Professional Documents
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CYTOLOGY PROTOCOLS
Table of Contents
SPUTUM PREPARATION
SPUTUM SMEARS
SPUUTUM (Blender method)
BRONCHIAL/GI BRUSHINGS
BRONCHIAL/GI WASHINGS
SPUTUM PREPARATION
A sputum series is the least invasive method for detecting pulmonary cancer. Patients
with a history of smoking, chronic obstructive
pulmonary disease or airflow obstruction,
long term exposure to uranium or asbestos, or a history of metastatic carcinoma are at a
higher risk for the development of tumor. A sputum series consists of one fresh specimen
collected the FIRST THING IN THE
MORNING for three consecutive mornings. The rate
of detection for pulmonary carcinoma improves when more specimens are
submitted. One
specimen may be a post bronchoscopy sputum specimen which is produced immediately after
the bronchoscopy
Procedure. This sputum should never be discarded as it may contain
valuable diagnostic material treed during the procedure. The
minimum volume of specimen
accepted is 1.0 ml, however the quality of sputum is Judged by its contents rather than
quantity. If a
series of consecutive early morning sputum specimens is collected and
submitted to the laboratory together as a complete group, they
may be pooled during
processing resulting in one final cytologic report.
SUPPLIES NEEDED
COPLIN JAR
WOODEN STICKS OR MICROSCOPE SLIDES
95% ETHANOL
TONGUE DEPRESSOR
BIOHAZARD HOOD
METHOD
COPLIN JAR
MICROSCOPE SLIDES
WARING BLENDER
SACCOMANNO FIXATIVE
BIOHAZARD HOOD
BLENDER CUPS
50 ML CENTRIFUGE TUBES
BLENDER METHOD
PROCEDURE NOTES
Ancillary Studies: If specimens are collected for culture and cytology, the sample
must go to Microbiology first. Detection of
Pneumocystis carini may be done on sputum;
however, bronchoscopic lavage is more successful in detecting the organism. If
Pneumocystis is requested, make an additional smear and submit to Histology for Grocott's
Methenamine Silver staining (GMS).
Sputum from the same patient which is collected on consecutive days may be poured
together or pooled.
If the specimen is watery, it probably represents saliva. Make direct smears if a cell
button is obtained after centrifugation. If not, use
Brushing specimens may be submitted from suspicious areas seen during bronchoscopy or
endoscopy.
SUPPLIES NEEDED
COPLIN JAR
SLIDES as needed
95% ETHANOL
3 SAMPLE CHAMBER ASSEMBLIES
PIPETS CYTOCENTRIFUGE
VORTEX MIXER
MICROSCOPE
BRUSH WASH VIALS
BIOHAZARD HOOD
SACCOMANNO FIXATIVE
BALANCED SALT SOLUTION
METHOD
9. Record the date of preparation on the specimen container and refrigerate any remaining
specimen. Specimen is stored for one
week before disposal.
PROCEDURE NOTES
transport medium for maintaining cell morphology. Add an equal volume of Saccomanno
fixative
upon receipt in the Lab. This specimen must be centrifuged by pouring into a clean
prelabeled
centrifuge tube and spinning for 5 minutes at 1500 RPMs. Decant supernatant down to the
conical
portion of the centrifuge tube and follow instructions for visual estimation of
cellularity.
If Brush Wash vial is submitted with only a drop or two of fluid, use additional
Saccomanno fixative to thoroughly rinse the container
and brush. Use vortex mixer to
remove as much material as possible.
SUPPLIES NEEDED
COPLIN JAR
SLIDES as needed
95% ETHANOL
MIXING VIAL
M ETHOD
PROCEDURE NOTES
Specimens received in formalin will be prepared for cell block only. No additional
cytologic smears will be made.
Specimens containing mostly red blood cells may be diluted to 20 cells per high power
field.