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The following specimen processing guidelines outline the proper way to handle each type of patient specimen in order to obtain the highest quality diagnostic results. Our staff is available to assist with any questions or concerns regarding these procedures. Helping your staff handle patient specimens properly is part of what we do. Please call us for clarification, further instructions or advice at any time. We are here to serve you.

 

 

Specimen Requirements 

Collection and Fixation Procedures For Histologic and Cytologic Specimens

 

HISTOLOGY

1. Specimen requisition forms and supplies are provided at no charge upon contacting the laboratory.

2. All specimens must be properly identified with the patient's name and source of specimen (biopsy site).* Specimens must also be accompanied by a request slip that includes all pertinent information, i.e. patient's name, age, source of specimen, date, attending physician, clinical history and insurance data.

3. Routine surgical pathology specimens should be immediately placed in a 10% formalin solution.* This solution and specimen containers of several different sizes may be obtained from the pathology laboratory. Special biopsies or tests, e.g. lymph node biopsies for suspected lymphoma, muscle, frozen section, immunofluorescence, or electron microscopy require different procedures and fixatives; please contact the pathology laboratory in advance for detailed instructions.

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CYTOLOGY

1. Specimen requisition forms and supplies are provided at no charge upon contacting the laboratory.

2. All specimens must be properly identified with the patient's name and source of specimen.* Specimens must also be accompanied by a request slip that includes all pertinent information, i.e. patient's name, age, source of specimen,date,attending physician, clinical history and insurance data.

3. Liquid-based pap smears are obtained by inserting the broom or brush collection device into the endocervical canal and applying gentle pressure until the bristles form against the cervix. Maintain gentle pressure and rotate the brush five times in a clockwise direction. Preserve by popping off the brush head (Cervex-Brush) and/or breaking off the brush head (cytobrush) and placing the entire sample into the preservative vial. Conventional pap smears are obtained by rotating the notched end of an Ayre spatula around the external cervical os and adjacent portio vaginalis. The endocervix is sampled by gently rotating an endocervical brush within the endocervical canal. Any suspicious areas can be scraped directly. All material obtained should be spread evenly over a single glass slide and fixed immediately with 95% alcohol or a suitable substitute, i.e. hairspray or a name brand cytologic fixative.*

4. Special testing on liquid-based cervicovaginal material:  indicate request for HPV, chlamydia, and GC testing on requisition (currently referred to Molecular Pathology Laboratory).

5. Sputum should be collected early in the morning, preferably before breakfast. After rinsing the mouth, the patient should be instructed to inhale to the full capacity of his/her lungs and exhale with an expulsive cough. A deep cough specimen is essential; saliva or sinus mucus is useless as a sputum specimen. It is preferable that the fresh specimen be sent immediately to the pathology lab. If this is not possible, the addition of a suitable cytologic fixative, such as Saccomanno, is necessary.*

6. Endoscopic brushings should be handled in the same manner as pap smears, i.e.spread evenly across one or two glass slides and immediately fixed with 95% alcohol or substitute.*

7. Aspirations, urine, other body fluids and washings are preferably sent fresh and unfixed to the pathology lab immediately. As this is seldom possible, other options are available. Refrigeration is recommended when the elapsed time between collection and processing will be several hours or less. Should the time interval exceed several hours, a cytologic fixative such as Saccomanno should be added to the specimen. Aspirations may be expressed directly onto two or more glass sides, spread thinly and evenly, then fixed immediately with 95% alcohol or substitute.*

8. Breast secretions should be milked directly onto one or more glass slides, spread evenly, and fixed immediately with 95%alcohol or substitute.*

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*It is imperative that all specimens be handled correctly by prompt fixation or by immediate processing of all unfixed specimens. Delayed handling ruins the subtle cytologic and histologic detail necessary for a correct and expeditious diagnosis. State and federal laws mandate the rejection of improperly identified and/or fixed specimens.

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