Histopathology / Cytopathology / Hematopathology / PLA Home Page
Test indication: For the detection and characterization of visible premalignant/malignant lesions; for the identification of some microbiologic pathogens (primarily viral and fungal).
Specimen types: Brushing specimens may be taken from any surface of the body including, but not limited to, the following sites: Gastrointestinal tract, Larynx, Nasopharynx, Oral Cavity, Paranasal sinus, Prostate, Respiratory tract and Trachea.
Routine cytopathologic evaluation.
Specimen requirement: Direct brush sampling of identified lesion.
Supplies: Two clean glass slides (single-end frosted), fixative (spray fixative, 95% ethanol, 50% ethanol, Saccomanno or proprietary transport medium, test requisition form, biohazard bag, slide mailer or clean non-sterile leak proof container.
Collection procedure: Using standard technique, identify the lesion in
question and obtain a brushing. 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 directly to the slides.
Fixation: The slide(s) should be fixed immediately. Immediate fixation of cellular sample is necessary to prevent air-drying which obscures cellular detail and compromises specimen evaluation. Fixation can be done by detaching the brush and leaving it in the vial/container of liquid transport medium (CytoRich Red cytology preservative, 50% ethanol or proprietary transport medium). The brush may be submitted in the 50% ethanol equal to the volume of the specimen or in a proprietary transport medium supplied by manufacturers of liquid based systems.
the smear(s) into 95% ethanol. If the specimen is immersed in
ethanol, it may remain in the ethanol for transport to the laboratory
or alternatively the specimen can be immersed in ethanol for
20-30 minutes, removed and allowed to air dry,
Spray fixation: If spray fixed, only quality controlled cytology fixative should be used. The manufactures instructions should be followed. Hold spray 6-10 inches (15-25 centimeters) from the glass slide when applied.
Transport: Fixed smears should be submitted in slide mailer(s), clearly labeled with patient name and specimen site(s). Slides in fixative should be submitted in leak proof container(s) that protect against breakage and clearly labeled with patient name and specimen site(s). Paper requisitions 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. Submit the specimen and the completed test request form to the Cytopathology Laboratory.
Causes for rejection: Incomplete patient requisitions, unlabeled/incorrectly labeled specimen, frozen specimen, incorrect test ordered for specimen, specimen submitted in incorrect or expired fixative, specimen from unauthorized person.
Specimen stability: Fixed slides: Indefinitely. Liquid preservative up to 72 hours, fresh refrigerated specimen time varies. If transport time will be less than 24 hours or fixative is not available, the specimen should be refrigerated at 4°C (or 39°F) or kept on wet ice until transport to the lab.
Reference interval: By report
CPT code: 88104 smears with interpretation.