CYTOLOGY
Specimen Collection and
Handling
I. Gynecological
Specimens
A.
Conventional Pap Smears
1.
Write the patient’s name on
the frosted end of the slide(s) in pencil.
2.
Prepare 1-2 slide(s) and
spray fix immediately.
3.
Once the slides are dry,
place into the slide holder.
4.
Completely fill out the
pathology request.
5.
Place the specimen and the
request in a biohazard bag.
6.
Submit to the Cytology
Department.
B. ThinPrep
Pap Smears
1.
Obtain an adequate sampling
from the cervix and endocervix.
a. For
broom-like device, rotate the broom in a clockwise
direction 5 times.
b. For
the endocervical brush device, insert the brush into the
cervix until the bottom most fibers
are exposed. Slowly rotate ¼ to ½ turn in one
direction. DO NOT OVER ROTATE.
2.
Rinse the devise as quickly
as possible in the PreservCyt Solution by rotating the
device in the solution
at least 10 times while
pushing against the PreservCyt vial wall.
3.
Tighten the cap so that the
torch line on the cap passes the torch line on the vial.
4.
Label the vial with the
patient’s name.
5.
Place the specimen and the
request in a biohazard bag.
6.
Submit to the Cytology
Department.
C. Maturation
Index Samples (MI)
1.
Label the frosted end of
the slide with the patient’s name (in pencil).
2.
Collect the specimen from
the lateral vaginal wall.
3.
Smear the material evenly
onto a clean glass slide.
4.
Spray fix immediately.
5.
Once the slides are dry,
place into the slide holder.
6.
Completely fill out the
pathology request.
7.
Place the specimen and the
request in a biohazard bag.
8.
Submit to the Cytology
Department.
II. Non-Gynecological
Specimens
A.
Body Fluids
1.
Add the body fluid to
Cytolyt Solution (3 parts specimen to 1 part Cytolyt).
2.
Label the container with
the patient’s name.
3.
Completely fill out the
pathology request.
4.
Place the specimen and the
request in a biohazard bag.
5.
Submit to the Cytology
Department.
B.
Smears
1.
Label a clean glass slide
with the patient’s name.
2.
Evenly smear the material
onto a clean glass slide.
3.
Spray fix immediately or
drop the slide into 95% alcohol container.
4.
Completely fill out the
pathology request.
5.
Place the specimen and the
request in a biohazard bag.
6.
Submit to the Cytology
Department.
C.
Fine Needle Aspirates (FNA)
Label all slides
and containers used in collection of the patient’s
specimen at the time of the procedure with the patient’s
name.
Place a drop of
the specimen on a clean glass slide.
Gently place an
inverted glass slide on top of the first slide and
lightly pull the two slides apart.
Smears should be made as
thin as possible.
Immediately fix
(spray with cytology fixative or drop into 95% alcohol)
one slide and allow the other one to air-dry.
Or both slides can be
fixed.
Place an “X” on
the fixed smear on the frosted end of the slide.
If tissue fragments or
clots are present on the slides, gently scrape these off
with a needle and place in 10% formalin.
Remaining clot or
fluid in the syringe should be placed in cytology
fixative.
Submit specimen
with completed requisition form.
a. Thyroid
FNA
1.
1-2 air-dried smears
2.
1-2 fixed smears
3.
cyst fluid placed in
cytology fixative
4.
needle/syringe rinsed in
cytology fixative
b.
Lymph Node FNA
1.
1-2 air-dried smears
2.
1-2 fixed smears
3.
needle/syringe rinsed in
cytology fixative
c. Breast
FNA
1.
1-2 fixed smears
2.
cyst fluid placed into
cytology fixative
3.
needle/syringe rinsed in
cytology fixative
d. Salivary
Gland FNA
1.
1-2 air-dried smears
2.
1-2 fixed smears
3.
needle/syringe rinsed in
cytology fixative
e. Subcutaneous
Nodule FNA
1.
1-2 fixed smears
2.
needle/syringe rinsed in
cytology fixative
Steps in preparation of smears and
cell blocks
1.
Separate the needle from the syringe.
2.
Fill syringe with
air.
3.
Reconnect the needle
to the syringe.
4.
Gently express one
drop of the needle content onto a clean glass slide.
5.
Place another glass
slide on top of the expressed material and pull the
slides apart. Try to keep the material
within a small area of the slide.
6.
Fix slide (or air-dry, if required).
7. Rinse
the needle in cytology fixative. This material may be
very valuable; do not discard.
NOTE:
Upon request, the NGMC pathologists will perform FNA
biopsies. Please contact the Cytology Department to
schedule.
D.
Cytogenetic Material
1.
Have the patient rise
his/her mouth and brush their teeth before scraping.
2.
Label a clean glass slide
with the patient’s name in pencil.
3.
Gently but firmly draw a
tongue depressor (which has been soaked in distilled
water) forward several
times along the buccal
mucosa. Avoid the white dentate line.
4.
Quickly smear the milky
material onto a clean glass slide and immediately fix in
95% alcohol
or spray fix.
5.
Make at least 4 smears.
6.
Completely fill out the
pathology request.
7.
Place the specimen and the
request in a biohazard bag.
8.
Submit to the Cytology
Department.
E.
Tzanck Prep for
Viral Inclusions
1.
Label a clean glass slide
on the frosted end with the patient’s name (in pencil).
2.
Clean area to be sampled
with Betadine and/or alcohol.
3.
Firmly scrape lesion area
with tongue depressor or scrape with sterile blade.
4.
Using a scalpel blade,
scrape over the lesions
5.
Smear the material
collected onto the glass slide.
6.
Fix immediately in 95%
alcohol or spray fix.
7.
Completely fill out the
pathology request.
8.
Place the specimen and the
request in a biohazard bag.
9.
Submit to the Cytology
Department.