Specimen Requirements

PLEASE REFER TO THE SPECIMEN TYPES BELOW FOR COLLECTION INSTRUCTIONS

Test Code: 46

CPT Code: 88112, Corresponding professional fees will also apply.

Specimen Collection:

Note: 24 hours prior to collection; Patient should abstain from having receptive anal intercourse, using enemas or douches, inserting anything into the anus (fingers or sexual aids)

Specimen sample is best achieved with patient positioned on their side in the fetal position with knees toward chest.

1. Insert a water-moistened Dacron swab 5-8 cm (length of patient’s little finger) into the anus to insure sampling of the anorectal transformation zone.
   • Use of lubricating jelly will interfere with cytologic examination.
2. Slowly rotate the Dacron swab in a circular arc pattern while maintaining firm pressure against the rectal wall mucosa to insure complete sampling of the rectum until the device is withdrawn.
3. When fully withdrawn from the anus the swab should be placed in the CytoLyt vial as quickly as possible and rotated 10 times while pushing against the container wall, and then vigorously stirred for at least 15 seconds to further release material.  Discard the swab.
4. Tighten the cap so that the torque line on the cap passes the torque line on the vial.
5. Record the patient’s full name and date of birth or Spectrum Health MRN on the vial.
6. Record the patient information and medical history, including pertinent clinical history (birth date and previous abnormal sampling), and source (Anal/Rectal Cytology) on the Anatomic Pathology Medical Cytology Requisition.
7. If HPV testing is requested another specimen must be collected at the same time with the specific “Digene HC2 DNA collection device” and a “Reference lab send out miscellaneous tests” (LAB848) must be ordered. These specific collection devices can be obtained by contacting the Referrals Department at (616)267-2753.
8. Place the vial and requisition in a specimen bag for transport to the Cytology laboratory at 35 Michigan.

Additional Information:  

Cytolyt and Dacron swabs can be obtained by contacting the Cytology Department at (616)267-2610

Test Code: 46

CPT Code: 88160, Corresponding professional fees will also apply.

Specimen Collection:

• Label container with patient's full name and birthdate or Spectrum Health MRN.
• Specimen should be a fresh, unfixed fluid collection in a clean, leak-proof container.
• Volume of at least 50 mL is preferred (CSF: Volume .5 mL is required)
• Refrigerate if there is a delay in sending specimen to the Laboratory.
• Indicate on the order specimen type, source of fluid and pertinent clinical information. Please also specify left or right side.

Test Code: 46

CPT Code: 88160, Corresponding professional fees will also apply.

Specimen Collection: Specify nipple discharge. Spread material evenly on slide and place IMMEDIATELY in cytology fixative container or spray with cytology fixative.

Applies to direct smears from the nipple discharge (for aspirated material, see Fine Needle Aspirations):

1. Label slides with patient's full name and date of birth on the frosted end of a clear glass slide with a No. 2 lead pencil. Also indicate left or right.
2. Gently express the nipple and subareolar area of any secretions which may be lying in the collecting ducts.
3. Allow a small drop of fluid to collect.
4. Immobilize the breast and smear the slide across the drop of fluid.
5. Immediately spray the slide with the cytology fixative or place in a container of 95% ETOH. A delay in fixation may result in marked cellular distortion! Make as many smears as the material allows. 
6. Include pertinent clinical data in the order. Specify left or right side. Label specimen container with 2 patient identifiers (full name and date of birth or Spectrum Health MRN). Include specimen source.

Test Code: 46

CPT Code: 88112, Corresponding professional fees will also apply.

Specimen Collection:

• Label container with patient's full name and birthdate or Spectrum Health MRN. Also include specimen source.
• Collect the washings/lavage (not less than 1-2 mL of fresh, unfixed material) in a clean, leak-proof container.
• Indicate on the order site lobe and pertinent clinical data (i.e. clinical impression, past diagnosis, radiographic findings and history of radiation or chemotherapy should be included in the order.)
• Refrigerate if there will be a delay in reaching the laboratory.

Test Code: 46

CPT Code: 88112, Corresponding professional fees will also apply.

Specimen Collection: Specimen includes collection from brushing of lesion or suspicious area.

• The brush should be sent in ThinPrep Cytolyt solution.
• Brushes received in formalin or 95% ETOH cannot be processed
• Specify and properly label the container with the site brushed, lobe and left or right side, and 2 patient identifiers that include patient's full name and date of birth or Spectrum Health MRN. Include in the order source and pertinent clinical information, i.e., history of malignancy, chemotherapy or radiation therapy, and tentative diagnosis.

Test Code: 46

CPT Code: 88108

Specimen Collection: Send air dried slides labeled with patient name and date of birth or MRN, source and date of collection in a cardboard mailer to the cytology lab. Giemsa stain is available upon request in the order.  For FNA eye, see Fine Needle Aspiration.

Please see test codes:

• LAB2111263 FNA, Cytology or
• LAB2111263 Endoscopy Ultrasound FNA, Cytology

 Please see test codes:

LAB1230097 - Pap Test

Fresh Tracheal Aspirate

Test Code: 46

CPT Code: 88160, Corresponding professional fees will also apply.

Specimen Collection:

1. Using a pencil, label the glass slide with the patient's full name and date of birth or Spectrum Health MRN.
2. Scrape the margins of the ulcerated area of the lesion. Do not scrape the center of the lesion, which is usually too necrotic to yield well-preserved cells.
3. Place in container of 95% ETOH IMMEDIATELY. If alcohol containers are not available, spray fix slides and send to the Laboratory in a cardboard slide folder.
4. Include the source of the scrape and pertinent clinical information in the order.

Bronchial Washings

Test Code: 46

CPT Code: 88112, Corresponding professional fees will also apply.

Specimen Collection: Includes fresh collection (not less than 3 mL) in sterile container

1. Label container with patient's full name and date of birth or Spectrum Health MRN. Include source and date of collection.
2. Instruct the patient to thoroughly cleanse the mouth before collection
3. Instruct the patient to cough deeply from the diaphragm upon awakening and before eating.
4. Encourage the patient to expectorate deep sputum, not saliva, into sterile container
5. Return container immediately to the laboratory along with orders.
6. Refrigerate if there will be a delay in specimen transport to Laboratory

Test Code: 46

CPT Code: 88112, Corresponding professional fees will also apply.

Specimen Collection: Freshly voided, clean-catch urine, catheterized urine, cystoscopy urine, washing of urinary bladder, urethra, ureters, or renal pelvis.

1. Label container with patient's full name and date of birth or Spectrum Health MRN.
2. Send specimen in a sterile (no preservative), leak-proof container.
3. Please indicate in the order or on the container whether the urine is voided or catheterized. Pertinent clinical information including history of recent instrumentation is necessary for interpretation of specimen.
4. If there will be a delay in specimen transport, refrigerate or add Cytolyt solution to the specimen.

Urine specimen is stable refrigerated for 72 hours without being put in cytolyte.

• Detailed Instructions (link): Urine Collection Guide for Staff