Non-Gynecologic Cytology

Non-Gynecologic Cytology

Request Form

  • Fill out the Cytology Order Requisition Form completely.  All information is important.
  • Patient name on form must match name on specimen container and/or slides. Do not use different variations of the same name (e.g. Jane Doe vs. Ms. John Doe or Margaret vs. Peggy).
  • Include any abnormal findings or pertinent history. This information is critical for an accurate diagnosis.

Specimen Handling

  • Observe universal precautions with all specimens.
  • Label specimens with at least two patient identifiers (e.g. name, date of birth, medical record #, etc.). If two patient identifiers are not on the specimen it will be returned for complete identification.
  • Indicate if the fluid has been fixed in an equal volume of 50% alcohol. If slides are prepared, indicate which are fixed (with spray fixative) and which are air-dried.

For Additional Help

Should you need help or advice in sending or preparing a specimen, you may contact the Cytology Department at the numbers below.
Phone: (715) 847-0075
Toll Free: (888) 228-3375
Fax: (715) 847-0065

How to Prepare a Cytology Specimen:  The following guidelines will help ensure that we receive an optimal specimen for processing.

FLUIDS - Urine, Washes, Effusions, Cyst Fluid, *Cerebral Spinal Fluid, Anal-Rectal Preparations, etc.

  • If the specimen is not already fixed, add an equal volume of 50% alcohol. Without fixation cells degenerate quickly and bacteria/fungus grow rapidly. These conditions can render a specimen unsatisfactory for microscopic examination.
  • Fluids should be sent in a leak proof container labeled with two patient identifiers and placed in a biohazard transport bag.
  • When at all possible, send the entire specimen. Exceptions to this are when the specimen needs to be split for other tests and/or procedures (e.g. microbiology, cytogenetics, etc.) or when the volume is a well mixed representative specimen (preferably not to exceed 100 ml), as in certain effusions.
  • If a portion of the specimen is sent, swirl the fluid in the larger container before pouring off the smaller amount. This is an important step and will ensure a homogenous sample. Fill the smaller container only halfway so there is room for the fixative (this is not a concern if the larger volume was already fixed).
  • *Cerebral Spinal Fluids are especially sensitive to cellular degeneration and should be fixed and sent to us ASAP.

SMEARS - Sputum, Nipple Discharge, Sperm Morphology or Tzanck Smears 
Certain specimens require you to make smears before sending them to AIP.

  • Specimens are at their best (retain sharp cellular detail) when made from unfixed material and immediately spray fixed. Immediate fixation is critical. Do not allow any air-drying to occur. You cannot fix a smear too soon.
  • Label slides with patient name in pencil (markers, tape and paper labels come off during staining).
  • Correlate the slides with specific sample sites and/or times of collection if sending multiple smears from different sites or collection times on the same patient.
  • See the following for preparing specific specimen types:
    • Sputum - Sputum specimens are always prepared by making smears. *You may send the sputum sample to AIP for processing (see section I. Fluids) or prepare the smears yourself. Smears prepared on site are generally in better condition because less cellular degeneration occurs.
      • Label two slides with the patient's name and second identifier in pencil.
      • Instruct patient to deposit sample coughed up from bronchial tree (deep cough specimen) into collection container. Specimen should not be saliva from the mouth or nasal secretions. Only one good specimen is needed.
      • Check sample carefully and transfer any discolored or bloody portions along with a general sample to a slide with forceps, pipette or by other means.
      • Gently crush/mash specimen between two slides until a smooth homogenous sample is produced.
      • Remove any large hard pieces or areas that would hinder cover-slipping.
      • Spray fix immediately. Avoid air-drying as best as possible. Make only two slides per specimen.
    • Nipple Discharge
      • Label all the slides with the patient's name and second identifier in pencil.
      • When a small drop of secretion appears, gently pull the face of the slide across the nipple.
      • Spray fix immediately.
      • You may repeat as long as secretion is obtained.
    • Sperm Morphology
      • Label two slides with the patient's name and second identifier in pencil.
      • Place a small amount of material on one of the slides.
      • Place the other slide on top of the one containing the specimen and allow the sample to spread between them.
      • Pull slides apart and spray fix immediately. Make only two slides per specimen.
    • Tzanck Smear (Herpes Identification) - Term referring to cytological preparations made from the base of vesicles in search of cytological features suggestive of herpes simplex virus. Note that detection of herpes simplex can also be done by PCR (molecular method) or viral culture. Please contact Aspirus Reference Lab for proper handling of those types of specimens.
      • Label one slide with the patient's name and second identifier in pencil.
      • The base of a freshly ruptured vesicle should be gently scraped with the dull side of a sterile scalpel blade or other sterile flat surfaced instrument so that material from the base and sides of the vesicle are obtained. A crusted lesion or non-ruptured vesicle will not yield diagnostic material.
      • Smear the sample on the slide and spray fix immediately.
    • Brush specimens should be prepared at the site of the procedure.
    • The brush itself should be sent to us for further processing. Many times we can remove additional material from the brush for the preparation of a cell block.
    • Label the slide(s) with the patient's name and second identifier in pencil.
    • Roll the brush over the slide(s) and spray fix immediately. Rubbing the brush aggressively across the slide(s) may crush the cells, hence yielding a suboptimal smear.
    • Place the brush in a labeled leak proof container with fixative (50% alcohol or 10% formalin) and sent to AIP for further processing.
  • FINE NEEDLE ASPIRATION (FNA) - (e.g. thyroid mass aspirate, salivary gland aspirate, parotid mass aspirate, submandibular gland aspirate, sublingular gland aspirate, transbronchial needle aspirate (TBNA), lymph node aspirate)
    • Label the slides with the patient's name and second identifier in pencil.
    • A 21-25 gauge needle attached to a syringe should be inserted into the mass.
    • With suction applied to the syringe, the needle is repeatedly moved in an in-and- out motion throughout the mass.
    • Suction on the syringe is released before withdrawing the needle.
    • Remove the needle from the syringe, introduce air into the syringe and replace the tissue filled needle back on the syringe.
    • The material is then forced out of the needle onto a slide.
    • Place a second slide on top of the one containing the specimen.
    • Pull the two slides gently apart allowing the specimen to spread across them.
    • Immediately spray fix one slide and let the other slide air-dry. Air-dried smears are especially helpful on thyroid, lymph node and salivary gland aspirates. The smears should be marked as fixed or air-dried. 
    • The optimal number of slides on a solitary nodule (thyroid, salivary gland and lymph node) is 8-10 (generally 3 passes).
    • After making the smears, rinse the needle (or needles if multiple passes are made) and syringe into a vial of fixative (50% alcohol or 10% formalin) – this may provide additional valuable tissue.
    • Label the vial with two patient identifiers and submit with slides and requisition form.