QFR 2

1)Techniques for preparing non-gynecologic specimen for cytology

a. SPUTUM COLLECTION
-obtain 3 consecutive morning sputum specimens
-collect early morning sputum by a deep cough in a wide- mouthed jar w/ Saccomano fluid( 50% ethyl
alcohol and 2% carbowax)
*if patient cant cough up sputum spontaneously. Collect Induced Sputum using inhalation of an aerosol sol’n
for 20 mins to produce deep cough sample.
*for extensive studies, 2-4 slides are used, 1 is air dried with Giemsa staining and at least 2 are stained by
Papanicolau method.
-sputum specimen is place in a petri dish and examined for blood-flecked or solid particles w/c then are
removed and placed into a slide and is crushed w/ another slide, distribute evenly.
-immediately placed in a fixative for a minimum of 1 hour
*sputum collected should have been coughed from “Down-deep” to ensure it is a sputum not a saliva
*Alveolar Macrophage on a sputum smear from a deep cough is confirmatory for sputum not saliva

b. BRONCHOSCOPY SPECIMEN COLLECTION

o BRONCHIAL BRUSHING
-2 labeled slides by pull technique
-fix w/ spray fixative or 95% alcohol
-failure to fix w/n seconds is unsatisfactory due to air drying artifact
o BRONCHIAL WASHING
-freshly collected in the bronchoscopy collection container & delivered to the Lab
o BRONCHIAL ASPIRATES
-collected either by aspiration into a glass suction apparatus or by washing the bronchi w/ 1-2cc
of saline
-with epithelial cells (ciliated bronchial cells) , RBC, WBC

c. CELL SUSPENSION SPECIMEN COLLECTION

-from direct taps of pleural or peritoneal effusions, also CSF and synovial fluid
-w/o fixative or anticoagulant
-20-30 mL
- cells remain viable up to 4 days if kept refrigerated @ 4C
- urine, serous effusions and watery lavages (BAL) require concentration of cells prior to transferring
them to glass slides.
- centrifugation is the standard technique
o 1000 RPM speed for 1 minute
o Remove supernatant fluid
o Cover slide w/ thin layer of egg albumin
o Fix smear in 95% alcohol
o If smear not prepared immediately cover w/ Absolute alcohol and place in Ref.
o Prevent drying
d. GASTROINTESTINAL SPECIMEN
-Principle: Collection is done to exclude the possibility of malignant tumors
Types of specimens:
o Gastric lavage
o Gastric brush
o FNA (for submucosal lesions)
-smear is collected by simple irrigation and aspiration technique
-patient must fast for 8 hours before gastric washing is performed
-Esophageal washing must examined immediately
e. PERITONEAL, PLEURAL and PERICARDIAL FLUIDS
- Jelly-like clots forming after removal may be prevented by adding 300 units of Heparin for every 100
mL of aspirate
- Collect specimen in heparinized containers
f. BREAST SECRETION SPECIMENS
- Nipple discharge: Low diagnostic yield for diagnosis of breast carcinoma
Result of hormonal imbalance in young patients
Due to a benign breast lesion like duct ectasia and papilloma or endocrine prob
If bloody and benign secretion “Intraductal Papilloma”
Smeared in a clean glass slide and placed in a fixative
 - Collection of N. discharge:
Any nipple discharge is abnormal except during lactation and post- lactation
period
Strip subareolar area and nipple using thumb and forefinger
Placed slide upon the nipple and draw quickly across the nipple
95% isopropanol or spray fixative
Obtain secretion from both L and R breasts
g. URINARY TRACT SPECIMENS
- Diagnose malignancy of urothelial origin also prostatic carcinomas (rare)
- Specimen: urine
- Labeled as
o Voided urine
o Catheterized specimen
o Washings from bladder or renal pelvis
- Discard first voided urine due to overnight degeneration of cells
- Second urine is preferred
- Preservative is not recommended
- Staining tech: Modified Papanicolau Technique
- Males: voided urine is sufficient
- Females: catheterized urine is recommended to prevent contamination from vulvar cells(early
morning yields great in number)
- Urine is collected and examined twice to reliable evaluation
- 50 mL is needed and must be centrifuged
h. BODY CAVITY EFFUSIONS
- For patients with history of cancer
Types of specimens: cavity fluid specimens
o Pleural fluid
o Ascitic fluid/ abdominal fluid
o Peritoneal washings
o Pericardial fluids
o CSF
- Fluid specimen is collected in a clean, non-sterile dry container and submitted fresh in Lab
- Avoid any kind of preservative
- For CSF specimens 1cc. Heparin is necessary

2)Describe the ff. Methods of sample collection

a. Scraping
b. Aspiration
c. Lavage
d. Brush technique

*Answers are described by the the previous specimens above.

3)Consideration in sampling and handling of specimens based on

a. Recommended Vol
b. Preservation

*Answers are described by the the previous specimens above.

4)ID fixatives for Cytology

*Answers are described by the the previous specimens above.

5)ID the gynecologic specimens for cytology. Note characteristic and correlation
Answer in QFR 3 - #6