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Gastrointestinal Specimen(s)

Test indication: For detection and characterization of endoscopically visible gastrointestinal lesions; for the identification of some microbiologic pathogens (e.g. herpes, CMV, and Candida, etc.).

Specimen types: Brushings (Esophageal, GI Junction, Gastric, Duodenal, Bile Duct, Other).

Methodology: Routine cytopathologic evaluation.
Performed: Monday-Friday.
Reported: 1 day.

Specimen requirement: Endoscopically-directed brushing sample of the identified lesion.

Supplies: Standard endoscopy 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 procedure: Instruct the patient to fast overnight or for a minimum of six hours prior to the procedure. Identify the lesion in question and obtain a brushing sample of the lesion using standard endoscopy technique.

Note: It is important to brush the edges of an ulcer, as well as the floor, in order to obtain diagnostic material. Upon withdrawing the brush, agitate the brush vigorously in a 5 to 10 mL vial of saline or fixative. DO NOT APPLY THE BRUSH DIRECTLY TO SLIDES. If possible, detach the brush and leave in the vial. Label the vial with the patient’s first and last name and specimen source. Submit the specimen along with the completed Cytology test request form to the Cytopathology Laboratory. Fixation: Preferred specimen: Fresh, no fixative. If transport will be delayed more than 4 hours the specimen should be partially fixed by adding a equal amount of 50% ethanol or CytoRich Red™ cytology preservative to the specimen or submit the specimen in a proprietary transport medium used for liquid based systems supplied by the 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: 4 hours fresh refrigerated (4°C or 39°F), all GI specimens tend to deteriorate rapidly in the fresh state due to enzymatic activity endogenous to the GI tract.

CPT Code(s): 88104

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