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Bronchial Brushings Collection

Indications: For the detection and characterization of bronchoscopically visible premalignant/malignant pulmonary lesions; for the identification of some microbiologic pathogens (primarily viral and fungal).

Specimen required: Bronchoscopically directed brushing of the identified lesion.

Supplies: Standard bronchoscopy equipment. One (or more if necessary) 5 to 10 mL vial or tube of sterile normal saline or fixative (either CytoRich Red™ cytology preservative or 50% ethanol).

Collection procedures: Using standard bronchoscopy technique identify the lesion in question and obtain a brushing sample of the lesion. Upon withdrawing the brush, agitate the brush vigorously in a 5 to 10 mL vial of sterile saline or fixative. DO NOT APPLY THE BRUSH DIRECTLY TO SLIDES. If possible, detach the brush and leave it in the vial. Label the vial with patient’s first and last name, date of birth and specimen source. Submit the specimen along with the completed Cytology test request form to the Cytopathology Laboratory. If transport of the specimen will be delayed more than 4 hours the specimen should be submitted in CytoRich Red™ cytology preservative or 50% ethanol. If transport time will be less than 4 hours, or fixative is not available, the specimen should be refrigerated or kept on wet ice until transport to the Cytopathology Laboratory.

Fixation: Submit specimens fresh and unfixed if at all possible (see below).
If this is not possible then either:
1. Refrigerate specimen (4°C) or (39°F) up to 24 hours.
2. Add a equal amount of CytoRich Red™ cytology preservative to specimen.
3. Add a equal amount of 50 % ethanol to specimen.
4. Submit specimen in a proprietary transport medium use for liquid based systems, supplied by laboratory (e.g. Cyto-Rich Red™, CytoLyt).

Transport: Each specimen should be placed in a clearly labeled container that is leak proof. Place specimen inside a biohazard transport bag. Paper requisition(s) that accompany the specimen or slides in fixative should be placed in the outside pocket of the biohazard bag to avoid exposure to any leakage of fixative.

Causes for rejection: Incomplete patient requisitions, unlabeled/incorrectly labeled specimen, frozen specimen, incorrect test ordered for specimen, specimen in incorrect or expired fixative, specimen from unauthorized person.

Specimen stability: Up to 24 hours for a fresh specimen, no fixative added and refrigerated (4°C) or (39°F). Fixative added to specimen at room temperature indefinitely

Reference interval: By report.

CPT code: 88104.

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