Additional Specimen Collection Information

All specimens for Cytology must be properly labeled with patient name, identification number, date and time collected and the type of specimen. Submit with the proper requisition. Slides must be labeled in pencil on the frosted end with patient name and date and time of collection.

Bladder Urine Washing, Cytology:

A random urine specimen is recommended for cytological evaluation of the bladder. DO NOT collect the first A.M> voiding. Urine specimens from female patients are to be collected using clean-catch technique. An equal volume of cytology preservative must be added to the specimen immediately after collection.

Cell Block Specimens, Cytology:

After collection, the specimen is fixed in 15 to 20 ml of 10% formalin or 15 to 20 ml of Cytology preservative. If the specimen is a fluid specimen, add an equal volume of Cytology preservative to the specimen immediately after collection. Liquid specimens without noticeable clots or tissue fragments are often unsatisfactory for cell block preparation. These specimens are to be handled as fluids.

Cerebrospinal Fluid, Cytology:

Submit a Wright Stained Cytospin slide, a fixed Cytospin slide and 1 ml CSF fixed in an equal volume of Cytology preservative to the Cytology Dept. Mercy DV laboratory submit a portion of unpreserved CSF to Mercy DBQ to set up the Cytospin slides for Cytology.

Fine Needle Aspiration, Cytology:

• Superficial Aspirations:

1. Make thin smears (as blood smears) or crush preps (place small drop of aspirated fluid on a slide, cover with another slide and pull slides apart).
2. Allow the smear to air dry completely.
3. Place the dried smears in a slide mailer and transport to the laboratory.
4. If cyst fluid is obtained, make 2 to 3 smears as above and then fix the remainder of the fluid in cytology preservative.

• Deep Viscera Aspirations (Performed under radiologic guidance):

Prior to the procedure, contact the laboratory and arrange to have a pathologist present for the aspiration to properly handle the specimens and render an immediate interpretation, if required.

• Superficial Aspirations (Performed by a pathologist):

Contact the MercyOne laboratory and schedule the procedure with the pathologist.

Fluids, Cytology:

Determine if other tests are required on the fluid submitted in addition to Cytology (e.g.: cultures, chemistries, etc…). If so, separate the sample accordingly. Following gentle agitation, laboratory personnel will prepare two air-dried and two spray fixed Cytospin specimens and then fix a 50-100 mL aliquot of a larger specimen or the remaining specimen (if small) with an equal volume of Cytology fixative.

Gastrointestinal Specimen, Cytology:

Specimen is fixed immediately after collection by adding an equal volume of Cytology preservative. In the case of brushings, the brush itself is sent to the laboratory in approximately 10 mL of Cytology preservative. If prepared smears are desired (at physician's discretion), spray-fix the smears immediately. See Prepared Smears, Fixed; Cytology.

Pneumocystis Stain, Cytology:

Collection: An equal amount of Cytology preservative is added by the collector to the specimen. Label the specimen appropriately with the patient name and two identifying numbers (patient ID number, DOB, etc,) Transport to the laboratory. Include patient insurance information.

Pathology: Assign the appropriate Cytology number. If insurance was not sent with the specimen obtain the current insurance information. Send the specimen with the specimen and a copy of the requisition to the CS Histology Dept for Cytology preparation.

Prepared Smear, Cytology:

Specimen is obtained and smeared on pre-labeled (patient’s name) glass slides (at least 2). Spray fixative is applied to cervical-vaginal smears (PAPs) only. Smears should be labeled “air-dried” to indicate that no fixative has been applied. This change from the use of spray fixative to “air-drying only” applies to nipple smears, oral smears, nasal smears, skin smears and fine needle aspirations of superficial palpable lesions (e.g.: breast, thyroid, lymph node).

Respiratory Specimen, Cytology:

Sputum is collected in the morning in a sputum container pre-filled to approximately half capacity with Cytology preservative. (Caution the patient that the preservative is poisonous.)

Collect the specimen using one of the following methods:

• Deep breathing and coughing: Obtain in early morning. Have patient rinse out mouth with water, if allowed. Instruct the patient to take a deep breath and blow it out; take another deep breath, hold it, and cough deeply. Expectorate mucous into a sterile container or luki tube. Label appropriately [including source, date and time of collection].
• Ultrasonic or heated hypertonic saline nebulization: Respiratory therapist will assist the patient with deep breathing treatment for 10 to 15 minutes to aid in loosening secretions. Follow collection procedure for deep breathing and coughing.
• Suctioning with use of sputum trap: Prepare suction equipment. Attach sputum trap between catheter and suction tubing. Provide intermittent suction by placing thumb on and off sputum trap until adequate specimen is collected. When specimen reaches the trap, keep thumb over opening until suction is turned off. Disconnect suction tubing and close opening with small rubber tubing connected to luki tube. Label appropriately [including source, date and time of collection].