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
Voided/Random/Clean Catch Urine, Bladder Washings, Catheterized Urine, Renal Pelvic Washings, Ureteral Washings, Kidney Washings, and other urologic specimens obtained during cystoscopy.
Thin layer preparations and cell Block, when indicated.
- 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 requisition.
- 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.
- First morning voided specimen is not suitable due to cellular degeneration. Collect second-morning clean catch urine.
- A mid-stream, clean catch specimen is preferred.
- Bladder washings should not be collected in a hypotonic
- If different sites are sampled, label the specimen container and requisition appropriately.
Urine submitted fresh or in CytoLyt fixative.
Volume: 20 mL Minimum volume: 5 mL
Urine specimens are examined to detect benign and malignant conditions of the urinary tract.
- Clean, leak-proof container(s) or CytoLyt container.
NOTE: CytoLyt is the preferred fixative for urine cytology.
- If FISH for bladder cancer is requested, please include an additional specimen in PreservCyt fixative.
- Label all containers with a minimum of two patient
Patient should not have had mineral oil cathartics.
Patient instructions included in Special Forms section of this manual
- Complete the requisition entirely.NOTE: Note the method or collection and test order.
- Pre-label collection container(s) with patient name and sample site.
- Using standard clean catch or cystoscopy techniques, obtain the specimen
- Collect the specimen in the labeled container.
Collect freshly voided, SECOND-MORNING clean catch, mid-stream urine.
For brushings, brush the area of interest, agitate the brush in saline or CytoLyt and leave in the container.
5. Specimen may be submitted fresh/unfixed or fixed in CytoLyt.
6. Urine cytology with Bladder cancer profile by FISH, please submit a minimum of 60 mL fresh, refrigerated within 24 hours or submit additional specimen in PreservCyt container.
7. Seal the container(s) well to prevent leaking.
8. Place the labeled container(s) into a Biohazard specimen bag and include the completed requisition in the outside pocket of bag.
9. 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 Urine Cytology section thoroughly.
NOTE: Clearly indicate the Specimen and Tests Requests.
- Complete clinical data section.
CAUSES FOR REJECTION
- Incomplete requisition.
- Specimen container not labeled properly.
- Gross contamination due to spillage.
- Prolonged period at room temperature.
- 24 hour collection.
- Low grade papillary transitional cell carcinoma may not be diagnosed by cytologic examination.
- Recent instrumentation and calculi may produce atypical changes in urothelial cells simulating a malignancy.
- Numerous chemotherapeutic agents produce cell changes that may mimic urothelial abnormalities.
- UroVysion FISH tests may not be performed on delayed (> 72 hours after collection) specimens.
- 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.
- Ideally, specimen should be as fresh as possible. Urine that has been in the bladder for prolonged periods shows extensive cellular degeneration.
- Voided urine is preferred over a catheterized sample due atypical changes caused by trauma.
- Catheterized specimens may lead to artifacts that may be misinterpreted if it is not known specimen is catheterized.
- Although poorly-differentiated cancers are diagnosed with relative ease, well-differentiated neoplasms may not be diagnosed by routine methods.
- UroVysion FISH may help in the detection of aneuploid cell lines.
Information is also available on the SEPA website under Resources –Directory of Services.
Please call laboratory if you have questions.