporting standards to which we aspire:

  • 80% within 7 days
  • 90% within 10 days
  • 95% within 21 days

An improvement programme is on-going and the laboratory continues to work on several initiatives to increase capacity. This includes the use of digital imaging (replacing microscopy) and implementation of new technologies.

Information on the current turnaround time (TAT) performance for all cases is shown below:

Monthly TAT (Turnaround time)
Month 7 Day TAT 10 Day TAT 21 Day TAT Number of Cases Total Slides
Month Apr 7 Day TAT 64.44% 10 Day TAT 80.10% 21 Day TAT 96.83% Number of Cases 4885 Total Slides 32987
Month May 7 Day TAT 64.77% 10 Day TAT 82.49% 21 Day TAT 96.77% Number of Cases 4712 Total Slides 32223
Month Jun 7 Day TAT 64.21% 10 Day TAT 79.66% 21 Day TAT 95.82% Number of Cases 6490 Total Slides 45070
Month Jul 7 Day TAT 64.12% 10 Day TAT 78.55% 21 Day TAT 95.91% Number of Cases 5278 Total Slides 36091
Month Aug 7 Day TAT 61.75% 10 Day TAT 78.86% 21 Day TAT 96.51% Number of Cases 5767 Total Slides 40499
Month Sep 7 Day TAT 65.34% 10 Day TAT 79.22% 21 Day TAT 96.05% Number of Cases 5015 Total Slides 32778
2026 monthly TAT

If you require an urgent result, please contact the department via its enquiries line ext. 217163 (if external 01223 217163) or email histopathology so that this can be escalated appropriately.

For a copy of the Histopathology handbook and information on biological reference ranges, please contact the department via email histopathology.

Fresh tissue for whole genome sequencing (WGS) - RNA later pathway

Overview

RNAlater is available for solid tumour WGS submissions to East GLH or via CUH histopathology. It stabilises DNA and allows safe storage and transport without immediate freezing. Local validation confirms its suitability for WGS workflows.

Requesting RNAlater

Phone 01223 348213 (Section leader) or email here.

We supply 6 x 5 mL RNAlater universals per request.

How to use RNAlater

  • Trim tissue to ≤5 mm; immerse in ≥5:1 RNAlater:tissue.
  • Storage: RT ≤1 week; 4 °C ≤1 month; for archival, –20 °C/–80 °C indefinitely after overnight at 4 °C to allow penetration.
  • After-hours: place fresh tissue in RNAlater and notify Histopathology the next working day.

Where to send external RNAlater samples needing purity assessment

1000 Discovery Drive, Trumpington, Cambridge, CB2 0AX

Further Information and request form for sending samples to Histopathology in RNA later are available here (opens in a new tab)