Histopathology / Cytopathology / Hematopathology / PLA Home Page
Indications: For the detection and characterization of premalignant/malignant pulmonary lesions.
Specimen required: 5 mL (about one teaspoon), or more if possible, of sputum obtained from a deep cough specimen submitted on three to five successive mornings.
Supplies: 120 mL clean plastic specimen container; fixative (either CytoRich Red cytology preservative or 50% ethanol).
Collection procedures: Sputum specimens should be obtained as follows when clinically feasible. The optimum time for specimen collection is within 15 to 30 minutes after waking and before eating breakfast. Brushing of teeth or rinsing of the mouth thoroughly with water will reduce contamination by saliva. Instruct the patient to inhale and exhale deeply, forcing air from the lungs using the diaphragm. Repeat until the patient coughs and is able to produce a sputum specimen. Collect the specimen in the container attempting to obtain at least one teaspoon of sputum. Specimen should be a deep cough specimen and not saliva. Saliva is of no diagnostic value.
Submit specimens fresh and unfixed if at all possible (see below).
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.
Reference interval: By report.
Note: If a good specimen is not obtainable by this method, or if the patient is unable to comply, obtain an induced sputum or tracheal aspirate. The Cytopathology Laboratory will not accept induced or any other sputum samples for the cytologic detection of Pneumocystis, fungi or acid-fast bacilli. If a bronchoalveolar lavage cannot be obtained, the preferred methodology for detection of Pneumocystis is by fluorescent antibody testing. Sputum specimens for fungi and acid-fast bacilli may also be submitted to the Microbiology or Mycology Laboratories for rapid detection procedures of these organisms.
Post-Bronchoscopy sputum: Collect one (1) good, deep cough specimen at any time during the 24-hour period following bronchoscopy, as outlined above. Submit the specimen to the Cytopathology Laboratory, along with the completed Cytology test request form.
CPT code(s): 88108 Concentration and interpretation; 88305 cell block. Additional CPT codes may apply if special studies are required.