NAME OF PROCEDURE:
- 88112 – Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal
- 88305 – Level IV – Surgical pathology, gross and microscopic examination
Bronchial, Colonic, Esophageal, Gastric, Oropharyngeal Brushings, Ureteral, Urethral, Bile Duct, and other miscellaneous brushings.
- Information regarding type of specimen, admitting diagnosis, and pertinent clinical history (i.e., age, clinical impression, past diagnosis, radiographic findings, and history of radiation/chemotherapy or malignancy) is essential to interpretation and should be noted on the
- Infectious diseases suspected and special stains requested should be
- Clinical evidence of immunosuppression should be indicated.
- Special handling requirements (isolation) should be clearly noted on the requisition.
- If other studies are required, submit to appropriate laboratory separately.
Brush from area of interest in CytoLyt (fixed) or saline (unfixed) and smear(s) fixed (spray-fixed or alcohol fixed) or unfixed.
Brushings allow for broad sampling of an area to diagnose benign and malignancy in areas of interest.
- Clean, leak-proof container (s) with normal saline.
- Slide container(s) with 95% alcohol.
- Cardboard slide holder(s).
- Label container(s) with a minimum of two patient identifiers.
- Complete the requisition entirely.
- Pre-label collection container(s) with patient name and sample site.
- If preparing slides, pre-label slides on the frosted-end with patient’s name and sample site.
- Obtain sample by brushing the area of interest using standard brushing techniques.
- Brushed material may be smeared directly on pre-labeled slides (Step 6) or submit detached brush (Step 8). If brush is used in multiple passes in the same site, the brush should be rinsed in a sterile container with normal saline.
- Fix immediately by immersing slide(s) in 95% alcohol container or by applying a cytology spray fixative. A second slide may be air dried for Diff-Quik staining.
NOTE: Optimum preservation is obtained if smears are prepared quickly without undue time spent spreading material.
- Immediately spray slide(s) with cytology spray fixative, holding container 6 – 12 inches from slide. Lightly mist entire slide with
- Gently place slide(s) into labeled cardboard slide holder(s) and allow to dry completely before closing and securing for transport.
- Secure cardboard slide holder(s) with tape or rubber bands to prevent opening during transport.
- After sampling, cut the brush, gently agitate, and immediately immerse into CytoLyt (fixed) or normal saline (unfixed). If necessary, add more saline to cover the brush to prevent drying.
- Brushed material may also be submitted by detaching the brush after sampling, gently agitate, and immediately immersing brush into CytoLyt (fixed) or normal saline (unfixed). If necessary, add more saline to container to cover the brush to prevent drying.
- Seal containers well to prevent leaking.
- Place labeled container(s) in a sealable Biohazard specimen bag and include the requisition in the outer pocket of the specimen bag. Slides are maintained at room temperature
- Send the entire specimen to the laboratory as soon as possible.
**REFRIGERATE ALL CYTOLOGY SPECIMENS IF IMMEDIATE DELIVERY TO LAB/CYTOLOGY IS NOT POSSIBLE**
- Complete patient information section.
- Complete the Non-Gynecologic section thoroughly.
CAUSES FOR REJECTION:
- Incomplete requisition.
- Specimen container not labeled properly.
- Improperly fixed specimen.
- Gross contamination due to spillage.
- Prolonged period (more than eight (8) hours) at room temperature.
- Delay in delivery for adequate preservation.
Allowing smears and brushes to dry before they are fixed will render them unsatisfactory for cytologic evaluation.
- Smears and thin layer preparations are examined microscopically using the Pap stain method and/or Wright-Giemsa stain.
- Cell block specimens prepared and stained using Hematoxylin & Eosin (H & E) stain method.
- Special stains and special studies (IHC, ISH, molecular, etc.), if needed.
Special stains and cultures may be indicated, especially for the diagnosis of infectious processes. Brushings are much more useful for the diagnosis of neoplasms than for diagnosing inflammatory or infectious processes. For gastrointestinal tract cytology, non-diagnostic if the specimen is contaminated with food or barium sulfate.
- Brushings are much more useful for the diagnosis of neoplasms than for diagnosing inflammatory or infectious
- Specimens from gastrointestinal tract cytology may render unsatisfactory diagnosis if the specimen is contaminated with food or barium
- For brushings that require an adequacy assessment, glass slides are submitted to pathologists for preparation.
- To prevent dilution of specimen with blood, brushings should be performed before Fine Needle Aspiration (FNA) if performing both procedures. Specimen for FNA should not be combined with brushing specimen. They should be collected into two separate labeled collection containers.
Information is also available on the SEPA website under Resources – Directory of Services.
Please call laboratory if you have questions.