Specimen Requirements

Specimen Collection:

• Please DO NOT add fixative to body fluid specimens.
• Identification needed: All specimen containers must be properly labeled (i.e. patient name, date of birth, date and time of collection, collector’s initials, and specimen type). Containers should also be labeled appropriately to indicate the specimen source (including laterality if applicable).
• Specimen should be a fresh, unfixed fluid collection in a clean, leak-proof container.
• Refrigerate if there is a delay in sending specimen to the Laboratory.

Specimen Collection:

• Identification needed: All slides, containers and/or slide holders must be properly labeled (i.e. patient name, date of birth, date and time of collection, and specimen type). Slides or containers should also be appropriately labeled to indicate the source of the specimen (e.g., right or left breast). Also, for nipple secretions please ensure that the frosted end of each glass slide is labeled with the name of the patient, date of birth, and the site (i.e. right or left breast) from which the specimen was collected. Please note that the patient’s name and date of birth must always be written on the slide label regardless of whether or not it appears on the outside of the specimen container (e.g. cardboard slide holder or bottle of 95% ethanol).
• Transportation: Specimens should be sent by courier to the Cytology Department as soon as possible.

FINE NEEDLE ASPIRATION BIOPSY COLLECTION:

The Physician may choose to prepare fixed smears and rinse the needle into CytoLyt or to place the entire specimen into a vial of CytoLyt solution. Ideally, whenever possible two fixed smears should be prepared first, with the remainder of the specimen being rinsed in CytoLyt solution. Needle aspirations that yield scant cellular material or consist mainly of fluid should only be placed into CytoLyt solution. For cases that require an immediate evaluation, smears fixed in 95% ethanol must always be prepared.

1. Label the vial of CytoLyt solution and the frosted end of the glass slides with the patient's name and date of birth. Also, please indicate the site from which the specimen is to be collected (i.e. right or left breast FNA), the date and time of collection, and the collector’s initials
2. Sterilize the skin surface by using a simple alcohol swab for superficial lesions.
3. Assemble the FNA syringe, the needle, and the optional handle
4. Introduce the needle into the target lesion.
5. Once inside the lesion, apply negative pressure move the needle back and forth with a slight change in direction during each motion. Three or four short strokes (less than 1 cm) are usually sufficient.
6.  Release negative pressure and withdraw the needle.

PREPARATION OF FIXED SMEARS USING GLASS MICROSCOPE SLIDES:

1. Remove the needle from the syringe and proceed to draw air into the syringe barrel.
2.  Reattach the needle to the syringe barrel. Express one or two drops of specimen in the middle of a properly labeled plain glass slide. The open edge of the needle bevel should be directed downward to avoid spraying the specimen past the slide.
3.  Place a second labeled plain glass slide face to face with the first slide and allow the specimen to spread without applying pressure. If tissue fragments are present, they may be flattened with very slight pressure. Grasp the ends of the slides and pull them apart in opposite directions. The smears are to be spray fixed or placed into a container of 95% ethanol as quickly as possible.
4. If the specimen clots, is very fluid-rich, or is bloody, too much specimen may be expressed. By touching other plain slides to the specimen pool, several slide pairs may be prepared.

PREPARATION OF SPECIMENS COLLECTED IN CYTOLYT SOLUTION:

1.  Remove the lid from the properly labeled vial of CytoLyt solution.
2. Deposit the sample into the CytoLyt solution vial. Be sure to rinse the needle and syringe thoroughly by drawing CytoLyt solution into the syringe barrel and releasing it back into the vial.
3. Replace the lid on the CytoLyt solution vial and tighten it completely to ensure that there will not be any leakage

NIPPLE SECRETION PREPARATION:

1.  Label one or two clean glass slides with the patient's name and date birth. Also, please indicate the specimen type and laterality (right or left nipple secretion), the date and time of collection, and the collector’s initials.
2. Have the spray fixative uncapped or 95% ethanol fixative prepared and the bottle open.
3. Apply gentle pressure on the areola and proceed to squeeze the nipple between the thumb and index finger. If a secretion is produced, only allow a drop the size of a pea to accumulate on the apex of the nipple.
4.  Support the areola and nipple with one hand.
5. With the other hand, place a properly labeled slide on the nipple and touch the drop. The drop will spread slightly laterally. Proceed to draw the slide quickly across the nipple.
6. IMMEDIATELY spray fix or place the slide into the bottle of 95% ethanol.
7. Repeat the complete procedure a second time if possible.

Specimen Collection:

• Identification Needed: All containers must be properly labeled (i.e. patient name, date of birth, date and time of collection, collector’s initials, and specimen type). Container labels should also indicate anatomic locations, including laterality when applicable (i.e. RUL).
• Transportation: Please transport the specimen(s) to the cytology department of the laboratory as soon as possible following collection. Please note that bronchial brushing specimens often contain the most diagnostic material collected. Therefore, it is extremely important that they be transported to the Cytology Department as soon as possible.
• Preservation: None, immediate processing. In the event that a bronchoscopy specimen arrives when the department is closed, the specimen(s) should be taken to the main lab processing area.

• Identification Needed: All specimen containers must be properly labeled (i.e. patient name, date of birth, date and time of collection, collector’s initials, and specimen type). All containers should be labeled in such a manner as to indicate the order in which they were collected (e.g., A. or 1 or first sample collected; B. or 2 or second, etc)
• Transportation: Specimens submitted for cytologic examination must be delivered to the cytology department IMMEDIATELY following collection. Even a 15 minute delay can result in degeneration of the cells in a CSF specimen.
• Preservation: None, immediate processing. If the specimen arrives during the time that the department is closed, a laboratory staff member should add an equal amount of CytoLyt solution to the specimen. A container of CytoLyt solution is kept on the counter in the Cytology Processing room. The specimen container should be labeled as PRESERVATIVE ADDED and left on the counter with its corresponding order form (if applicable).

Specimen Collection: 

• Identification Needed: All specimen containers should be labeled with the patient name, date of birth, date and time of collection, collector’s initials, and the specimen type (e.g. gastric brushing). When applicable, they should be labeled numerically to indicate the order in which they were collected.
• Endoscopic brush specimens, remove the lid from the vial of PreservCyt solution.  Following collection of the specimen, rinse the brush thoroughly in PreservCyt solution. Press the bristles of the brush against the wall of the container and swirl the brush vigorously to ensure that all of the collected material is released. Discard the brush in a biohazard refuse container. Replace the lid on the PreservCyt solution vial and tighten it until the black torque line on the lid passes the black torque line on the vial.
• Gastric washing specimens, should be collected fresh and transported to the laboratory IMMEDIATELY following collection. Do not rinse gastric washing specimens into PreservCyt solution. Be sure to label the specimen container with the patient name, date of birth, collection date, and the specimen type.
• Transportation: Specimens should be transported to the Cytology Department in the laboratory as soon as possible following collection

Specimen Collection:

 Early morning specimens are preferred and should be collected whenever possible. Prior to collection of the sputum specimen, the patient should brush their teeth and rinse their mouth out with water. This rids the oral cavity of any unnecessary debris that may be seen microscopically

• Identification Needed: All specimen containers must be properly labeled (i.e. patient name, date of birth, date and time of collection, and specimen type).
• Transportation: Specimens submitted for cytologic examination must be delivered to the Cytology Department as soon as possible following collection. If immediate transport is not possible, please refrigerate the specimen in the interim.
• Preservation: None, immediate processing. If the specimen arrives when the department is closed, a laboratory staff member should add 30 ml of CytoLyt solution to the specimen. A container of CytoLyt solution is kept on the counter in the Cytology Processing room. The specimen container should be labeled as PRESERVATIVE ADDED and left on the counter with the corresponding order form (if applicable). Specimens that arrive in the department more than two hours following collection and those that have not been preserved may be considered to be less than optimal for diagnostic evaluation.

Specimen Collection:

PREPARATION OF A FIXED SMEAR USING A GLASS MICROSCOPE SLIDE:

1.  Label the frosted end of the glass slide with the patient's name and date of birth. Also, be sure to indicate the specimen source (including laterality when applicable), the date and time of collection, and the collector’s initials.
2. For open vesicle lesions, gently wipe off surface debris prior to specimen collection. Use a spatula to carefully scrape the lesion and spread the collected material thinly and evenly onto the glass slide. Fix the slide immediately by using the spray fixative
3.  For closed vesicle lesions, carefully break them open and gently remove any fluid and debris before collecting the sample. If the lesion is very dry, it may be moistened gently with a saline soaked gauze prior to sample collection.

PREPARATION OF SPECIMENS COLLECTED IN PRESERVCYT SOLUTION:

1.  Label a PreservCyt vial with the patient's name and date of birth. Also, be sure to indicate the specimen source (including laterality when applicable), the date and time of collection, and the collector’s initials
2.  Remove the lid from the vial of PreservCyt solution
3. Gently wipe off surface debris from open vesicle lesions prior to specimen collection. For closed lesions, carefully break them open and gently wipe away any fluid and debris before collecting the specimen.
4. Carefully brush the lesion with the cytobrush and rinse it into the vial of PreservCyt solution. Press the bristles of the brush against the wall of the vial while stirring the solution ten times.
5. Swirl the brush vigorously to further release cellular material. Discard the brush in the appropriate refuse container. DO NOT leave any portion of the brush in the PreservCyt vial.
6. Replace the lid on the PreservCyt solution vial. Tighten the lid until the black torque line on the lid passes the black torque line on the vial.