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
Pulmonary Series; Random Sputum, Sputum Cytology, Random Collection, Sputum Series.
- 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.
- For induced sputa, contact Respiratory Therapy.
Expectorate material fresh or in CytoLyt.
Sputum specimens are examined to detect benign and malignant conditions in the lung.
- Clean, leak-proof container(s).
- Label all containers with a minimum of two patient identifiers.
- Upon awakening, clear your throat of any material, which may have accumulated overnight and discard it.
- Perform oral hygiene duties (i.e., brush teeth, etc.)
- Gargle and rinse your mouth with warm water several times to reduce contamination.
- DO NOT EAT BREAKFAST (food particles may distort results).
NOTE: A complete sputum series consists of a fresh early morning deep cough specimen each day for three days.
- Complete the requisition entirely.
- Pre-label collection container(s) with patient name and sample site.
- Cough deeply several times during the first hour that you are wake. Sputum must come from lungs, not saliva (NOTE: Optimum specimen collection is within 15 – 30 minutes of waking This is best accomplished by sitting up straight, breathing deeply, and coughing forcefully)
- Expectorate all material (ideally 2-5 tablespoons) into the labeled specimen container (NOTE: If a good specimen is not obtainable by this method, obtain an induced sputum with the assistance of Respiratory Therapy Department).
- Repeat steps if completing sputum series collection
- Seal container well to prevent leading.
- Place labeled container (s) into a Biohazard specimen bag and include the completed requisition in the outside pocket of the bag.
- Send the entire specimen to the laboratory as soon as possible.
- If transport is delayed more than 24 hours, add an equal volume of CytoLyt.
**REFRIGERATE ALL CYTOLOGY SPECIMENS IF IMMEDIATE DELIVERY TO LAB/CYTOLOGY IS NOT POSSIBLE**
CAUSES FOR REJECTION
- Incomplete requisition.
- Specimen container not properly labeled.
- Specimen fixed with formalin.
- Saliva or nasal aspirates.
- Contaminated container.
- If bronchial cells and/or dust-pigmented macrophages are not identified, the specimen may be reported as unsatisfactory for adequate evaluation.
- Not all cancer can be detected, especially, peripheral or “coin” lesions.
- Thin layer preparation is examined microscopically using the Pap stain method.
- Cell block specimens prepared and stained using Hematoxylin & Eosin (H & E) stain method.
- Special stains and special studies (IHC, ISH, molecular, etc.), if needed.
- When a pulmonary lesion is suspected, a complete series should be examined.
NOTE: The complete sputum series consists of a fresh, early morning deep cough specimen each day (3 days) for the series. The complete sputum series increases the detection of primary bronchogenic carcinoma from 45% (one specimen) to 86% (three specimens).
- A post-bronchoscopy sputum should be included in the series.
- Sputum cytology can usually 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/washings are more productive in detection of infections.
- Microbiology studies are not a part of this procedure. They must be ordered separately.
Information is also available on the SEPA website under Resources – Directory of Services.
Please call laboratory if you have questions.