Pathology

Reference Specimens

NOTE: If pathology slides need to be picked up, notify the pathology secretary at 814-333-5661. Please call at least 2-3 working days prior to the date needed.

Pathology

Included below is some general information. Due to the wide variety of procedures, it is sometimes best to handle each case individually. If you have any questions regarding your particular specimen, such as the collection or fixation of a specimen, please call before the specimen is collected. Our histology department is located at the Liberty Street facility. The phone number is 814-333-5517. If you request information regarding pathology reports, please call our pathology secretary at 814-333-5661.

Pathology/Cytology specimens
Inpatient Order Entry

Please record the following information in Order Entry; Category “PATH”/”CYTO”; Procedure “PATH”/”CYTO”:

  1. Pre-op diagnosis
  2. Post-op diagnosis
  3. Pertinent history
  4. Specimen site, (be specific as to the location of the specimen)
  5. Date of the specimen collection

 

Cytology only

Under “Comments” record volume of aspirated specimen.

Any additional specimen may be placed in “Comments” e.g., specimen collected by the patient or additional copy needed for another doctor.

 

Transportation

All specimen containers are to be placed in special biohazard zip-lock transport bags. Large bags are available upon request. Please secure all lids tightly before transporting. The Pathology/Cytology (non-Gyn) request form is to be filled out in entirety and placed in the outer pouch.

Inpatient Pneumatic Tube Transport

The following specimens are not to be transported in the tube system. They should be hand carried to the lab.

  • Thoracentesis
  • Spinal fluids
  • Pathology/Cytology specimens

Cytology Information

See “Request Forms – Instructions” for help on filling out the Pathology/Cytology (Non-Gyn) form.

All specimens are to be labeled with the patient’s name and the source of the specimen. Note on label if fixative has or has not been added.

Due to the fact that cell morphology in fluid aspirates deteriorates as time elapses, we ask that fluid aspirates be placed in CytoLyt™ fixative immediately. If you choose not to fix the specimen, please deliver it as soon as possible to the histology department of the lab, so we may give it prompt attention.

Notify lab personnel immediately if the specimen does not have a fixative.

Note: When fluid is preserved by the following methods, the specimen is not acceptable for other laboratory studies. Please collect the general laboratory specimen in a separate red-top vial or appropriate swab.

Complete GYN Cytology Requisition

  1. Write patient’s first and last name with #2 pencil on frosted end of slide.
  2. Do not use lubricant on the speculum (may use warm water if desired).
  3. Place the vaginal pool mucus on the slide, near the frosted end. Do not smear.
  4. Scrape the cervix with a spatula. Rest the spatula on the glass slide, with the specimen face-up.
  5. Insert endocervical brush into the endocervical canal, until brushes are barely visible. Rotate 90-180 degrees and remove.
  6. Transfer sample to glass slide- The object is to quickly but evenly spread the cellular material in a thin layer (1 cell thick) on the glass slide.
    1. Smear the spatula specimen over the left-hand side of the slide, mixing in half of the vaginal pool mucus.
    2. Roll the brush specimen along the right side of the slide, mixing in the remaining half of the vaginal pool mucus. Bending the bristles will help transfer the cells to the slide.
  7. Immediately, spray-fix the slide. Hold spray 8-10 inches from slide, spray 3-4 times.
  8. Dry slide completely before packaging for transport.

NOTE: If the patient is a Medicare patient, record the date of the last pap smear.

Complete GYN Cytology Requisition

Brush/Spatula
  1. Sample ectocervix with a plastic spatula.
  2. Rinse spatula in the PreservCyt® vial by swirling vigorously 10 times. Place cap on vial until step 4. Discard collection device.
  3. Sample endocervix with an endocervical brush.
  4. Rinse the brush in the PreservCyt® solution by rotating the device in the solution 10 times while pushing against the PreservCyt® vial wall. Swirl the brush vigorously to further release material. Discard the collection device.
  5. Cap the PreservCyt® vial tightly. Tighten the cap of the vial so that the black “torque” line on the cap passes the black “torque” line on the vial.

 

Broom
  1. Obtain a sample from the cervix using a broom-like device.
  2. Rinse the collection device into a PreservCyt® Solution vial by pushing the broom into the bottom of the vial 10 times, forcing the bristles to bend apart to release the cervical material. As a final step, twirl the broom between the thumb and forefinger vigorously to further release cellular material. Discard the collection device.
  3. Cap the PreservCyt® vial tightly. Tighten the cap of the vial so that the black “torque” line on the cap passes the black “torque” line on the vial.

 

NOTE:

  • Patient Acknowledgement of Non-Covered Services (ABN) form MUST accompany the specimen for prompt processing. This form is necessary to allow Meadville Medical Center to bill the patient, due to some insurance restrictions.
  • If the patient is a Medicare patient, note the date of the last pap smear.

CompletePathology/Cytology (Non-Gyn) form.

If a diagnosis is needed for each pass, a separate CytoLyt jar is to be submitted accordingly. Collect fluid as follows:

  1. Slowly inject the collected fluid into a jar of ThinPrep™ CytoLyt™ Solution. (Do not add more than 80 mL of fluid to container).
  2. Draw up ½ syringe volume of Cytolyt.
  3. Flush the syringe slowly back into the jar.
  4. Repeat flushing 2-3 times to collect all the cells remaining in the needle and syringe.
  5. Dispose of syringe and needle.

 

Record the following on the label and requisition along with normal patient information:

  1. volume of fluid aspirated
  2. type of fluid collected or site collected from
  3. If CytoLyt fixative is unavailable, place specimen in sterile screw capped container and refrigerate

 

Deliver to lab as soon as possible

NOTE: If fluid, such as thoracentesis or paracentesis, is collected in a large collection bag, please deliver promptly to the lab.

Complete Pathology/Cytology (Non-Gyn) form.

Collect aspirate and immediately add to Cytolyt Fixative.

Record the following on the label and requisition along with normal patient information:

  1. volume of fluid aspirated
  2. type of fluid collected or site collected from
  3. If CytoLyt fixative is unavailable, place specimen in sterile screw capped container and refrigerate

 

Deliver to lab as soon as possible.

Complete Pathology/Cytology (Non-Gyn) form.

  • An early morning specimen is best, resulting from a deep cough. Post-bronchoscopy sputum specimens are acceptable.
  • Collect the sputum in a screw-cappedcontainer. Immediately transfer into CytoLyt™ solution.

 

NOTE: Often, three multiple specimens are submitted. All multiple specimens are to be dated and numbered on both specimen container and requisition.

Complete Pathology/Cytology (Non-Gyn) form.


Acceptable specimens are scrapings from possible Herpes skin lesions.

  1. Collect specimen by scraping area of concern with a scalpel blade.
  2. Gently swirl blade in CytoLyt fixative to dislodge scraping.
  3. Discard used scalpel blade.

 

Do not leave blade in CytoLyt fixative.

 

Complete Pathology/Cytology (Non-Gyn) form.

  • A catheterized specimen should be obtained from a female.
  • Voided urine, (preferably mid-stream), is suitable from a male.

 

If fixation is done at the office, urine is not to exceed the 80 mL mark on the CytoLyt™ container. Record on the form that urine has been added to the CytoLyt™.


NOTE: If urine specimen is not fixed, send the specimen promptly to the lab so that CytoLyt™ may be added. Label the container as “unfixed urine” so proper identification will be made.

Pathology Information

See “Request Forms – Instructions” for help on filling out the Pathology/Cytology ( Non-Gyn) form.

Complete Bone Marrow form.


The basic bone marrow collection should include the following specimens:

  1. Clot
  2. Core
  3. 1 mL aspirate in purple top (EDTA) tube
  4. Bedside smears (6-8)

 

If additional testing is ordered, please refer to the following tests in the test dictionary.

  • BCR/ABL Double Fusion, (FISH)
  • Chromosome Study, Hematological Malignancy
  • Culture, Bone Marrow
  • Leukemia/ Lymphoma Panel, B Marrow
  • MTHFR (Methylenetrahydrofolate), DNA

Ticks are sent to Erie County Dept. of Health for identification.

  • Complete Pathology/Cytology (Non-Gyn) form.
  • Place specimen in a screw-capped sample cup supplied by Meadville Medical Center Laboratory.

 

Include the following information on form:

  1. Where on the body was the tick located?
  2. Was the tick attached?
  3. Location of patient where tick may have been obtained, (e.g., field in Venango, Pa.)

 

Label the container with name, date and “Tick”. Place container and form in a biohazard bag, and deliver to Pathology.

Complete Pathology/Cytology (Non-Gyn) form.

  • The majority of pathology specimens, such as tissue, are to be submitted in 10% formalin.
  • Specimens from separate locations are to be submitted in separate containers. (Label the site accordingly).
  • No tissue specimen is to be submitted fresh; (unfixed – with no preservative), unless the pathologist has been consulted prior to obtaining the specimen.
  • Uterine contents should include the gestational age and pertinent information.
  • Specimens brought to the lab after 1:00 PM are processed on the next working day.

Complete Pathology/Cytology (Non-Gyn) form.

  • The specimen is to be submitted dry.
  • Send specimen regardless of size.
  • If multiple specimens are collected, note the date and time on the requisition and the specimen label.