UPMC Presbyterian-Shadyside
Pittsburgh, Pennsylvania
DEPARTMENT OF PATHOLOGY
POLICIES AND PROCEDURES
Policy: CYTO 2.1
Subject: Specimen Collection
Effective Date: February 2011
POLICY/PRINCIPLE
It is the policy of the PUH/SHY cytology lab to assure that specimens submitted for cytologic
evaluation be collected and submitted in the appropriate manner to ensure optimal quality of
patient care. Properly collected specimens yield the optimal quality and volume of cells to enable
the most accurate diagnoses.
SCOPE
Instructions for collection of cytology specimens are included on SharePoint and are available to
nursing units and physician offices, entitled Laboratory Test Information and Specimen Collection
Manual.
Instructions for collection of cytology specimens outside of the UPMC system can be accessed on
the UPMC Department of Pathology Non Gynecologic Cytology Webpage (link to word document
half way down the page).
RESPONSIBILITY
This policy is the responsibility of all individuals involved in the collection, labeling and handling of
Cytopathology specimens.
PROCESS
Patient Identification
According to UPMC PUH-SHY policy # CP-17 Patient Identification, “It is the policy
of UPMC Presbyterian Shadyside (UPMCPS) that all patients receiving care shall
be properly identified by hospital personnel. It is further the policy of the hospital
that each department will define and implement an intradepartmental procedure in
support of this policy which will assure proper patient identification at all times.”
Type of container and amount of specimen to be collected/collection requirements.
All collection containers submitted to the Cytopathology Lab for processing must
be labeled with the patients full name, a second patient identifiers (i.e., Date of
Birth or, Medical Record Number or, Social Security Number) and the source from
where the sample was collected (ie, Pleural Fluid, Bile Duct Brushing, etc...). A
paper requisition or electric order with matching information must also accompany
the patient sample for testing. Any missing items will delay specimen
processing or result in specimen rejection. *95% EtOH slide jars, formalin, and
CytoLyt available from the Cytology Lab (PUH: 412-647-0375 or SHY: 412-6232331).
Cytology
Specimen Type
Container/Media
Special Handling Instructions
Fine Needle
Aspirations (USguided, CT-guided,
EBUS, EUS, and
Superficial FNA's)
excluding Thyroid
FNA's (see below).
PUH: Smears fixed in
95% EtOH jars.
Additional needle
rinses must be
submitted in formalin or
CytoLyt.
Smears made on-site at the time of procedure should
be fixed immediately in a container of 95% EtOH to
prevent air-drying artifact. Smears should be labeled
using an approved STAT pen or a No 2 pencil with
the patients name and second identifier (DOB, SS# or
MR#). DO NOT USE A REGULAR PEN OR SHARPIE
MARKER.
SHY: It is preferred that
no slides be made and
all needles just be
rinsed in CytoLyt.
Thyroid FNA's
CSF
Core Needle
Biopsies without onsite evalutaion
Air dried smears and
smears fixed in 95%
EtOH are required for
thyroid evaluation.
Additional needle
rinses may be collected
in a CytoLyt container
for Thin Prep
processing. Molecular
Testing Note:
Samples being
collected for potential
MAP studies should be
collected in RNA/DNA
Stabilization Reagent.
Fresh and in a clean
container with at least
1 cc of fluid is
preferred.
Two smears should be made for each FNA pass onsite at the time of procedure. One should be air dried
and sent in a clean container and the other should be
fixed immediately in 95% EtOH to prevent air-drying
artifact. Smears should be labeled using only an
approved STAT pen or a No 2 pencil with the
patients name and second identifier (DOB, SS# or
MR#). DO NOT USE A REGULAR PEN OR SHARPIE
MARKER.
Cores should be
submitted in formalin
All specimen containers must be labeled with patient
name and second identifier (DOB, SS# or MRN#).
Core needle biopsies should be placed directly into a
formalin container and submitted to Surgical Pathology.
All specimen containers must be labeled with patient
name and second identifier (DOB, SS# or MRN#).
Note: All CSF's delivered to Specimen Processing
between 4:30 PM and 4:00 AM Monday through Friday,
as well as weekends are sent to Hematology Lab for
preliminary processing.
BAL/Bronchial
Washing
Minimum 5 ml. Fresh
and in a sterile
container.
Bronchial Brushing
Brush submitted in
CytoLyt Vial or
Clean container with
saline
Brush submitted in
CytoLyt Vial or
Clean container with
saline
Fresh and in a clean
container.
Bile Duct Brushing
Brain Cyst Fluids
Bladder
Washing/Urine
Esophageal
Brushing
Fresh in clean
specimen container.
Add CytoLyt if it will be
sitting over night or
over the weekend.
CytoLyt Vial or
Clean container with
saline
Submit with requisition (Cytology order written) to the
Microbiology Lab at the Clinical Lab Building (PH: 412647-3727). If Microbiology is not requested please
send sample directly to Cytology Lab.
All specimen containers must be labeled with patient
name and second identifier (DOB, SS# or MRN#).
All specimen containers must be labeled with patient
name and second identifier (DOB, SS#, MRN#).
CytoLyt vial should also contain the brush.
All specimen containers must be labeled with patient
name and second identifier (DOB, SS# or MRN#).
CytoLyt vial should also contain the brush.
Submit all brain cyst fluid originating at PUH directly to
PUH Gross Room for processing. Those originating
from SHY remain at SHY unless there is a correlating
surgical.
All specimen containers must be labeled with patient
name and second identifier (DOB, SS# or MRN#).
All specimen containers must be labeled with patient
name and second identifier (DOB, SS# or MRN#).
CytoLyt vial should also contain the brush.
Misc. Fluid
Collections
Fresh and in a clean
container.
All specimen containers must be labeled with patient
name and second identifier (DOB, SS# or MRN#).
Pleural, Ascites, &
Pericardial Fluids
Fresh and in a clean
container. A minimum
of 5 ml, not to exceed
1000 ml.
Fresh and in a clean
container or in CytoLyt
container
DO NOT SEND IV COLLECTION BAGS OR
PLEURAVACS. All specimen containers must be
labeled with patient name and second identifier (DOB,
SS# or MRN#).
All specimen containers must be labeled with patient
name and second identifier (DOB, SS# or MRN#).
Sputum
Fresh and in a clean
container.
All specimen containers must be labeled with patient
name and second identifier (DOB, SS# or MRN#).
Lymphoma Work-up
Preferably in RPMI
media, fresh fluid is
also acceptable.
All specimen containers must be labeled with patient
name and second identifier (DOB, SS# or MRN#).
Send to Cytology with written request for FLOW
Cytometry.
Smears should be labeled using only an approved
STAT pen or a No 2 pencil with the patients name
and second identifier (DOB, SS# or MR#). DO NOT
USE A REGULAR PEN OR SHARPIE MARKER.
Pancreas Cyst Fluid
PUH ONLY
Tzank Smear
Gently scrape the area
of abnormality. If the
abnormality is a
vesicle, remove the
covering and scrape.
Smear the material on
glass slides and fix in
95% EtOH
immediately.
5.0
REFERENCES
Gill GW. Cytopreparation. Principles and Practice. Springer 2013.
6.0
ATTACHMENTS
Attachment 2.1 A: Cytopathology Requisition
TS Reviewed:
NPO 11/23/12 (SP)
WK 11/14/12 (SP)
NPO 11/23/11 (SP)
WK 11/14/11 (SP)
WK 3/21/11
NPO 2/14/2011
NPO/WK 1/2010
MD Reviewed:
SY 1/17/12 (SP)
RD 1/17/12 (SP)
Date of Initial Issue: March 2009