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Non-Gynaecological (SYSTEMIC) Cytopathology

 

All samples should be sent to the laboratory as quickly as possible but if not practical, may be refrigerated until transportation can be effected. Samples from the GHH/ SOL sites, may be refrigerated in central reception and sent the following day on the first available shuttle if no other viable option is available.

  • Breast and respiratory samples requiring URGENT attention to meet with Multi-disciplinary Meeting deadlines are prioritised and sent on the next available shuttle of the day.
  • Broncho-alveolar samples sent on ice for differential white cell count and cerebrospinal fluids are also sent on the next available shuttle, to minimise the effects of cellular degeneration. For optimal results BAL samples should be collected and received at the laboratory for processing on the same day. This ensures that the slide preparation can be completed as soon as possible to minimise the risk of cellular degeneration on the differential cell count results.

Non-gynae Specimen Labelling and Request Form

Completing the non-gynaecological request form

Each sample must be accompanied by the appropriate Non-Gynae Cytopathology request form complete with the following essential patient details:

  • Full Name
  • PID or NHS Number or Date of Birth
  • Location or destination for report
  • Consultant or GP
  • Specimen type
  • Test required
  • Date and time collected.  This is especially important for CSF and BAL specimens as delays may compromise the reliability of the test result.

Non-Gynae request forms are available from the Cytology department or electronically via ICE requesting. All sections of the paper copy request form should be fully and legibly completed in ball point pen.

Labelling of non-gynaecological specimens

Specimens should be collected in an appropriate transport vessel which is intact undamaged and with the lid firmly fitted to prevent spillage or leakage and must be clearly labelled with:

  • Full Name of Patient
  • PID, NHS Number or Date of Birth (whichever is given on form)
  • Specimen type
  • Date and time collected which is essential for CSF and BAL specimens as time factors affect the test result.

Any unlabelled samples which can easily be repeated, such as urines, will be rejected on receipt into the laboratory. In cases of unlabelled or mislabelled samples from an invasive procedure, the responsible clinician will be notified as soon as possible and requested to identify and label the sample in the laboratory before it can be processed.

In the event of multiple specimens from one site, each sample pot must be labelled clearly so they are readily distinguished from one another. In the case of samples from different sites, a separate request form for each specimen site is required.

Glass slides must be labelled using PENCIL with:

  • Full Name of Patient
  • PID, NHS Number or Date of Birth (whichever is given on form)
  • Air-dried or alcohol-fixed.  This is particularly important to ensure slides undergo the correct processing method aiding accurate microscopic assessment. 

Please note: ink or marker pen labelling of glass slides will be lost during processing rendering the slides unlabelled.

 

For urgent specimens, including Cerebrospinal Fluid and Bronchoalveolar Lavage, please notify the laboratory prior to dispatch to ensure staff availability for timely preparation and reporting.

·         Cytology Laboratory 0121 424 1191.  Opening hours: 08.30 – 17.30.

Specific Instructions for the Packaging of Non-gynae Specimens

  • After labelling, samples should be placed in an individual clear plastic transport bag and sealed using incorporated fastener. DO NOT secure with pins, staples, etc.
  • Please place the request form in the integral side pocket (not in the bag with the specimen) to avoid contamination in the event of a spillage. 
  • Place multiple individual sample bags in large orange transport bags and seal ready for transport to the laboratory. These bags are available from Pathology Stores Tel: 0121 424 2461 and must be used where possible.  This will ensure samples are delivered directly to the Cytology laboratory, thereby avoiding unnecessary delays.
  • Sealing the bags will minimise the risk of loss of samples during transport to the laboratory and protect courier from any spillages that may occur.
  • Bronchoalveolar Lavagesamples must be sent to the laboratory on ice - this is essential to ensure minimal cell degeneration. They should be packed in ice, sealed and delivered to Pathology by a porter. Please inform the lab of their expected arrival time, to ensure staff are available to process the sample.

Non-Gynae reporting times

Non-gynaecological cytology specimens are usually reported within 5 working days of receipt unless special or immunocytological stains are required which may cause a delay.

Non-gynaecological specimens are kept by the department for 7 days following receipt, after which they are considered unsuitable for diagnosis. Although requests for further examinations are possible, this will only be carried out following discussions with a Consultant Pathologist. 

Out of hours, a Consultant Pathologist may be contacted via UHB HGS (Heartlands, Good Hope, Solihull) switchboard.

Interpretation of results

Should you require an interpretation of results please contact the department and request to speak to the reporting pathologist.

Interpretation of results can only be discussed with the reporting pathologist

Key Factors affecting the performance of the examination or interpretation of results

·        Ensure that samples are sent to the laboratory as soon as possible after collection as unfixed cells degenerate quickly.

·        Send non-gynae cytology specimens to the laboratory using the ORANGE non-gynae cytology transport bags to ensure that once received at Laboratory Medicine Central Reception they are forwarded to the correct department.

·        Ensure that cellular material prepared onto glass slides following FNA procedures undergoes either air-drying or alcohol-fixation as appropriate without delay to facilitate optimal staining by the laboratory, thereby assisting in accurate microscopic assessment.  Label slides as air-died or alcohol-fixed to ensure slides undergo the correct processing method.

·        Immerse any residual sample material from cytology fine needle aspiration or brush samples in CytoLyt immediately if they are to be transferred to the laboratory for processing.  Universal Containers of CytoLyt are available from Cytology (Tel: 0121 424 1191).

·        Inform the laboratory of any urgent samples to facilitate timely reporting.

·        Due to the fragile nature of some specimens such as CSF and BAL samples please contact the laboratory prior to taking specimens to ensure that the department can be available to process these specimens.

 

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