Sputum Cytology

NAME OF PROCEDURE

Sputum Cytology

TEST CODE

NGYN

CPT CODE

  • 88112 – Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal
  • 88312 – Special stains (if needed – list separately in addition to code for surgical pathology examination) Group I for microorganisms (e.g. Gridley, acid fast, methenamine silver)

SYNONYMS

Pulmonary Cytology, Series; Random Sputum Cytology; Sputum Cytology, Unfixed, Random Collection; Sputum Series Cytology.

SPECIAL INSTRUCTIONS

Information regarding type of specimen, admitting diagnosis, and pertinent clinical history (i.e., age, clinical impression, past diagnosis, exposure to carcinogens, radiographic findings, and history of radiation or chemotherapy) is essential to interpretation and should be noted on the requisition. Clinical evidence of immunosuppression should be indicated where appropriate. For induced sputa, contact Inhalation Therapy.

SPECIMEN

Sputum

CONTAINER

Capable plastic container.  Please label submitted container(s) with a minimum of two patient identifiers.

PATIENT PREPARATION

Upon patient’s first awakening in the morning the patient should brush his/her teeth and rinse mouth with water.

A complete sputum series consists of a fresh early morning deep cough specimen each day for three days.

COLLECTION TECHNIQUE

The patient should breathe in as deeply as possible and then expectorate a deep cough specimen into the specimen container.

If the patient is unable to obtain a deep cough sputum with a natural cough, an aerosol technique may be becessary. Using an aerosol machine, the patient should be instructed to inhale aerosol into the bronchial tree to produce moisture in the lungs and then cough with a deep forceful cough. (usually performed and collected by the Inhalation Therapy Department)

Label specimen container with a minimum of two patient identifiers, date, and time of collection.  Deliver to the laboratory immediately.

If the specimen cannot be brought to the laboratory in a timely manner, the specimen should be mixed with an equal volume of Cytolyt solution and refrigerated until transport.

REQUEST FORM

Complete a Anatomical Pathology Requisition as indicated in the Test Ordering section of this manual. The patient information section as well as the Non-Gyn Cytology portion of the form should be completed.

CAUSES FOR REJECTION

Specimen container or slides not properly labeled.

Fixation with formalin

Saliva or nasal aspirates

Contaminated container

24 hour collection

LIMITATIONS

If bronchial cells and/or dust-pigmented macrophages are not identified, specimen may be reported as unsatisfactory for adequate evaluation.

ADDITIONAL INFORMATION

Microbiology studies are not an integral part of this procedure. They must be ordered separately.

Special stains are sometimes required

When a pulmonary lesion is suspected, a complete series should be examined.

The complete sputum series consists of a fresh, early morning deep cough specimen each day for three days. A post-bronchoscopy sputum should be included in the series. The complete sputum series increases the detection of primary bronchogenic carcinoma fro 45% (one specimen) to 86% (three specimens). Sputum cytology can adequately distinguish between non-small cell carcinoma and other carcinomas. Although occasional cases of infectious pulmonary disease are detected or suspected cytologically, culture, biopsy, or bronchoalveolar lavage are more productive.