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Diagnostic Cytology

Diagnostic Cytology is the study of cells to identify disease. It may be used to diagnose various types of cancer and certain infections.

Hours of Operation: 8:00 am- 4:00 pm, Mondays to Fridays (except statutory holidays)

Proper specimen collection, labelling of specimen and complete requisition are imperative. Improper fixation, incomplete information or lag in transport may result in delay or rejection

Turnaround-time for results is 2-5 business days from time of receipt. Orders may be made Rush but must be clearly marked with supporting clinical information to indicate the reason for the request. 

Physicians are encouraged to check Care-Connect or Sunset for results. In the event a faxed copy of results is needed, the physician must complete and return the request form. 

1Collect specimen

Supplies:
  • Dacron swab or Cytobrush
  • Fixative: PreservCyt collection fluid
• Insert Dacron swab or cytobrush approximately 1.5 to 2 inches into the anal canal to ensure sampling of squamocolumnar junction. Pull swab/brush out while applying pressure to wall of anus in rotating spiral motion. 

• Rinse swab/brush into PreservCyt vial by swirling in solution to release cells. Do NOT leave the swab/brush in the vial. 

Supplies:
  • Standard paracentesis equipment. 
  • Two clean collection container of appropriate size
  • Fixative: 10% buffered formalin
  • Fixative: CytoLyt
• All body cavity fluids should be submitted in two separate containers.  One container with the sample fixed in equal volume CytoLyt.  The second container with the sample fixed in equal volume formalin.  Do not mix the formalin and CytoLyt together. 

• Indicate corresponding fixative on each container

• Volume not less than 5 mL but 50 mL or more is preferred.

Supplies:

  • Standard bronchoscopy/endoscopy equipment
  • Fixative- One (or more if necessary) centrifuge tube(s) with approximately 30mL of CytoLyt fixative.

• Using standard bronchoscopy/endoscopy technique, obtain a brushing of area of interest. 


• Upon withdrawing the brush, remove sheath, agitate the brush vigorously in centrifuge tube(s) with approximately 30 mL of CytoLyt fixative. If possible, detach the brush and leave it in the vial. Do NOT smear material onto slides. 

Supplies:
  • Standard bronchoscopy/endoscopy/suction equipment
  • Fixative- CytoLyt, or 50% methyl or ethyl alcohol
• Using standard bronchoscopy/endoscopy/intra-abdominal surgery technique, lavage the region of interest.

• Collect the wash in a clean container. Add equal volume of fixative (CytoLyt preferred or 50% ethyl or methyl alcohol). 

Supplies: 
  • Clean sterile container such as a red top tube. 
  • Fixative: 50% ethyl or methyl alcohol or CytoLyt.
• Specimen volume of at least 1mL preferred

• If possible deliver fresh (unfixed) to the lab within 24hrs (refrigerate, ship cool; do not freeze).  If a delay of more than 24 hours is anticipated, add equal volume fixative (CytoLyt, 50% ethyl or methyl alcohol) immediately and mix well. 

Supplies:

  • Needles and syringes as required 
  • Fixative- Container filled with at least 30mL CytoLyt

• Express and rinse all aspirated material directly into container filled with CytoLyt as soon as possible.

Supplies:

  • Two clean class slides and spray fixative; or one container filled with at least 30mL Cytolyt

• Express nipple secretion directly onto glass slide. Layer a second slide on top to distribute material into thin film over both slides. Pull in horizontal motion to separate. Spray slides immediately with spray fixative.


• ALTERNATIVELY, express secretion directly into container containing at least 30mL of CytoLyt. 

Supplies:
  • Oral Spatula
  • One (or more) clean class slides and spray fixative; or one container filled with at least 30mL Cytolyt. 
• Gently scrape the area of abnormality with spatula. Quickly and evenly smear the collected material on a glass slide. Immediately spray fix. 

• ALTERNATIVELY, swirl spatula into a container with at least 30mL CytoLyt to release cells. 

Supplies:
  • Clean specimen container
  • Fixative: 30mL CytoLyt or 50% methyl/ethyl alcohol
• A series of three consecutive sputa collected over three days is preferred. Separate containers and requisitions are required for each. 

• Rinse mouth and clean teeth prior to obtaining a specimen to avoid oral contamination.  Inhale and exhale deeply, forcing air from the lungs using the diaphragm to produce a deep cough. Repeat until at least 1 teaspoon of deep cough specimen can be produced. 

• Collect the specimen in a clean container. Add equal volume of fixative (CytoLyt preferred, or 50% methyl or ethyl alcohol). 

For voided urines, midstream of second voiding is preferred for maximum yield of diagnostic material. 

If specimen was collected via cystoscopy, catheter or ileal conduit, clearly indicate so on requisition as procedures can produce artifacts leading to misinterpretation. 

Supplies:
  • Clean specimen container of appropriate size
  • Fixative: CytoLyt or 50% methyl/ethyl alcohol
• Collect 50mL sample in equal volume fixative (CytoLyt, 50% methyl or ethyl alcohol). If fixative not available, refrigerate or keep on ice for transport to lab. 


2

Label specimen

Specimens (containers and slides, where applicable) must be labelled with:

  • Patient first and last name
  • One unique identifier (i.e PHN, medical record number)
  • Specimen source

3Fill out Diagnostic Cytology Requisition

Completed requisition must contain:

  • Patient first and last name
  • Patient PHN or medical record number
  • Ordering physician
  • Source of specimen

Where pertinent, also include clinical information, previous malignancies, treatment history, or radiation therapy. 

4Transport specimen

Transport specimen and completed requisition to Vancouver Cancer Centre Cytopathology Lab at room temperature as soon as possible. 

If a delay of more than 24 hours is anticipated, ensure specimen is properly fixed and refridgerate.  Ship cool; do not freeze. 




SOURCE: Diagnostic Cytology ( )
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