Cytopathology

The Cytology department processes approximately 5000 diagnostic cytology samples per annum. It is part of the Pathology Department which in turn is part of the Central Clinical Services directorate.

Contact numbers

 
 
Examinations offered by the laboratory

 

EBUS clinics

Turnaround times

Transportation of samples

The acceptance and rejection of samples

Key factors known to affect performance

Availability of clinical advice

Andrology

The Andrology service operates from 9am to 3pm Monday to Friday. Samples received outside of these times might be rejected. No appointment is necessary however samples must be accompanied with a GP request form in order for it to processed.

Contact numbers

Cytopathology contact numbers are included in the Cellular Pathology contacts - click here.

Opening hours

Monday to Friday, 8.00am to 5pm.

Diagnostic cytology requests

All specimens should reach the department as soon as possible. If there are any queries regarding specimen collection/preparation please telephone the laboratory on ext. 64410 before sample collection. If a specimen is taken out of hours (especially if the correct specimen container is not available), the specimen should be refrigerated at 4°C until the cytopathology laboratory is open, but note that CSF specimens are unlikely to be suitable for processing if refrigerated.

Specimen containers

120 mL Uricyte kit containing 12 mL of preservative for urine cytology, 500 mL bottles containing EDTA for effusions, and 60 mL Sterilin container with metal lid for semen samples are available from the pathology store, ext. 64407.

Specimen request forms/ clinical information

A request form must accompany all specimens. Guidance on completing the request form can be found under general information on this website.

In order to ensure that the correct tests are performed the user must provide clear, sufficient and relevant clinical information. This information will help in the interpretation of the specimen and may include:

  • Symptoms
  • Underlying conditions
  • Previous history of neoplasia/pathological conditions
  • Recent infections

Specimens

All specimens must be clearly labelled with three patient identification points that correspond to the same identification points on the request form.

Prepared slides that are to be processed within the laboratory must be labelled with pencil as ink is removed by solvents used during specimen preparation.

Please be advised that air-dried preparations should not be performed on patients that are identified as ‘danger of infection e.g. ?TB, ?HIV.

Urgent specimens

Telephone the laboratory giving the nature of the specimen, the patient’s details, when results are required, who to contact and their bleep/phone number.
 

Examinations offered by the laboratory

Fine needle aspirates (FNA)

The material obtained should be gently spread onto frosted end glass slides and rapidly air dried.  The slides must be clearly labelled in pencil with the patient’s name and date of birth and the site of aspiration. Slides must be completely dry before they are put into transport boxes. If fluid is aspirated this can be put in a blood bottle containing EDTA (pink top blood bottle).

Respiratory tract

Sputum, bronchial washings/lavages

The whole specimen should be sent in a wide mouthed, screw-capped container or trap and should reach the laboratory the same day. Sputum specimens should be three early morning sputums taken on successive days before breakfast to avoid contamination with food or toothpaste.

Nasal, pharyngeal swabs, buccal smears and bronchial brushings

Bronchial brushings and swabs/buccal smears should be smeared gently onto frosted end glass slides and fixed immediately with cytology fixative. Allow 10 minutes before putting the slide in the transport box. The slides must be clearly labelled in pencil with the patient’s name and date of birth.

Gastrointestinal tract

 

Washings and lavage specimens

The whole specimen should be sent in a wide mouthed, screw capped container and should reach the laboratory the same day.

Endoscopic brushings

Brushings should be smeared gently onto frosted end glass slides and fixed immediately with cytology fixative.  Allow 10 minutes before putting the slide in the transport box. The slides must be clearly labelled in pencil with the patient’s name and date of birth.

Effusions

Effusions consist of pericardial, pleural, ascitic or peritoneal fluids. Specimens should be collected in 500ml bottles labelled “FOR CYTOLOGY OF EFFUSIONS”. These bottles contain an anticoagulant (EDTA) to prevent clotting.

Urine

Types of suitable samples include: voided, catheter, bladder washings and ileal loop urine. Specimens are collected in 120 mL Uricyte kits containing 12 mL of preservative.

The bottle contains fixative (alcohol and glacial acetic acid). Complete voided specimens are required. Midstream urine is not suitable for cytology as cells are often passed at the beginning and at the end of voiding. Early morning urine is also unsuitable because it contains degenerate cells, causing difficulty in interpretation.

Joint fluids

Synovial specimens should be received in sterile pots.  Send an aliquot fresh to the Cytopathology department in an anticoagulant-free container.

Cerebrospinal fluid (CSF)

The CSF should be collected in a sterile universal container without fixative (plastic is preferable as some cells adhere to glass).

CSF samples must be sent to the department immediately after being taken as they deteriorate rapidly, any delay may result in them being non-diagnostic. CSF samples should not be taken after 3pm to allow for transport and preparation time.

In order to ensure successful cytological diagnosis and subsequent triage a sample volume of 3 mL+ should be collected where possible.

If flow cytometry is required please send a separate sample to Blood Sciences.

EBUS clinics and BMS assistance at FNA clinics

The Cytology department also have a consultant led service which provides on-site provisional diagnosis at EBUS clinics and BMS assistance at a wide range of FNA clinics, including adequacy assessment at head and neck clinics.

Please note the BMS staff do not perform the aspirations however the support of a BMS is recommended for optimal sample preparation.

Turnaround times

The diagnostic cytology department uses the Royal College of Pathologists (RCPath) guidelines for turnaround times (TAT). That is, 80% of cases are to be reported within seven calendar days of the sample being taken whilst 90% are to be reported within ten calendar days.

TAT relates to the final local report and excludes cases sent for external opinion and those that require immunocytochemistry or molecular analysis.

Transportation of samples

Samples are delivered directly to the laboratory by portering staff or sent using the courier system. Please ensure that all lids are secured prior to transportation of the specimen, as leaking specimens may not be processed.

The acceptance and rejection of samples

If either the request form or specimen is incorrectly labelled then the sample may be returned or rejected. A Datix incident will be completed on all unsatisfactory labelled specimens.

Key factors known to affect performance

In order for the laboratory to perform the correct tests and provide the appropriate results it is important for requesting clinicians to be aware of the factors which can affect test performance and the interpretation of results. For example:

  • Samples place in formalin fixative
  • Wrong specimen container used e.g. effusion bottle for a urine specimen
  • Inappropriate specimen container used e.g. ‘normal’ sterile container used for urine collection instead of Uricyte container thus resulting in bacterial overgrowth
  • Delay in transportation, e.g. with CSF samples
  • Inadequate volume of specimen
  • Poor quality specimens
  • Insufficient supply of clinical details.

If in any doubt, please contact the laboratory for advice.

Availability of clinical advice

Clinical advice from Consultant Pathologist is available. This can be obtained by telephoning the department during normal working hours.