Cytology


General Considerations

All specimens delivered to the laboratory must adhere to the following requirements. Specimens will be accepted only from physicians or authorized clinicians.

  • Requisition forms must include:

    • Patient's legal name -- legibly printed or typed

    • Patient's date of birth

    • Type of specimen submitted

    • Office or hospital submitting specimen

    • Date of service

  • The specimen container must indicate two unique identifiers:

    • Patient Name, D.O.B., Social Security number; Medical Record Number

    • or Type of specimen submitted

  • All non-gyn specimens must be submitted in a leak-proof container that is placed in a sealed biohazard specimen bag

  • All bagged specimens shall have an accurately completed requisition accompanying them

  • Allow all spray fixed and air dried slides to dry completely before placing in cardboard slide carriers for transport

  • When sending slides fixed in 95% alcohol filled bottles, be certain the caps are tightened before transport

Unacceptable Specimens

  • A specimen may be considered unacceptable if certain of the above criteria are not fulfilled. Unlabeled specimens may be returned for proper identification (This is an accreditation requirement)

Note: if surgical specimens are co-submitted--they must be placed in a separate bag from the cytology specimen to avoid formalin fume contamination.


Cytology At-A-Glance Submission Requirements

Gynecological Specimens
Chlamydia smears One air dried slide
Smear for detection of viral changes (Tzanck smear) Spray fixed slide(s)
Pap smear, liquid based-See instructions below SurePath vial Note: HPV, Chlamydia GC, and HSV tests may be run from the same vial.
Pap smear, conventional Spray fixed slide(s) 
Smear for maturation index Spray fixed slide(s)
Non-Gynecological Specimens
Prepared slides  
Buccal smear Spray fixed slide(s)
Nipple secretion Spray fixed slide(s)
Smear for detection of viral changes Spray fixed slide(s)
Urinary Tract  
Urethral wash Add equal amount of cytology fixative, refrigerate
Ureteral wash Add equal amount of cytology fixative, refrigerate
Bladder wash Add equal amount of cytology fixative, refrigerate
Urine; voided Add equal amount of cytology fixative, refrigerate
Urine; catheterized Add equal amount of cytology fixative, refrigerate
Bronchoscopy Specimens  
Bronchial wash Refrigerate until pickup/delivery; fresh specimen
Bronchial brush Prepared slides; spray fix OR drop into bottle of 95% alcohol
Used brush Place brushes into a container of cytology fixative
Sputum Collect in cytology fixative
Cytology and/or Special Stains Collect in cytology fixative, refrigerate
FNA (Fine Needle Aspiration)  
Prepared smears Spray fix; air dried slides may be made on some samples
Fluids Express material into a container of cytology fixative
Esophageal wash/brush Refer to bronchial wash/brush instructions above
Body Cavity Fluids Refrigerate until pickup/delivery
Cyst Fluids

Refer to body cavity fluids

Peritoneal washing

Refer to body cavity fluids


SurePath Submission Instructions

  1. Observe universal precautions for collecting and handling specimens.

  2. Insert the broom into the endocervical canal. Apply gentle pressure until the bristles form against the cervix. Maintaining gentle pressure, hold the stem between the thumb and forefinger. Rotate the brush five times (360 degrees) in a clockwise direction.

  3. Preserve the entire sample by placing your thumb against the back of the broom pad, and disconnecting the broom head from the stem directly into the SurePath preservative vial. 

  4. Place the cap on the labeled vial. 

  5. Mark the lab requisition with the tests to be performed on the specimen: 

    a. Pap: Pap smear results 

    b. HPV: HPV testing performed whether or not the Pap result is abnormal 

    c. HPV Reflex: HPV testing performed if the Pap result is atypical 

    d. CT: Chlamydia testing

    e. Gonorrhea: Gonorrhea testing

  6. Quad screen: Pap, Reflex HPV, Chlamydia, and Gonorrhea testing

  7. Quad screen plus: Includes the Quad screen and HSV testing. 

    Note: All of the above tests may be performed on one specimen
     

  8. Place the vial and requisition into specimen bag and submit to the laboratory.