Cytopathology Services for Upstate University Hospital - Community Campus

Specimen Labeling:

All specimen containers and slides must be labeled with the patient’s name and specimen source. Containers should additionally include another patient identifier (such as date of birth), and the date and time collected. Slides should be labeled in pencil, as our processing reagents will dissolve ink.

The specimen should be accompanied by a cytology requisition form. This form should be completed to include pertinent patient history, especially history of previous malignancy, treatment with chemotherapy or radiation therapy, and significant clinical findings such as the presence of a mass/lesion. Multiple samples representing different body sites must each be accompanied by a separate requisition form.

GYN (Cervical/Vaginal) Cytology:

The examiner should sample the squamocolumnar junction (T-zone). Use of broom-type devices or combined use of Ayre spatula with cytobrush are acceptable methods of sampling.

Collecting exfoliated cells from the vaginal pool is desirable in postmenopausal women, as it improves the chance of detecting endometrial carcinoma.

For SurePath Pap tests, the collection device is detached so that the end of the device and patient specimen are deposited in the SurePath fixative vial. For Thin Prep Pap tests, the collection device should be rinsed directly into a vial of Preserv-Cyt solution, available from the cytology section. For conventional Pap smears: the specimen should be spread evenly across the glass slide and be immediately immersed in 95% alcohol (available from the cytology section). Alternatively, the specimen can be spray fixed with cytology fixative. ThinPrep or SurePath specimens are preferred.

It is important not to contaminate the specimen with lubricant if a ThinPrep Pap test is being performed.

Rejection of Specimens:

A diagnostic report will not be issued if:

  1. The apparent condition of the specimen indicates that it is unsatisfactory for testing or that it is inappropriate for test requested.
  2. It has been collected, labeled, preserved or otherwise handled in such a manner that it has become unsatisfactory or unreliable as a test specimen. Specimens submitted in formalin cannot be processed for cytology.
  3. The slide is broken to such an extent that it cannot be repaired adequately so that cells are not obscured or lost.
  4. It contains insufficient cells or the cells are obscured by inflammation, blood, or lubricating ointment, so that an accurate diagnosis cannot be made.
  5. The specimen is unlabeled or mislabeled.

Non-GYN Cytology:

  1. Includes anal rectal cytology, urine, body fluids, washings, brushings, and fine needle   aspiration cytology.

Anal Rectal Cytology (ARC):

  1. Use a moistened Dacron swab.
  2. Insert into the anal canal until resistance is not met (approximately 5-6 cm above the anal verge to distal rectum).
  3. Rotate/apply pressure to walls of canal while removing sampling device.
  4. Agitate sampling device in liquid-based cytology solution (ThinPrep or SurePath).
  5. Label specimen and complete requisition.
  6. For more information, call the Cytology Department during normal business hours.

Urine Cytology:

  1. Voided urine, catheterized urine, bladder washings, ureteral washings, and renal pelvic washings, are acceptable.
  2. Send the specimen in clean, leak-proof container. At least 50 ml. of specimen is needed for optimal processing.
  3. No fixative should be added.
  4. Deliver to the laboratory immediately. The specimen may be stored in a refrigerator overnight.
  5. Submitting urine cytology on the weekend should be avoided as the cells tend to degenerate after 24 hours.
  6. First morning voided urine should not be sent, as the cells tend to degenerate while sitting in the bladder overnight. Second morning voided urine specimens are recommended for Cytology testing.

Body Fluids:

  1. Acceptable specimens include pleural fluid, thoracentesis fluid, ascites, paracentesis, pelvic washings, culdocentesis, peritoneal fluid, pericardial fluid, and synovial fluid.
  2. Send the specimen in a clean, leak-proof container. At least 5 ml. of specimen is needed for optimal processing, although 50 ml is preferred. No glass Vacutainer bottles are accepted.
  3. No fixative should be added.
  4. Deliver to the laboratory immediately. The specimen may be stored in the refrigerator over the weekend if necessary.

Brushings:

  1. Acceptable specimens include bronchial brushings, esophageal brushings, gastric brushings, small bowel brushings, colonic brushings, and bile duct brushings.
  2. Roll brush over a labeled glass slide to cover the area of a dime, and drop immediately into 95% alcohol (available from the cytology section).

Washings:

  1. Acceptable specimens include bronchial washings and bronchioloalveolar lavage (BAL) fluid.
  2. Send specimen in clean, leak-proof container. At least 2 ml. of specimen is needed for optimal processing.
  3. No fixative should be added.
  4. Deliver to the laboratory immediately. Specimen may be stored in the refrigerator for up to 24 hours.

Sputum:

  1. A deep cough specimen, preferably early in the morning, is recommended. At least 3 ml. of specimen is needed for optimal processing.
  2. Place in a clean sputum container.
  3. No fixative should be added.
  4. Deliver to the laboratory immediately. Specimen may be stored in the refrigerator for up to 24 hours.
  5. Three consecutive first morning sputum specimens are recommended to significantly increase the chance of cancer detection.

Cerebrospinal Fluid:

  1. Place the fluid in a sterile tube or leak-proof container.
  2. At least 1 ml. of specimen is needed for optimal processing.
  3. No fixative should be added.
  4. Deliver to the laboratory immediately. Specimen may be stored in the refrigerator for up to 24 hours.

Nipple Discharge Cytology:

  1. Allow a pea-size drop to accumulate on nipple. Place a labeled glass slide on nipple and slide across quickly. Fix immediately in 95% alcohol (available from the Cytology department, 315-410-7210).

Fine Needle Aspiration Cytology:

  1. Preparation and interpretation of aspirates is performed Monday through Friday, from 8:00 a.m. to 3:00 p.m.
  2. These specimens receive priority attention, and every effort will be made to provide a turnaround time of 24 hours.
  3. Aspirates are not processed or interpreted on evenings/weekends.
  4. The contents of the needle must be injected into a vial of Cytolyt solution (available from the cytology section). Flush the needle with the Cytolyt solution from the container until the entire contents of the needle have been expelled into the Cytolyt container. If a second pass is to be attempted, the needle must be changed. Do not attempt to re-aspirate with the same needle. The Cytolyt contains methyl alcohol which is poisonous.
  5. The Cytolyt vial containing the specimen is then sent to the laboratory for processing.
  6. Alternatively, the specimen may be expelled from the needle onto a glass slide. A second slide can be placed on top of the first slide; the two slides are then gently pulled apart and immediately fixed in 95% alcohol (available from the cytology section). The alcohol-fixed slides are then sent to Cytology for processing.

Quick Read Evaluation of Fine Needle Aspiration Biopsy Specimens:

  1. Send an unstained air-dried smear along with a completed Adequacy Form to the Pathology lab.
  2. The smear will be stained and reviewed by the pathologist on call to determine the adequacy of the specimen.
  3. The pathologist will call the radiologist to report on the adequacy of the specimen. The entire process usually takes 10-15 minutes. If the specimen is deemed inadequate, the radiologist has the option of performing additional passes.
  4. Any smears that are not going to be sent for immediate evaluation should be quickly placed in 95% alcohol and sent to Cytology with a completed requisition form.
No Appointment Necessary
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