Regional Medical Laboratory

Collection and Preparation

IMPORTANT!

Please complete GYN CYTOLOGY CLINICAL HISTORY section on the front page of requisition. Last Menstrual Period (LMP) & Gynecological history is important for optimal evaluation.

NO FORMALIN SHOULD BE ADDED TO ANY SPECIMEN SENT FOR CYTOLOGICAL EXAMINATION

Thinprep® (Liquid-based Pap test)

1. Thinprep® vials, which contain PreservCyt solution, and broom or spatula collection devices are provided to physicians and clients upon request.
2. Adequate sampling from the cervix using a broom-like device. Water-soluble gel lubricant sparingly applied to the posterior blade of the speculum can be used if necessary. Insert the central bristles of the broom into the endocervical canal deep enough to allow the shorter bristles to fully contact the ectocervix. Push gently, and rotate the broom in a clockwise direction five times. Rinse the broom as quickly as possible into the PreservCyt solution vial by pushing the broom into the bottom of the vial 10 times, forcing the bristles apart. As a final step, swirl the broom vigorously to further release material, place cap on vial and tighten. Discard the collection device.
3. An adequate sampling from the ectocervix using a plastic spatula. Water-soluble gel lubricant sparingly applied to the posterior blade of the speculum can be used if necessary. Select contoured end of plastic spatula and rotate it 360 degrees around the entire exocervix while maintaining tight contact with exocervical surface. Rinse the spatula as quickly as possible into the PreservCyt solution vial by swirling the spatula vigorously in the vial 10 times, place cap on vial and tighten. Discard the spatula.
4. Obtain an adequate sampling from the endocervix using an endocervical brush device. Insert the brush into the cervix until only the bottommost fibers are exposed. Slowly rotate 1/4 or 1/2 turn in one direction. DO NOT OVER-ROTATE. Rinse the brush as quickly as possible in the PreservCyt solution by rotating the device in the solution 10 times while pushing against the PreservCyt vial wall. Swirl the brush vigorously to further release material, place cap on vial and tighten. Discard the brush.
5. Label the vial with two patient identifiers including: Patient's name (first and last) and Date of Birth along with the Collection Date/Time and the Collector's Initials. Specimen must be accompanied by a completed requisition.

SurePath® Prep, Liquid Based Pap

Insert the cervical brush into the endocervical canal. Apply gentle pressure until the bristles form against the cervix. Maintaining gentle pressure, hold the stem between the thumb and forefinger and rotate the brush five times in the clockwise direction. Gently remove the brush from the endocervical canal and disconnect the entire brush head from the stem and place the brush head into the CytoRich® preservative vial. If the special endocervial brush is also used, rotate the brush one time in a clockwise direction then disconnect and place it in the CytoRich® preservative vial. The endocervical brush should never be used by itself. After placing both brushes in the vial, close the vial and label with two patient identifiers including: Patient's name (first and last) and Date of Birth along with the Collection Date/Time and the Collector's Initials. Specimen must be accompanied by a completed requisition.

Conventional Pap Smear

Insert the cervical brush into the endocervical canal. Rotate the brush no more than one turn. Remove the brush and immediately smear on the end of the glass slide opposite the frosted end and spray fix with Cytospray® fixative to avoid air-drying. Make sure that the sample is dispersed on the slide to avoid thick deposits and an “unsatisfactory” result. A charge will not be generated for an “unsatisfactory” result. Another sample should be taken as soon as possible.
Slides should be labeled on the frosted end of the slide by printing the patient’s first and last name in pencil; markers of any kind are removed from the slide by the fixation process. Specimen must be accompanied by a completed requisition.

Non-Gynecologic Preparations

For cytology preparations prepared by the physician, i.e., bronchial brushings or fine needle aspiration cytology, the patient's first and last name must be written on the frosted end of the slide with pencil and a thin cellular spread made on the same side. The test requisition should be wrapped around the slide holder with a rubber band or placed in a biohazard baggie along with the slide holder. For fluids, specimens should be sent fresh or in CytoRich®. DO NOT send fluids placed in 50% alcohol. Specimens should be labeled with two patient identifiers including: Patient's name (first and last) and Date of Birth along with the Collection Date/Time and the Collector's Initials. Specimen must be accompanied by a completed requisition. If there is uncertainty as to the method of specimen handling and/or preparation, contact our Cytology Department at (918) 744-2553; (800) 722-8077.