Instruction guides cytology

1. ANATOTOMICALPATHOLOGICALSURGERY (CYTOLOGY)
1- Samplingcriteria
Collectionofthe Fine Needle Aspiration(FNA) specimen
1-Expel the contentsof the needle barrel intothe cytologypreservative.Formost
lesions all of the aspiratedmaterial shouldbe placedintoCytolytfixative.
2-Rinse the needle:Aspirateapproximately2ccof preservative intothe syringe,
throughthe needle,torinse the needle andsyringe of anyremainingspecimen.
Expressintothe specimen container
3-Tightlyre-capthe specimencontainer
4-Ensure the specimencontainer(s) and anyslide(s
5-Keepthe preservedspecimenatroomtemperature orrefrigerated(2-8ºC).Itis
recommendedtoreturnthe specimentothe laboratoryassoonas possible after
collection.Specimenintegrityiscompromisedafter8 daysaftercollection.
Collectionguidelines(otherthanFNA)
 Contact laboratorybefore obtainingcerebrospinal fluidspecimenonpatientsuspected
to have Creutzfeldt-Jakobdisease.
 All specimens mustbe capped/sealedtightly.
 Whenorderingcytologicevaluationandtestsforotherlabs,wheneverfeasible,provide
a separate specimenforthe CytologyLaboratory.If one specimenistobe shared
betweentwolaboratories,pleaseindicateso.
 Refrigerate specimensthatcannotbe sentimmediately.
Breastsecretions: Six-slide technique:The sample isimmediatelyplacedinto95percentalcohol
or sprayedusingan appropriate fixative,beingcertainthe sprayingnozzle isatleast12 inches
away fromthe sample.
Breastsecretionemployingthe cytocentrifuge technique:
The sample be collectedfreshinaclean,coveredcontainerandsubmitteddirectlytothe
CytopathologyLab.Inthese cases,atleast2 mL of sample isgenerallyrequired
Effusions-Ascites, pleural ORpericardial:If aspecimencanbe transportedpromptlytothe lab,
we preferfreshfluid.If itcannotbe immediatelydelivered,addthree unitsof heparinpermLof
fluidtopreventclotting,andplace inrefrigeratoruntil itcanbe delivered. We preferatleast30
mL of sample;andupto 100 mL of sample if possible.
Gastrointestinal tract:Brushedmaterial maybe smeareddirectlyonslides,whichshouldhave
the patient’slastname anda secondidentifierprintedinpencil onone end.If prepared,the
smearsshouldbe fixedIMMEDIATELYin 95 percentethanol andthe slidessenttothe
CytopathologyLab.If the brushis usedinmultiple passesinthe same site,the brushshouldbe
rinsedina sterile containerwith5mLof sterile Plasmalyte® or sterilebalancedelectrolyte
solution(BSS;e.g.Hanks’BalancedSaltsolution).Immediately,afterthe procedure isfinished,
thisrinse fluidshouldbe addedtothe Cytolyt® (preservative)vial orCytolyt® shouldbe addedto
the rinsedfluidtofixed/preserve the material.The minimumCytoLyt® tosample ratioshouldbe

2. 1:3. The brush usedinthe procedure maybe submittedinCytoLyt® (ThinPreppreservative)
preservativefluid(providedbythe Lab) for processingwithpreparedslides.
Respiratorytract(sputum):We preferfreshunfixedsamples.Specimensmaybe refrigerated
until theycan be deliveredtothe CytopathologyLab.Forbestresults,aseriesof earlymorning
specimensshouldbe submittedeachmorningforthree consecutive days.
Bronchial:Sendfreshbronchial secretionsorwashingstothe CytopathologyLabimmediately,or
refrigerate specimensuntil theycanbe deliveredtothe Lab forprocessing.
If slidesare made. Smearthe brushingor aspiratedmaterial andfix the slideimmediatelyin95
percentethanol.DONOTALLOW THE SMEAR TO AIR-DRY.The brush mayalso be placedin
saline orCytolytandsubmitted.Donotforgetto sendthree post-bronchoscopysputum
specimenstothe Lab,obtainedoverthe nextthree days.
In caseswherea sampleis to be shared between the Cytology and Microbiology Labs,a cytology
requestformshould accompany thespecimen to the lab.
Urinary tract (forcancer detection): Sendfreshurine ora bladderwashingimmediatelytothe
CytopathologyLab.Please indicate whether the specimenisvoidedorcatheterizedurine,ora
bladderwashing.If the specimencannotbe broughtimmediatelytothe lab,itMUST be
refrigerated.
For cytomegalicinclusiondisease(CMV) orpolyoma (BKvirus) detection:Freshurineshouldbe
sentIMMEDIATELY to the CytopathologyLabaftercollection.Atleast35mL of urine isrequired.
Woundor lesionscrapes: Scrape the woundwitha moistenedtongue bladeandplace the
material directlyonthe slides.IMMEDIATELYplace the slidesin95 percentethanol,orspray
themwithan appropriate fixative,keepingthe spraynozzle 12 inchesawayfromthe slide
surface.If the woundishard and crusted,itshouldbe soakedwithwarmsaline before obtaining
the scrape.
Testing note: Old-style Tzanck smears for viral changes are of low quality, and we no longer will interpret
them.