URINE CYTOLOGY
Bladder washings, ureteral washings, renal pelvic washings, voided urine, catheterized urine

For voided urine, do not send first morning specimen.  A second morning, voided specimen is preferred.

Send specimen in clean, leakproof container; not less than 50 ml.

Deliver immediately or store in refrigerator (no more than 24 hours). Do not freeze.

Voided urine is much preferred over a catheterized sample, due to atypical cell changes caused by trauma.

SPUTUM CYTOLOGY
Sputum series

Three (3) consecutive first morning sputum specimens of at least 3 ml (1 tablespoon) (significantly increases chance of cancer detection).

Place in clean sputum container.

Deliver immediately or store in refrigerator (no more than 24 hours.) Do not freeze.

Do not submit saliva or nasal aspirates.

If macrophages are not identified, specimen will be reported as “unsatisfactory”.

CEREBROSPINAL FLUID
Spinal fluid cytology

Not less than 1 ml fresh fluid.

Place in sterile tube or disposable leakproof container.

Deliver immediately or store in refrigerator (no more than 24 hours.) Do not freeze.

NIPPLE DISCHARGE CYTOLOGY
Breast discharge (drainage from any body site)   

Allow a pea-size drop to accumulate on nipple.

Place a glass slide on nipple and slide across quickly.

Fix immediately with spray fixative.

Drying of smear before fixation will render it unsatisfactory for evaluation.

Please have patient identifying information labeled on glass slides(s) with pencil.

BRUSHINGS, CYTOLOGY
Bronchial brushings, esophageal brushings, gastric brushings, small bowel brushings, colonic brushings, tracheal brushings, oropharyngeal brushings, bile duct brushings.

If smearing directly onto a slide: Roll brush over glass slide to cover the area of a dime and fix immediately in 95% alcohol provided or spray fixative (spray fixative is preferred).

If more than one slide is used, separate them with paper clips on frosted end of slide

AND/OR

Label one CytoLyt container (provided to floors upon request to the Cytology lab) with the patient’s name, date of collection and specimen type.

After the brush specimen has been obtained, cut off the brush and drop it into the CytoLyt container.

Send the container to Cytology.

If necessary, this specimen may be held overnight, or over the weekend unrefrigerated.

If smearing directly to the slide:
Causes for rejection or unsatisfactory specimen are: improper fixation, air drying artifact, unlabeled slides or container;

If using CytoLyt:
Unlabeled vial.

WASHINGS CYTOLOGY
Bronchial washings, esophageal washings, tracheal aspirate

Submit 2 - 50 ml plastic centrifuge tubes.

Deliver immediately or store in refrigerator (no more than 24 hrs). Do not freeze.

Do not allow to stand for prolonged periods (greater than 24 hrs).  Deterioration of cells occurs and makes evaluation difficult.

Specimens should not be sent in glass containers.

The plastic centrifuge tubes are provided by the Operations Center.

BODY FLUIDS CYTOLOGY
Ascitic fluid, culdocentesis, paracentesis, pelvic fluid or washing, pericardial fluid, peritoneal fluid or washing, pleural fluid, synovial fluid, thoracentesis fluid

Submit 2 - 50 ml plastic centrifuge tubes.

Deliver immediately or store in refrigerator no more than 24 hrs. Do not freeze. Do not add fixative.

May be stored in refrigerator over the weekend.

FINE NEEDLE ASPIRATION CYTOLOGY
Fine needle aspiration (including cysts/ abscesses)

The Pathology Department also provides adequacy assessment for FNAs. Please call 470-2626 or extension 8123 during the hours of 7:30 a.m. to 5 p.m. to let us know a specimen will be sent for adequacy assessment. After 5 p.m. or during weekends, call Central Receiving at 570-7391 to contact the on-call pathologist.

Request from the lab a vial of CytoLyt.  Label the container of this solution with the patient’s name, date of collection, and specimen type.  The specimen is collected in a needle and syringe.  Use air to inject the contents of the needle into the CytoLyt solution container.  Flush the needle with CytoLyt solution from the container until the entire contents of the needle have been expelled into the CytoLyt container.

DO NOT ATTEMPT TO RE-ASPIRATE WITH THE SAME NEEDLE.  CHANGE NEEDLES IF A SECOND “PASS” IS TO BE ATTEMPTED.  THE CYTOLYT CONTAINS METHYL ALCOHOL WHICH IS POISONOUS.

If necessary, this specimen may be held overnight or over the weekend unrefrigerated. 

In addition, direct smears should be performed for FNAs of a thyroid or salivary gland lesion.  If direct smears are to be performed, half of the slides can be immediately spray-fixed or placed in 95% ethyl alcohol (spray-fixed is preferred), while the other half can be air-dried.  The slides must be labeled with patient identifying information in pencil.

Please note:  Place no more than a pea-size drop of aspirated material on a glass slide to make direct smears.  Also note that after aspirated material is expelled onto a glass slide for direct smears, the needle should be rinsed in CytoLyt (or RPMI if lymphoma is suspected).

If lymphoma is suspected or needs to be ruled out, the first passes should be placed in RPMI transport medium, which maintains cell viability for flow cytometry and cytogenetics testing.  RPMI should be transported to Central Receiving in the Laboratory as soon as possible or refrigerated if delayed delivery; RPMI should be kept refrigerated prior to use as well.

Please make two air-dried smears from the first pass by expelling a very small drop from the needle onto a glass slide prior to placing remaining  aspirated material in RPMI.  The air-dried slides will help correlate the morphologic features with the flow cytometry testing.  Minimum number of passes is 3-4.  Any additional passes can be placed in CytoLyt.

HERPES CYTOLOGY
Tzanck cell prep

Use a tongue depressor or moistened cotton swab to get a direct scrape of lesion. 

Place in PreservCyt solution and gently agitate for 10 seconds.  This solution is provided to the floors upon request to the Cytology Lab.

Place patient name, ID, specimen site/type on vial.

THINPREP PAP SMEAR

Labeled ThinPrep vial, collected by cervix brush or cytobrush/spatula – rinse collection device well in fixative.

Unlabeled/mislabeled.

SUREPATH PAP SMEAR

Labeled SurePath vial with the end of the sampling device and patient specimen in the fixative.

Unlabeled/mislabeled.

Rejected if sampling device is not present in vial.

CONVENTIONAL PAP SMEAR

One slide Pap smear, labeled in pencil, collected with cervix brush, cytobrush or spatula, mono-layer smear fixed with 95% ETOH or spray fix.

Unlabeled, mislabeled, air-dried or formalin fixation.