Special notes from Cytology





Sputum cytology                     Sputum induction is the preferred method of choice.  Post bronchoscopy sputum is also considered adequate.  A minimum of 2 ml of specimen is needed.


                                                When sputum induction is not possible, a spontaneous early morning deep cough specimen may be obtained.  Nursing Unit personnel give the patient a sputum container (available from the Store Room).  The patient is instructed to rinse his/her mouth thoroughly with water.  Instruct the patient to cough the specimen up from the lung and not from the nasal passages.  Once 5 ml of sputum (not saliva) is collected, the specimen is immediately transported to the Laboratory.  If delivery time is delayed, refrigerate the sputum.  Specimens held longer than 24 hours may be rejected.


Bronchoscopy specimen*       Collect specimen in trap.  Label each specimen to include location (e.g. Bronchial washing left lower lobe lung).  For bronchial brushings, if possible, send the brush in a container with a small amount of saline.  Otherwise, vigorously swirl the brush in the saline to dislodge cellular material.  Please complete the Endoscopy Fiberoptic Bronchoscopy form (MR-34) and submit with the specimen(s).


Fine needle aspiration*           Laboratory staff is available for assistance.


                                                FNA procedures for in-house patients should be scheduled 24 hours in advance.  Please call extension 22870.  A Fine Needle Aspiration Consultation Request (LAB-23) should be completed by the ordering physician and submitted with the specimen(s).


                                                For FNA procedures performed on Outreach patients, aspirate or prepared slides may be submitted.  Please contact Hematology at 962-2870 for assistance.


Fluid cytology*                       Nursing Unit or physician will collect specimen.  Pleural, pericardial or ascitic fluids may be collected plain or heparinized to prevent coagulation.  If anticoagulants are used, heparin, 5-10 units per 1 ml of fluid; or 3.8% sodium citrate, 1 ml per 10 ml; of fluid; or EDTA, 1 mg per 1 ml of fluid.  The entire specimen is immediately transported to the Laboratory.  The maximum amount of fluid should be sent but need not exceed 1500 ml.  Specimens may not be accepted if they are not received in the Laboratory within two hours of collection.


PAP smears                             PAP smears are collected by the physician or personnel from the nursing staff.  Supplies for liquid-base monolayer PAP’s are available from the Laboratory Specimen Center.  Include birth date, social security or other identification number, previous malignancy, drug therapy, radiation therapy, LMP, PMP, surgery, exogenous hormones, abnormal vaginal bleeding, abnormal PAP results, IUD, and all other pertinent clinical information on the request form.  HPV testing is sent to a reference lab.



Tzanck smears                        

or Herpes FA*                        The Herpes direct FA test is more specific and sensitive than a Tzanck smear and should be ordered instead of a Tzanck.  The physician or nursing personnel will normally collect specimens.  To collect proper specimen, remove blister from lesion and then scrape the peripheral base of lesion with a swab.  Place the swab in virus transport media and rotate vigorously.  Squeeze excess media from the swab by rolling it against the side of the tube, then discard swab.  Supplies are available from Microbiology.


Urine cytology                        The second voided specimen of the morning is preferred.  Nursing personnel will instruct patient on how to collect a voided urine specimen.  Specimen is collected in a clean urine container and immediately transported to the Laboratory.  A sterile container is necessary only if a culture is requested on the same specimen.  The Laboratory may not accept specimens if they are not received within 1 hour of collection.


“*” These specimens should be hand delivered to the main lab located in the Tower Building (Building 4) on the "A" level.  They should not be sent via the tube system.