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Lab Manual for Moffitt-Long and Mount Zion

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Education

Immunology Rotation

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  • UCSF Departments of Pathology and Laboratory Medicine
  • 185 Berry Street, Lobby 2, Suite 100
  • Box 0506
  • San Francisco, CA 94143-0506

Residents gain directed, specific experience in Immunology during a two month combined Clinical Chemistry and Immunology rotation at the UCSF Clnical Labs at China Basin. The major resident educational experience in the Immunology section involves training in the design and interpretation of flow cytometric testing. The laboratory performs over 1000 multi-parameter evaluations of lymph node biopsies and fine needle aspirations, bone marrow aspirates, peripheral blood samples and surgical specimens per year. These studies are done primarily for the diagnosis of hematopoietic malignancy. The standard testing utilizes panels of 20-25 different monoclonal antibodies.

Residents are taught to interpret these data through didactic teaching, one-on-one sessions with the attending and via presentations at a weekly “flow cytometry” conference. Typically, the resident is consulted by the referring physician, obtains the clinical history on the patient and coordinates the testing with the technical staff. Following the testing, the resident reviews the flow data with the attending and then verbally communicates the results with the referring physician. Within the day, the resident produces a written report of the testing results, which the attending reviews/signs and is subsequently entered into the medical record.

Each week, the Immunology resident is responsible for selecting 4-5 flow cytometry cases from the previous week for presentation at the weekly “flow conference.” Through this conference, residents receive basic training in flow cytometry prior to their Immunology rotations.

Residents also receive experience in the evaluation of immuno-fluorescence microscopy for anti-nuclear antibody testing, western blotting for HIV confirmatory testing, and immuno-diffusion testing for various infectious diseases. The Immunology resident is responsible for the approval of most of the low volume infectious disease serologic referral testing done by the UCSF Medical Center under the supervision of attending pathologists.

The UCSF Immunology laboratory performs 300-400 CD4/CD8 counts per month, 400-500 HIV viral load determinations (by bDNA hybridization methods), 2000 serologic tests/month for infectious disease (mainly viral serology), and 300 - 400 serologic tests for autoimmunity. Most of the above testing is partially or fully automated. The clinical immunology laboratory at UCSF is not involved in histocompatibility testing for transplantation.

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