Non-Gynecological Specimens

Superficial Skin Lesions (Viral Smears)
Smears may be utilized when examining a variety of body sites.  Example:  oral mucosa, ulcerated skin lesions, etc.  Smears are most often used in herpes detection.  A direct scrape procedure is preferred.  A cotton swab should not be used to obtain a sample because diagnostic cells will become trapped in the fiber matrix.

1. Apply a wet compress over the lesion for 15 minutes.  This loosens cellular debris and makes a lesion easier to scrape.

2.  The overlay crust or vesicles dome should be removed and the underlying ulceration scraped.  The edges of the lesion will have the best yield of cells with morphologically recognizable inclusions.

3.  One of two methods can be used to collect and preserve cells.

• A.  Using the edge of a spatula, scalpel blade or glass slide, scrape ulceration.  Spread collected material thinly on labeled glass slide.  Fix immediately with spray fixative or immerse in 95% ethyl alcohol.
•  B.  Using a plastic spatula, scrape ulceration.  Quickly immerse and rinse spatula vigorously in the vial 10 times.  Use only plastic spatula approved for use in Thin Prep Solution vials.  Label vial with patient's name

4.  Fill out cytology request slip completely to include patient's name, date of birth and pertinent history.  Also include site from where smears were taken.

Nipple Secretion

1.  Wipe areolar area with alcohol soaked gauze.

2.  Squeeze nipple to produce a drop of secretion.

3.  Wipe away first drop of secretion.

4.  Label frosted slide with patient's name.  Touch slide to second drop and draw slide across nipple epithelium.  Immediately spray fix slides or immerse in jar of 95% alcohol.

5.  If possible, secretion can be expressed directly into vial of Thin Prep PreservCyt solution.  Label vial with patient's name.

6.  Fill out cytology request slip completely, including patient's name, date of birth, date of specimen obtained, and pertinent history.

Sputum
Early morning sputum specimens yield the greatest number of diagnostic cells.  The patient must be able to produce a deep cough that is confirmed by the presence of macrophage on microscopy or the specimen will be deemed unsatisfactory.  A series of three first morning specimens (one collected each of three consecutive mornings) should be obtained.  Post bronchoscopy sputum specimens are potentially richest in cellular material and thus high in diagnostic value.

1.  Collect expectorated deep cough specimen into cup.  The patient should be encouraged to expectorate deep sputum, not saliva.  Refrigerate or fix with 50% ethyl alcohol.

2.  Label cup with patient's name.

3.  If a series of three are collected, label each with #1, #2, #3 to correspond with the specimen number.

4.  Fill out cytology request slip completely, including patient's name, date of birth, date specimen obtained, and pertinent history.

Bronchial Washings
The specimen for cytology - send to laboratory immediately.  Fill out cytology request slip completely, including patient's name, date of birth, date specimen obtained, and pertinent history.

Bronchial Brushing
Label frosted end of slide with patient's name.  When specimen is obtained, make a few slides by rolling brush across slide.  Immediately immerse slides in jar of 95% ethyl alcohol or spray fix.  Clip the end of the brush and immerse in 95% alcohol.  Fill out request slip completely, including patient's name, date of birth, date specimen obtained, and pertinent history.

Urine
The method of collection is critical to cytologic interpretation as is the specimen preservation.  Voided urines represent an excellent sample for cytological examination.  Catheterization may produce a somewhat cleaner specimen in samples from women.

The best samples are those which are collected during periods of high flow through the urinary tract.  Urine which has been sitting in the bladder for a long period of time, such as the first morning voided specimen, is of little value.  It is desirable to duplicate the protocol below as much as possible when collecting voided urine samples.

1.  Ask the patient to drink one glass of water every fifteen minutes for two hours.  This should cause the patient to void frequently.  Collect the specimen at the end of two hours.

2.  Collect 50-100 ml. of voided urine.

3.  Label sample cup with patient's name and date collected.

4.  Fill out request slip completely, including patient's name, date of birth, date obtained, and pertinent history.

5.  The specimen should be kept cold (refrigerated or on ice) until it is received in the cytology lab.

6.  If the specimen will not reach the cytology lab within 24 hours, add an equal volume of 50% ethyl alcohol to the specimen.

Body Fluids
This method can be used for effusion, cyst aspiration, synovial fluid aspiration, etc.

1.  Collect specimens as condition dictates.

2.  If there is a large amount of fluid collected, mix contents well and send 150-200 cc. to cytology lab.

3.  Label containers with patient's name and date collected.

4.  Fill out request completely, including patients name, date of birth, date specimen obtained, pertinent history, and type of specimen.

5.  Specimen should be kept cold until it is received in the cytology lab.

Spinal Fluids
When specimen is collected, it should be kept refrigerated until it is sent to lab.  If specimen will not reach lab within 24 hours it should be fixed with an equal volume of 50% ethyl alcohol.  If specimen is fixed, it should be noted on slip.  Fill out request slip completely including patient's name, date of birth, date specimen obtained, and pertinent history.