Tufts Medical Center

CLINICAL CYTOLOGY LABORATORY

Telephone Numbers:
Laboratory:	(617) 636-5839
Supervisor:	Kristi Bedrossian (617) 636-6460
Hours:	Monday - Friday 7:30 - 5:00 PM

Services:	The Cytology Laboratory processes specimens for the detection of cancer, infection, and other diseases.
Requisition Form:	Requisition for all cellular material: Cytology 151594 (yellow). Patient identification and submitting physician’s name must be present and legible. Source of specimen and patient history must be stated.
Specimens:	STAT specimens cannot be processed after 4:00 PM. Expedite delivery of all fresh specimens for optimal results. All fluid specimens: If drawn during night or weekend, refrigerate until laboratory is open. Pertinent clinical information must be indicated on the requisition. Designate if specimen is STAT. More ordering information is available from the lab. Obtain SurePath Preservative or CytoRich Blue from the Cytology laboratory. Call the Cytology laboratory for detailed instructions on specimen collection from any body site. Specimen Turn Around Time

1. Anal/Rectal Pap
(88112)

Patient preparation:	Physician performs procedure.
Method of collection:	Brush or swab collection device used to obtain sample from Anal/Rectal Transformation Zone is submerged and left in SurePath collection vial. HPV may be requested. HPV on same specimen. Reflex testing not available.

2. Ascitic/pleural fluids:
(88112 ± 88305)

Patient preparation:	Physician performs para or thoracentesis, or collection from drain.
Method of collection:	As much fresh fluid as possible to optimize tumor recovery. Cells can be examined from any volume but >50 cc is preferred.
Fixative:	Anticoagulant recommended for bloody or proteinaceous fluids. Specifically, heparin (3 units/cc) is to be placed in collecting container prior to collecting specimen. Agitate container gently to coat walls of container before collection begins. Refrigerate until delivery.

3. Bile Duct:
(88112)

Patient preparation:	Physician performs procedure.
Method of collection:	Brushings in SurePath Preservative. Be sure that brush head remains submerged in fixative.

4. Breast-nipple discharge:
(88160)

Patient preparation:	None
Method of collection:	Touch glass slide to secretion several times. Spread uniformly with another slide and spray immediately with fixative. Make 1-2 successive smears.

5. Breast Cyst fluid:
(88112 ± 88305)

Patient preparation:	Physician performs procedure.
Method of collection:	Submit aspirated fluid to the lab in the original syringe with needle removed and replaced with cap securely tightened. Deliver ASAP.

6. Bronchial brush and wash:
(88112 ± 88305)

Patient preparation:

Explanation of procedure. Bronchoscopy must be arranged.

Method of collection:

Bronchial brushings in SurePath Preservative. Be sure brush head is submerged in fixative (agitate brush). Bronchial aspirate or wash in aspirating tube or sterile container. Label separately. Complete separate requisition for each specimen.

STAT pneumocystis staining cannot be processed after 12pm for same day results.

7. CSF:
(88112)

Patient preparation:	Physician performs spinal tap.
Method of collection:	CSF for Cytology should be immediately mixed with equal volume SurePath fixative. If not available, refrigerate. Any volume can be examined although higher volumes yield better results. At least 5 cc is recommended.

8. Gastric and esophageal brushings/washings:
(88112 ± 88305)

Patient preparation:

Physician performs procedure.

Method of collection:

Washings, Dry, sterile tube with minimum 1 cc of fluid, more if possible. Deliver immediately.

Brushings: Agitate brush in SurePath Preservative. Submit brush and aspirate, or wash. Label separately. Complete separate requisitions for each specimen.

9. Vitreous/Intraocular Fluids:

Patient preparation:

Physician performs procedure.

Method of collection:

Routine vitrectomy specimens should be received diluted in saline (from washing procedure).

If lymphoma or infection is to be ruled out, 0.5-1.0cc of undiluted fluid is recommended in order to perform PCR (send out). If volume permits or additional material from saline wash is available, slides will be made internally for more immediate evaluation. Note: Undiluted, fresh specimen should be delivered immediately to Ziskind Pathology Department for immediate fixation. If not possible, undiluted specimen should be kept frozen, if possible, to preserve specimen for PCR.

10. Oral Path Directions:

Oral Path Directions

11. GYN pap smears:

Patient preparation:

Physician performs procedure.

Method of collection:

A. Conventional Smears: (88164) The ectocervical and endocervical specimens should be evenly spread on a glass slide immediately, before air-drying occurs; spray fix at once. Slide must be labeled in pencil with patient’s name or medical record number and put into cardboard slide folder.

B. SurePath Pap Specimens: (88142) Ectocervical, endocervical, and vaginal specimens obtained with a broom or spatula/brush combo. Device tips should be placed in a SurePath pap collection vial. Cap tightly; label with patients name and medical record number. Clinicians encouraged to attend a SurePath training session scheduled by the Cytology department*.
* Training bulletins are available in the Cytology Department. High risk HPV testing is done automatically on an ASC-US interpretation. HPV may be also ordered regardless of pap interpretation by marking on requisition.

12. Sputum:
(88112)

Patient preparation:	None
Method of collection:	Submit deep cough fresh specimen in dry container, 1 cc to 10 cc, do not collect 24 hour specimens. Early morning specimens have increased yield for tumors.

13. Tzanck Prep:
(88160 or 88112)

Patient preparation:	Physician performs procedure.
Method of collection:	Scrape lesion, be sure to sample epithelium at the edge of the blister. Spread uniformly on glass slide and spray immediately with fixative. Make 1-2 smears. Swab or brush can also be submerged and detached into a SurePath fixative vial.

14. Urine:
(88112)

Patient preparation:	None
Method of collection:	Clean catch voided or catheterized urine in dry non-sterile container, preferably 50-100 cc. Expedite delivery or refrigerate until able to deliver specimen, not to exceed 24 hours. Add equal volume CytoRich Blue preservative to specimens to be delayed in delivery as degenerated specimens result in less than optimal or unsatisfactory reports.