Cytology

General
Breast
Body Fluid
Bronchial
GYN (Vag/Cervical)
Oral
Sputum
ThinPrep
Urine

General

All cytology specimens must be labeled and accompanied by a properly completed cytology request form. Specimens should be delivered to the laboratory receiving area if the cytology department is closed (Monday through Friday after 5:00 p.m., Saturday after 12 noon, and Sunday all day) and refrigerated.

Top ^ Breast Cytology

Cyst Fluid
Send the specimen directly to the laboratory. Do not add fixative. The specimen can be sent in a capped, labeled syringe (with the needle removed), if desired.

Nipple Secretions
Place secretions directly onto a frosted-end slide labeled with the patient's name. Gently place a second labeled slide on top of the smeared slide and pull apart forming a thin smear on both slides. Immediately drop the smeared slides into 95 percent ethanol.

Solid Mass
Aspirations from solid masses are collected by a pathologist. NOTE: Include patient age and pertinent clinical data on the request form.

If there are any questions about specimen collection or if you need to order, call the laboratory's Cytology Department.

Top ^ Body Fluid Cytology

Fluid specimens may be collected in any suitable specimen container and transported directly to the laboratory without adding fixative. If the fluid is submitted in a syringe, be sure to remove the needle and cap the syringe before transport. All specimens must be labeled and accompanied by a requisition indicating the patient's name, social security number or medical record number, site of specimen, submitting physician, and any pertinent clinical information including pre/post-operative diagnoses and ICD-9 code, if available.

Top ^ Bronchial Cytology

• Bronchial specimens are collected in surgery by a physician.
• Bronchial brushing slides should be put into Coplin jars containing alcohol immediately after they are made.
• Bronchial fluid specimens should be sent directly to the laboratory unfixed.

Top ^ GYN Cytology

This laboratory accepts both traditional smears and ThinPrep solutions. The preferred procedure for GYN pap smears is using an ectocervical scraper and an endocervical brush. Other sampling techniques are fully acceptable provided both vaginal and cervical-endocervical components are obtained. The following are recommended steps for the Slide Smear Protocol procedure.

• Write the patient's name on the frosted portion of the slides using a lead pencil.
• Insert vaginal speculum without lubricant. If necessary, normal saline or vaginal fluid may be used to moisten the speculum and assist introduction. Obtain vaginal pool and ectocervical material from the ectocervix and the posterior fornix with the large end of a cervical scraper.
• Smear the material down the length of one of the slides. Drop the slide into the alcohol fixative immediately.
• To make a cervical smear, place the endocervical brush through the external os high up in the endocervical canal, and rotate the brush 360 degrees.
• Quickly remove the brush and apply material to the second slide by rolling the brush down the length of the slide.
• Immediately drop the second slide into 95 percent ethanol with the first slide.
• Fill out a requisition, making sure to indicate the patient's full name, social security number, birth date, submitting physician, LMP, site of specimen and any pertinent clinical information such as previous smear or biopsy results, hormone therapy or gravida/para statistics. It is not necessary to label the 95 percent alcohol container, as both slides are identified with the patient's name.

Top ^ Oral Cytology (Smear from Lesion)

• Write the patient's name on the frosted end of a glass microscope slide.
• Soak a tongue blade in water.
• Support the area to be scraped whenever possible.
• Using a tongue blade, vigorously scrape the entire surface of the lesion several times in the same direction.
• Rapidly and evenly spread the scrapings on the microscope slide.
• Immediately drop the slide into alcohol fixative.

Top ^ Sputum Cytology

Have the patient do the following in the morning before eating or drinking.

• Rinse mouth thoroughly with water and discard water. Remove dentures if present.
• Open mouth and take a deep breath and cough deeply with force.
• Repeat until it feels like some material is being coughed up from the lungs.
• Expectorate material directly into a container of sputum fixative.
• Screw cap on tightly.

NOTE: It is recommended that patients follow the above procedure for three consecutive mornings using a separate container each morning.

Top ^ ThinPrep Protocol

• Obtain an adequate sampling from the ectocervix using a plastic spatula. Rinse the spatula into the PreservCyt Solution vial by swirling the spatula vigorously in the vial 10 times. Discard the spatula.
• Obtain an adequate sampling from the endocervix using an endocervical brush device. Insert the brush into the cervix until only the bottom most fibers are exposed. Slowly rotate the brush _ or _ turn in one direction only. Do not over-rotate.
• Rinse the brush in the PreservCyt Solution by rotating the device in the solution 10 times while pushing against the PreservCyt vial wall. Swirl the brush vigorously to further release material. Discard the brush.
• Tighten the cap so that the torque line on the cap passes the torque line on the vial.
• Record the patient's name and social security number on the vial.
• Fill out a requisition making sure to indicate the patient's name, social security number, birth date, submitting physician, LMP, site of specimen and any pertinent clinical information such as previous smear or biopsy results, hormone therapy or gravida/para statistics.

Top ^ Urine Cytology

• Specimens may be collected any time during the working hours of the cytology laboratory.
• Female patients should be instructed to wash their external genitalia with soap and water.
• Have the patient void directly into container or collect a catheterized specimen.
• Send the specimen directly to the laboratory.