Diagnostic Cytology Specimen Collection Information:

All samples:  

Request forms and sample bags: Please ensure the request form is fully and legibly completed with relevant clinical details and attached to the outside of the sample bag. Sample bags with a pocket are available for this purpose. If you are using two bags for the specimen and form, please ensure that the form is in the outer bag.

Sample containers: Please ensure that the pot is adequately and legibly labelled with 3 pieces of Patient Identifiable Data/Details (PID) and sealed in the pocket of the specimen bag with the request form on the outside. Please do not over-fill containers. Ensure all lids are secured and not cross threaded before sending to the laboratory.

Delivery: Send all samples to the laboratory as soon as possible. If delays are expected, unfixed samples should be refrigerated. Please see additional notes for ‘Out of Hours’ samples. 

Serous fluids (pleural, ascitic and pericardial fluids): Fresh samples, ideally of a minimum volume of 50-75ml (RCPath, 2019) should be sent in 100ml specimen containers. These containers have a label stating, ‘Cytology Sample Container’ with PID prompts underneath, these have been placed on them by the laboratory. Please do not use these pots for samples intended for other departments. If the sample is from a drain, ensure this is well mixed for representative sampling. Please ensure specimen containers are not filled to the top to minimise risk of leakage.

Breast seroma fluid for assessment for Breast Implant Associated Anaplastic Large Cell lymphoma (BIA-ALCL): The entire seroma fluid should be aspirated and sent fresh. 100ml specimen containers are available and several may be used if required.

Peritoneal washings: These should be sent in 25ml, 50ml or 100ml containers according to the volume collected.

Endoscopy samples - brushings and washings: These must be placed into a 25ml universal container, containing 15ml CytoRich Red (CRR) fluid, supplied to the clinic by the lab. Please ensure the wires and tubing from the brushes are trimmed sufficiently to fit into the container, with the wire slightly longer than the tubing, enabling the tubing to be separated from the brush in the lab. Do not overfill these containers – if there is more than 5ml to add, please use a second pre-filled CRR container.

Endoscopy samples - Endobronchial ultrasound bronchoscopy (EBUS) FNAs: Must be placed into 25ml universal container containing 15ml formalin (10% NBF), supplied to the clinic by the lab. Do not overfill these containers – if there is more than 5ml to add, please use a second pre-filled NBF container.

Fine Needle Aspiration (FNA) – Needle washings: The needle must be rinsed in a 25ml universal container, containing 15ml CRR, supplied to the clinic by the lab.

Fine Needle Aspiration (FNA) direct spread air-dried slide preparations: These should only be prepared by adequately trained members of staff and only in limited circumstances as material is wasted if thick preparations are made and are not suitable for assessment. To prepare the slides - aspirate material from the needle onto labelled glass slide(s) (before rinsing the needle in fixative as above), spread very thinly using a second slide, and rapidly air-dry by waving vigorously in the air.

Urgent FNAs: The laboratory can provide an immediate reporting service for direct spread FNA samples if required. The doctor requiring the service should phone York extension 6258 to request the number of the duty pathologist to agree this with. They should then send the sample to the laboratory. The request form must clearly state the telephone extension number for reporting.

Cyst fluids:  A fresh representative specimen should be sent to the laboratory in a 25ml or 50ml white-topped Universal container.

Sputum: Sputum samples should only be sent for cytology if there is a reasonable suspicion of malignancy in patients who are unsuitable for bronchoscopy. In most cases, the respiratory pathology is due to infection which resolves on treatment. Sputum should only be sent if the clinical symptoms and radiological findings do not resolve after a course of treatment. The pick-up rate for malignant cells is very low because of inappropriate patient selection and the examination of sputum samples is an expensive and time-consuming process. Early morning specimens of sputum on three consecutive days are desirable, and these should be obtained before eating and oral hygiene have been commenced.  The specimen should be a deep cough specimen and sent straight to the laboratory.

Urine - voided samples: A fresh sample of urine (not the first void/early morning specimen) is required in a 50ml container (30ml is sufficient). Long-standing catheter samples should be avoided where possible. If a catheter has been used, ensure this is clearly stated on the request form.

Urinary tract washings and brushings samples: The sample should be sent fresh in a 25ml or 50ml container as appropriate. Ensure the nature of the sample is clearly indicated on the request form.

Urine – ileal conduit samples: The sample should be sent fresh in a 25ml or 50ml container as appropriate. Ensure the nature of the sample is clearly indicated on the request form.

Cerebrospinal fluid: CSF should be sent immediately, ensuring a separate cytology request form has been completed. Diagnostic Cytology assessment is for the presence of non-haematological malignancy. If samples only require assessment for haematological malignancy, these should be sent directly to the Haematology laboratory with a blood sciences request form and/or HMDS form.

How to send us a specimen – Haematological Malignancy Diagnostic Service (hmds.info)

Semen samples for fertility and post vasectomy analysis:  For comprehensive information for all aspects of the service please use the following link: www.yorkhospitals.nhs.uk/andrology

Cytology specimen container guide:  

Web page 47 last updated: April 26