skip to main content

FNA/Non-Gyn Cytology Submission Guidelines

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the anal canal past the anal verge and into the rectal vault.The swab is rotated with firm lateral pressure and slowly withdrawn (1).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.
  • Send with the next available courier to the PSMG Cytology Department.
 
BREAST OR NIPPLE SECRETIONS FIX
  • 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.
  • Send to the PSMG Cytology Department with the next available courier.
 
BRONCHIAL (OR GASTRIC) WASHINGS FIX  
  • 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.
  • Send with the next available courier to the PSMG Cytology Department. 
 
BRONCHOALVEOLOAR LAVAGE:  FIX UNLESS… If requesting a lipid stain, do not add Saccomanno fixative
  • If no lipid stain request - 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 in the exterior pocket of the plastic bag.
  • Refrigerate specimen if Saccomanno fixative is not available.
  • Send with the next available courier to the PSMG Cytology Department.
 
BRUSHINGS (bronchial, esophageal, gastric, other) FIX 
  • Label slides with patient’s name and specimen type (in pencil).
  • Rotate brush gently, but rapidly on clean glass slide.
  • Fix slide immediately with spray fixative.
  • Rinse the remaining material from brush or clip off the wire and place the entire brush in a container 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.
  • Send with the next available courier to the PSMG Cytology Department.

 

CSF (Cerebrospinal Fluid) DO NOT FIX

Minimum volume of 1mL (3ml – 10ml preferred) 
  • 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.
  • Send with the next available courier to the PSMG Cytology Department.
  • Do not freeze specimen.
CYST FLUID (Breast, Ovarian, Other) FIX
  • 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.
  • Send with the next available courier to the PSMG Cytology Department.

     

FINE NEEDLE ASPIRATIONS (Breast, Head + Neck, Lung, other) Fixation is specimen dependent 

  • 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.
  • Send with the next available courier to the PSMG Cytology Department.

        

MISCELLANEOUS SMEARS (Skin Lesion, other) FIX
  • 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.
  • Submit to the PSMG Cytology Department with the next available courier.
 
PELVIC WASHING (Abdominal Wash) FIX
  • 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.
  • Send with the next available courier to the PSMG Cytology Department.
 
SPUTUM:  FIX
  • 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.
  • Send with the next available courier to the PSMG Cytology Department.

 

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.
  • Send to the Pathology Sciences Medical Group with the next available courier.

 

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.
  • Send with the next available courier to the PSMG Cytology Department.
 
 
 
Please contact us with questions or to request a specimen pick-up. 
 
cap Accredited
The CAP Certification Mark is a service mark owned by CAP and is used pursuant to a license from CAP.