ANAL PAP SMEARS FIX

• The sample is collected with the patient in the lateral recumbent or dorsal lithotomy position.
• A Dacron swab moistened with tap water is inserted blindly 5 to 6 cm into the anal canal past the anal verge and into the rectal vault.The swab is rotated with firm lateral pressure and slowly withdrawn (1).
• Place Dacron swab in SurePath vial, snap off handle and send to PSMG.
• Clearly indicate “ANAL PAP” on requisition to distinguish it from GYN Pap specimen.
• Label the specimen container with specimen source and at least 2 patient identifiers (name and DOB preferred).
• Place completed cytology requisition in the exterior pocket of the plastic bag.Send with the next available courier to the PSMG Cytology Department.
• PSMG does not run HPV testing from Anal Pap smears at this time.

(1) Cibas, Edmund S., and Barbara S. Ducatman.  CYTOLOGY: Diagnostic Principles and Clinical Correlates, Third edition. Philadelphia: Saunders, 2009.

BODY CAVITY FLUIDS (Pleural, Pericardial, Peritoneal) DO NOT FIX

Specimen < 1 Liter send entire specimen.

Specimen > 1 Liter mix specimens thoroughly and remove a 100 ml. aliquot. 

• Label the specimen container with specimen source and at least 2 patient identifiers (name and DOB preferred).
• Place specimen container in plastic biohazard bag and seal.
• Place completed cytology requisition in the exterior pocket of the plastic bag.
• Refrigerate specimen if pick up is not within 24 hours.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up.

• Gently strip subareolar area and nipple with thumb and forefinger.
• When secretion occurs, allow a pea-sized drop to accumulate.
• Touch a clean slide to the nipple and withdraw slide quickly.
• Immediately spray slide with fixative.
• Repeat procedure until all secretions from the breast are collected on two or more slides.
• Label slides with the patient’s name and DOB (in pencil).
• Place slides, when dry, in slide container with completed cytology requisition.
• If no slides are available, you may collect on a Pap smear collection device and place the head of this device into a patient labeled SurePath vial.Be sure to write clearly on the requisitions “Nipple Discharge” to differentiate the specimen from a Pap smear.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up.

• Mix specimen with equal volume of Saccomanno fixative.
• Label the specimen container with specimen source and at least 2 patient identifiers (name and DOB preferred).
• Place specimen container in plastic biohazard bag and seal.
• Place completed cytology requisition into exterior pocket of the baggie.
• Refrigerate specimen if Saccomanno fixative is not available.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up.

• In order to prevent cellular degeneration, send to PSMG promptly.
• Label the specimen container with specimen source and at least 2 patient identifiers (name and DOB preferred).
• Place specimen container in plastic biohazard bag and seal.
• Place completed cytology requisition into exterior pocket of the baggie.
• Refrigerate specimen if pick up is not within 24 hours.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up. Refrigerate specimen if pick up is not within 24 hours. Do not freeze specimen.

• Mix specimen with equal volume of Saccomanno fixative.
• Label the specimen container with specimen source and at least 2 patient identifiers (name and DOB preferred).
• Place specimen container in plastic biohazard bag and seal.
• Place completed cytology requisition into exterior pocket of the baggie.
• Refrigerate specimen if Saccomanno fixative is not available.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up. Refrigerate specimen if Saccomanno fixative is not available. 

• Telephone the Pathologist on call at 891-6244 for technical questions.
• For general questions ask for the Cytology Department at the same number.
• Label slides with the patient’s name and DOB (in pencil).
• Rinse the FNA needle in the Saccomanno fixative and send this rinsing to PSMG for processing. The rinsed needle should be disposed of properly at clinic/hospital, and NOT sent on to the lab
• Label the specimen container with specimen source and at least 2 patient identifiers (name and DOB preferred).
• Place completed cytology requisition into exterior pocket of the baggie.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up.

      

• Label slides with patient’s name, DOB and source of smear in pencil.
• Fix slides immediately with spray fixative.
• Allow to dry and place slide in slide carrier.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up.

• Label the specimen container with specimen source and at least 2 patient identifiers (name and DOB preferred).
• Place specimen container in plastic biohazard bag and seal.
• Place completed cytology requisition into exterior pocket of the baggie.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up.

• Early morning, deep cough specimens are preferred. Instruct patient to rinse mouth with water prior to each collection.Have patient cough deeply from diaphragm and collect sputum.
• Mix specimen with equal volume of Saccomanno fixative.
• Label the specimen container with specimen source and at least 2 patient identifiers (name and DOB preferred).
• Place specimen container in plastic biohazard bag and seal.
• Place completed cytology requisition into exterior pocket of the baggie.
• Refrigerate specimen if Saccomanno fixative is not available.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up. Refrigerate specimen if Saccomanno fixative is not available.

TZANCK SMEAR (Viral/HSV/Herpes Preparation) FIX

• The Viral/Herpes/Tzanck Preparation is the scraping of a lesion or vesicle in order to determine possible viral origin.
• Write patient’s name and DOB on the frosted end of 2 slides in pencil.

Slide One: Open a FRESH vesicle with a sterile blade, spatula or other appropriate instrument (you may also aspirate the lesion) touch the instrument to the labeled slide. Immediately spray fix with cytology (Pap) fixative.  Please DO NOT AIR DRY the slide.

Slide Two:  Scrape the vesicle and touch to the second slide. Do NOT smear.  Immediately spray fix with cytology (Pap) fixative.  Please DO NOT AIR DRY the slide. 

• Place slides, when dry, into slide container and plastic baggie.
• Place completed cytology requisition into exterior pocket of the baggie.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up.

URINE (Void, Catheter, Ileal Conduits) BLADDER WASHINGS FIX

Minimum specimen volume is 25 ml

• First morning urine should be avoided due to possible overnight cellular degeneration. A “clean catch”/ midstream specimen for women is recommended to avoid vaginal cell contamination.
• Hydrate the patient before collection.
• Mix specimen with Saccomanno fixative to a max volume of 100 ml.
• Label the specimen container with specimen source details:voided, catheter, ileal, washing, and at least 2 patient identifiers (name and DOB preferred).
• Place completed cytology requisition into exterior pocket of the baggie.
• If Saccomanno fixative is unavailable refrigerate specimen until pick up.
• Leave for the next scheduled PSMG courier pick-up or call for a pick-up if you do not have a scheduled courier pick-up. Refrigerate specimen if Saccomanno fixative is not available.