MANCHESTER CYTOLOGY CENTRE USER MANUAL 2010
Contents
1. 010 6 z gt ejeujsog C NOILIGNOD esp fyoads jueuDejg sjuened 491 18quinw 21ui 2 Jedsog Z ALIS 0395 JO 31Vd Je duies jeojueoopu3 Z Gusnig xeue 321 40 9Nndlvs AWVNUNS S 3WvN3303 190 6 sieaws jenuuy Q peyeoipul 3AVNhS Jeaus onsiunuoddo g jueugeei sdolq 6 2 eunnos 7 uvas SHOYYI LNAATYd OL ATHV3T9 NOLLVIWSOJNI ayenbapeul Aaig 2 Isenisid 498 sSSIYAAY 3WOH OL 32N30NOdS3MN09 1 d 159 SNOB SHN T MeP si aW149 0 W804 LSANDIY 49010142 1V2IAN32 Jeaws JO Fw 9901 3uIN3O A9010149 331S3HONVIN IHL 25 SHN V Xipueddy Appendix Manchester Cytology Centre Non Gynaecological Cytology Request Form PATIENT S DETAILS AFFIX STICKER HERE SPECIMEN DETAILS PLEASE TICK Surname URINE GASTROINTESTINAL Voided Pancreatic cyst fluid Catheterised 1 Biochemistry sent Post instrumentation No biochemistry Forename Bladder washings Biliary brushings Ureter 1 Stent present Ileal conduit Stent absent Address BODY CAVITY Ascitic Fluid2. FNA SITE amp SIDE Lt or Peritoneal Fluid Rt Pericardial Fluid Peritoneal Washings Pleural Fluid 1 CT Guided Ultrasound Guided MISCELLANEOUS Endoscopic U S Cyst Fluid other Transduodenal Transgastric Please state site Sex DOB Private NHS CSF Transbronchial Hospital NHS OTHER number Please give details Ward Dept Consultant to whom the report is to be sent please print Copy report to Department please print Consultant s department where report is to be sent Time taken Bleep contact number for requesting clinician Date taken CLINICAL INFORMATION IET DII p Previous Cytology Previous Histology Previous Treatment Right Head and Neck FNAs Please indicate area and label diagram below Left Chemo radiotherapy High Risk Yes No Requesting aspirating Clinician PLEASE PRINT 2 0 6 66 6 ee nennen Sigpat r e ANG EIL TIDEMIDII BL vase ye adele dacs eddevees desea sees sesewesecccese NB Insufficiently filled in forms will result in delay in the reporting of the specimen
3. MANCHESTER CYTOLOGY CENTRE ay d 7 USER MANUAL ETT E UT E UU A TT ME TT UU UT T January 201 0 Version 004 Table of contents About us 3 Services available at the Manchester Cytology Centre 3 Services provided to the Christie Hospital 3 Find or contact us at Manchester Cytology Centre 3 Hours of opening at Manchester Cytology Centre 4 Key personnel at Manchester Cytology Centre 4 Find or contact us at the Christie Hospital 4 Specimen acceptance policy 4 Section 1 Non Gynaecological Cytology 5 12 Turn around time 6 Non gynaecological cytology sample collection e Body cavity fluids pleural ascitic peritoneal peritoneal 7 e Cyst fluid 7 e Respiratory tract samples Sputum Bronchial lavage wash trap BAL amp brush 8 e Urinary tract samples Voided catheter urethral washings ileal conduit industrial urine 9 e Cerebrospinal fluid 9 e Fine needle aspiration cytology 10 Section 2 Gynaecological Cytology 13 22 Quality Statement 14 General Enquires 14 Specimen collection and transport 14 Hub and Spoke arrangements for sample processing 14 LBC Kits 14 Completing the request form and labelling the sample vial 15 Report generation and distribution 15 Urgent referrals for further investigation 15 Prioritising the workload turn around time 15 Audit 16 Feedback on inadequate cytology reports 16 Research activities 16 HPV Triage in primary screenin
4. by placing your thumb against the back of the broom head Push the broom head from the stem into the SurePath preservative vial THE BROOM HEAD MUST BE PRESENT IN THE VIAL CAP THE VIAL securely so that it does not leak For further copies please contact the Manchester Cytology Centre on 0161 276 5111 www surepath com P R Y ge 800 m M N S Me 5 2 04 0 35 NO s de MAT R SaaS LE Awarded for excellence Investor in People January 2010 22 AT4V319 GALNIYd 29 Asdoig Jo 04 0451 snoiejd jo swozdw s sufis 1 s ejep jue ejeJ STIVLAG IWIINITD se YON ANOLOAYSLSAH Sseippe d Buipeejq senpa Y jesnedoueuusog 2 pie cine ps Buipeeq jensueuueju Buipeojq 021804 L aoe HEA ye Jepueg SX 9 40 d33MS 334930 096 ji yon GASIMWNSIA ATIN XIAN32 49 ouo JO piem 9180095 0 d9 LON dl jueuDi e A 6 2 30 Je Sod pue 1940 Z Japuas 1504 Jesnedoueujsod 9 doni e
5. then Refer b Two follow up cytology tests show borderline Without radiotherapy Follow up after treatment for invasive cervical cancer excluding hysterectomy routine recall ack for colposcopy if changes OR one follow up cytology test shows dyskaryosis Repeat in 6 months then annual smears for 10 years and then routine recall unless specialist opinion indicates otherwise January 2010 18 Version 004 FOLLOW UP AFTER TOTAL HYSTERECTOMY Where there is no CIN or invasive For women on routine recall for at least 10 years prior to hysterectomy cervical cancer on histology Suggest cancel recall For women on routine recall for less than 10 years prior to hysterectomy Take vault smear at 6 months then suggest cancel recall if negative For fully excised CIN Suggest cancel recall after 2 subsequent negative cytology tests at 6 months and 18 months after surgery For fully excised CGIN Suggest cancel recall after 2 subsequent negative cytology tests at 6 months and 18 months after surgery For incomplete unspecified uncertain Follow up cytology tests at 6 and 12 and 24 months or unknown excision of CIN 1 If all are negative return to routine recall For incomplete unspecified uncertain Follow up cytology tests at 6 and 12 months Then annual follow up for a total of 10 years or unknown excision of CIN 2 or CIN 3 If all are negative return to routine recall
6. suspected please also send an aspirate to microbiology in a sterile container e If a reactive lymph node or lymphoma is suspected please send a 3 aspirate for flow cytometry analysis in RPMI transport medium which can be provided by the BMS The ideal FNA sample is prepared as follows e Even monolayer spreads onto glass slides for 1 air dried direct smear and 2 alcohol fixed direct smear e needle is rinsed in saline or CytoLyt collection fluid for optimal cell preservation of residual material Note saline is acceptable if the correct transport medium is not available However as saline is not a preservative solution these specimens must be received by the laboratory as soon as possible Version 004 N c m Un Gynaecological cytology January 2010 13 Version 004 NHS CERVICAL SCREENING PROGRAMME QUALITY STATEMENT The Manchester Cytology Centre is a CPA accredited department and all cervical liquid based cytology LBC samples are processed and screened following NHS Cervical Screening Programme guidelines and the regional Quality Assurance Reference Centre recommendations The department participates in the regional gynaecological and technical EQA schemes and the performance of all screening staff is assessed quarterly as per NHSCSP guidelines The management and staff within the department are committed to providing a quality service to our users We aim to continually i
7. tool Women between the ages of 20 to 64 were recruited to this trial Their cervical sample was taken and processed by the ThinPrep LBC system and from the clinical details section on the request form the laboratory arranged subsequent HPV testing if required The ARTISTIC trial is now complete and the report is to be published in 2010 MAVARIC TRIAL Manual Assessment Versus Automated Reading In Cytology This HTA funded trial was to compare manual screening of cervical samples with the automated screening devices FocalPoint SurePath and Imager ThinPrep The trial included HPV testing to determine patient management The trial comprised Randomisation to either manual assessment only or manual assessment AND automated reading HPV testing if the cytology result is borderline or mild dyskaryosis Visit our web page for more information about the MAVARIC trial which is due to report out late 2010 www cmmc nhs uk directorates labmedicine departments cytology HPV TRIAGE IN PRIMARY SCREENING SENTINEL SITE IMPLEMENTATION PROJECT The Manchester Cytology Centre has been selected as one of six national sentinel sites to begin the controlled implementation of HPV triage in primary screening All women with first ever borderline or mild dyskaryosis results will be included and managed according to their HPV result The new patient management protocols commenced in March 2008 Visit our web page for more information and copies of the Se
8. For incomplete unspecified uncertain Follow up cytology at 6 and 12 months Then 6 monthly cytology for a total of 5 years or unknown excision of CGIN Then annual cytology for a further 5 years If all are negative return to routine recall For invasive cervical carcinoma Follow up at 6 and 12 months then annual cytology for a further 9 years If negative no radiotherapy routine recall unless specialist opinion indicates otherwise Follow up after radiotherapy No need for follow up cytology unless specialist opinion indicates otherwise For endometrial ovarian carcinoma Suggest cancel recall unless specialist opinion indicates otherwise References e NHSCSP Publication No 1 Achievable Standards Benchmark for Reporting Criteria for Evaluating Cervical Cytopathology October 1995 amp May 2000 e NHSCSP Publication No 8 Guidelines for Clinical Practice and Programme Management December 1997 e ABC2 A Regional Guide to Implementation e NHSCSP Publication No 20 Colposcopy and Programme Management 2004 In July 2005 the North West Regional Quality Assurance Reference Centre issued additional guidance for follow up cytology after radical hysterectomy and radiotherapy for the treatment of cervical cancer Women who have undergone radical hysterectomy for cervical cancer In general cytological follow up is not recommended in the assessment of these women but decisions regarding this small group of patient
9. Transbronchial guided specimens Radiology Endoscopy Respiratory Medicine and Head amp Neck ENT and Maxillofacial departments please book with the Manchester Cytology Centre in advance Equipment required for a fine needle aspiration e Standard disposable 21 25 gauge needles A 25 gauge needle is suitable for most lesions e Disposable 5 10 ml plastic syringe e Clean container with tight lid preferably universal containing saline or Cytolyt if available e Standard microscopic glass slides onto which aspirate is to be smeared e Commercial spray fixative for wet fixation of smears Completion of request form and sample container Please see specimen acceptance policy on page 4 Do not refrigerate please January 2010 10 Version 004 How to perform a fine needle aspiration e Disinfect skin using pre packed alcohol swabs e Before insertion of needle wipe away any excess ultrasound jelly with tissue paper if U S guided e Perform the aspiration according to the instructions A G A Position needle within target tissue B Pull plunger to apply negative pressure C Move needle back and forth inside target D Release negative pressure while needle remains in target tissue E Withdraw needle F Detach needle and draw air into syringe G Push a drop of sample onto microscopy slide Churchill Livingstone January 2010 11 e 2 fine needle aspirations are recommended where possible e If Tuberculosis is
10. arge Where there is a strong clinical suspicion of malignancy refer to gynaecologist regardless of any smear report January 2010 17 Version 004 PATIENT MANAGEMENT PROTOCOL FOR THE CERVICAL SCREENING PROGRAMME Management for women included in the Sentinel Site HPV triage can be obtained from Cytology Report Patient Management excluding HPV triaged women Negative Routine recall Inadequate because endocervical cells are absent with a Repeat smear in 3 months history of CGIN Endocervical and ectocervical sampling is recommended 19 Inadequate Repeat in 3 months X 2d Inadequate Repeat in 3 months Yd 3 Inadequate Refer for colposcopy 1st Borderline changes warty changes Repeat in 6 months 214 Borderline Repeat 6 months L 4 3 Borderline Cf Refer for colposcopy Follow up after borderline changes 15 Negative taken at 6 months 2nd Negative 34 Negative regardless of the numbe 1st Borderline changes in endocervical cells Note there should be no more than 3 borderline results in any 10 year period without referral for colposcopy Repeat in 6 months Repeat in 12 months Routine recall r of negative cytology tests in between Refer for colposcopy 15 Borderline high grade dyskaryosis cannot be excluded E Refer for colposcopy Mild dyskaryosis Refer for colp
11. eedle aspiration cytology e Gynaecological Cytology Services provided to the Christie Hospital e Non gynaecological Cytology 1 Exfoliative and aspiration cytology 2 Fine needle aspiration cytology Find or contact us at the Manchester Cytology Centre The Manchester Cytology Centre is located on the first floor of Clinical Sciences Building 2 All visitors should access the department via the reception area of Clinical Sciences Building 1 Address Manchester Cytology Centre First Floor Clinical Sciences Building 2 Manchester Royal Infirmary Oxford Road Manchester M13 9WL Email cyto pathology cmft nhs uk Enquiries Telephone Fax General 0161 276 5111 0161 276 5149 Gynaecological results 0161 276 5111 Non gynaecological results 0161 276 5115 5116 6727 Booking an FNA 0161 276 5111 or Bleep 0765 950 3113 Advice on non gynaecological sample collection 0161 276 5118 5108 January 2010 3 Version 004 Hours of opening The department is open from 8 00 am 5 00 pm Monday to Friday except bank holidays Non gynaecological samples should be received in the department by 4 45 pm Consultant Cytopathologists Dr M Desai Clinical Head of Cytology amp Director of the Manchester Cytology Training Centre Tel 0161 276 5099 Fax 0161 276 5113 Dr M Holbrook 0161 276 6475 Dr M Perera 0161 276 5109 Dr D Rana 0161 276 5108 Medical Secretaries Tel 0161 276 5115 5119 6727 Consultant Bi
12. eoplasia requires urgent referral for further investigation as these are possible cancer cases The laboratory will contact the sample taker by phone and arrange to fax the report through to a safe haven fax so that referral process can commence as soon as possible A failsafe system is in place to ensure that the report has been received and the patient referred Prioritising the workload The majority of samples received by the laboratory are taken as part of the NHS cervical screening programme The national screening office has advised that laboratories should make the final report available to women within 14 days of sample collection The laboratory is aiming to meet this new national target by 2010 for all samples regardless of the source e g primary care colposcopy January 2010 15 Version 004 department participates the Trust audit programme and has a rolling programme of audit projects Feedback on inadequate cytology reports The laboratory sends data to the regional Quality Assurance Reference Centre on a quarterly basis and samples takers can access the information on line To register for access to the sample taker database contact QARC via their web site www nwcsqarc org uk or telephone Michael Wall at NWCSQARC on 0151 702 4284 RESEARCH ACTIVITIES ARTISTIC TRIAL A Randomised Trial In Screening To Improve Cytology This HTA funded trial was to assess the use of HPV testing as a primary screening
13. g Sentinel Site Implementation Project 16 Protocol for Cervical Screening 17 Patient management protocol for the cervical screening programme 18 Follow up after total hysterectomy 19 Guidelines for management of negative vault samples 20 Preparing a ThinPrep LBC sample 21 Preparing a SurePath LBC sample 22 Appendix 1 NHS Cervical Screening Programme request form 23 Appendix 2 Manchester Cytology Centre non gynaecological request form 24 January 2010 2 Version 004 Manchester Cytology Centre is the largest unit of its kind the country It accepts ThinPrep and SurePath Liquid Based Cytology samples as part of the NHS Cervical Screening Programme fine needle aspiration FNA cytology samples as well as other non gynaecological specimens We also provide a non gynaecological service to the Christie Hospital NHS Foundation Trust The department is housed in a new building with state of the art facilities and is affiliated to the Manchester Cytology Training Centre which is situated on the ground floor of Clinical Sciences Building 2 The department is CPA accredited We are fully committed to maintaining this accreditation by an established quality management system and standards determined by the North West Quality Assurance Centre together with scheduled clinical and quality audits Services available at the Manchester Cytology Centre e Non gynaecological Cytology 1 Exfoliative and aspiration cytology 2 Fine n
14. mprove our service through internal audit and feedback from users If you do have complaint or concern about any aspect of the service this should be addressed to the laboratory manager on 0161 276 5119 General enquiries Tel 0161 276 5111 Fax 0161 276 5149 A consultant cytopathologist or a consultant biomedical scientist is available to answer any gynaecological queries and discuss any aspect of the cytology report as well as give advice on patient management Specimen collection and transport The Manchester Cytology Centre processes and reports both ThinPrep and SurePath cervical LBC samples These should only be collected by trained sample takers Training in sample collection for primary care staff is available on request from the cytology training leads at the local Primary Care Trust The cytology lead can also arrange for three yearly update training for sample takers in order for them to remain aware of developments within the cervical screening programme and to maintain competence Instruction sheets on sample collection are also available from the laboratory A courier service will deliver LBC kits and collect LBC samples on a daily basis If there are any issues relating to the courier service please contact the laboratory manager on 0161 276 5119 Hub and spoke arrangements for sample processing The laboratory has a large capacity for LBC sample processing As such it functions as a one of two hub laboratories
15. ntinel Site protocols www cmmc nhs uk directorates labmedicine departments cytology sentinel asp January 2010 16 Version 004 Manchester Cytology Centre Protocol For Cervical Screening and Management COARI Commence cervical smears after woman s 25 birthday need to screen women under the of 25 years Continue routine 3 yearly recall between the ages of 25 49 years inclusive Continue routine 5 yearly recall between the ages of 50 64 years inclusive Cease smears at 65 years only screen those who have not been since age 50 those who have had recent abnormal tests Additional unscheduled smears are NOT justified any of the following situations taking or starting to take an oral contraceptive On insertion of an IUCD taking or starting to take hormone replacement therapy In association with pregnancy neither antenatally nor postnatally nor after termination In women with genital warts In women with a vaginal discharge In women with cervical vaginal In women who have had multiple sexual partners In women who are heavy cigarette smokers One year after the first ever negative smear Women with symptoms of cervical cancer should be referred for gynaecological examination Postcoital bleeding in women over 40 years Intermenstrual bleeding Postmenopausal bleeding Persistent vaginal disch
16. omedical Scientist Hospital Based Programme Co ordinator Cervical Cytology Mrs Janet Marshall 0161 276 5103 Laboratory Manager Yvonne Hughes 0161 276 5119 Find or contact us at the Christie Hospital We are located in the Bereavement Suite at Christie Hospital and are available between the hours of 09 00 hrs to 12 30 hrs Monday to Friday except bank holidays One staff member is available for FNA services and answer queries relating to non gynaecological cytology only Pease note that no results can be issued from this site Telephone enquires 0161 446 3643 E mail cytology christie nhs uk Specimen acceptance policy All specimen containers must be clearly labelled with the patient s full name date of birth NHS or Hospital number and specimen type non gynaecological Each specimen must be accompanied by a completed and matching sample request form Please ensure all fields of request forms are completed See appendix 1 and 2 for cervical cytology and non gynaecological request forms respectively Alternatively we can supply bulk forms on request January 2010 4 Version 004 Section 1 Non gynaecological cytology fFEP W 2 2 2010 Version 004 e Non gynaecological cytology reports are printed and sent out daily addressed to the consultant or clinician who requested the test discuss the cytology report with the consultant cytopathologi
17. oratory After collection and labelling the sample and request form should be placed in separate sections of the plastic specimen bag provided before dispatch to the laboratory Vaginal vault samples Women who need vaginal vault cytology following surgery are no longer included in the NHS Cervical Screening Programme The recommendation from the North West Cervical Screening Quality Assurance Reference Centre March 2009 is that vault cytology should be performed with a colposcopic examination and therefore women requiring this should be referred to colposcopy Vulval samples These are not considered part of the NHS cervical screening programme If a sample has been collected using the Cervix Brush it is rinsed or placed into the LBC vial depending on the system being used Report generation and distribution Printed reports are sent to the surgery or clinic where the sample was collected Copy reports are sent to Call Recall agency at the Primary Care Trust PCT and the woman s GP when the GP practice is not the source of the sample Unidirectional links are in operation between the laboratory and the Manchester Salford amp Trafford Wigan and Bolton and Bury Screening Agencies to allow electronic transmission of the cytology report Other PCT s receive a daily spreadsheet containing the cytology results Urgent referrals for further investigation Any test reported as suspected invasive carcinoma or suspected glandular n
18. oscopy Moderate dyskaryosis Refer for colposcopy Severe dyskaryosis Refer for colposcopy Suspected invasive carcinoma Urgent colposcopy referral Suspected glandular neoplasia Urgent colposcopy or gynaecological referral depending on cell type 1st follow up smear is negative 1st follow up smear is borderline 1st follow up smear shows dyskaryosis 3 Yn b w Cone biopsy large loo 15 Negative taken at 6 months 2nd Negative Follow up after referral to colposcopy for mild dyskaryosis or less normal colposcopy amp no treatment Repeat in 12 months Follow up after treatment of CIN 1 Return to routine recall Refer back for colposcopy p excision LLETZ or local ablation Repeat in 6 months Repeat in 12 months Routine recall 34 Negative Cone biopsy large loo 1st Negative taken at 6 CDU 274 Negative 3 Negative 2 5 Cone biopsy 15 Negative taken at 6 months 218 Negative Subsequent negative smears Follow up after treatment of CIN 2 and CIN 3 Follow up after treatment of CGIN p excision LLETZ or local ablation Repeat in 6 months Repeat in 12 months Repeat in 12 months Repeat annually for a total of 10 years then routine recall arge loop excision LLETZ Repeat in 6 months Repeat in 6 months Repeat at 6 monthly intervals for 5 years then annually for 5 years
19. ple will be reported as inadequate OBTAIN an adequate sample from the cervix using a broom like device 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 ina CLOCKWISE direction FIVE TIMES RINSE the broom 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 Examine the broom for residual material and repeat if necessary DISCARD THE BROOM DO NOT LEAVE THE BROOM HEAD IN THE VIAL TIGHTEN the cap so that the torque line on the cap passes the torque line on the vial For further copies please contact the Manchester Cytology Centre on 0161 276 5111 www thinprep com 5 Janga ry 40 10 Ney 25 M 2 AR 21 47 Awarded for excellence Investor in People Version 004 Manchester Cytology Centre PREPARING A SUREPATH LBC SAMPLE IMPORTANT NOTICE If the broom head 15 not present in the vial the sample will be reported as inadequate COLLECT an adequate sample from the cervix using a broom like device 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 ina CLOCKWISE direction FIVE TIMES DETACH THE BROOM HEAD
20. processing LBC cervical samples on behalf of a number of spoke laboratories in the Greater Manchester region such as Stepping Hill Hospital in Stockport Tameside General Hospital and Macclesfield District General Hospital Both ThinPrep and SurePath cervical LBC samples are prepared and the resulting slides returned to the spoke laboratories for reporting LBC kits The laboratory uses a database to keep a record of the number of LBC kits used by each surgery and clinic to ensure that supplies are readily available For any enquiry regarding LBC kits please contact the laboratory on the general enquiries number 0161 276 5111 January 2010 14 Version 004 Completing the request form and labelling the sample vial Request form The request form should be completed in full with all information PRINTED legibly Relevant clinical information should be printed clearly on the form The NHS number should be used whenever possible as this is the unique patient identifier The sample taker is required to print their name in block capitals in order for the laboratory to assign the correct PIN code PIN codes are created by the laboratory office manager and recorded against each test The laboratory is required to record sample taker details and the PIN code allows periodic audit of this information Sample The label on the sample vial should record the forename surname and date of birth to allow matching of the vial with the request form in the lab
21. s should be determined by the gynaecological oncologist who carries out the procedure Women who have undergone radiotherapy for the treatment of cervical cancer Cervical or vaginal vault cytology should not be performed on women who have undergone radiotherapy as part of their treatment January 2010 19 Version 004 Guidelines for Management of Negative Vault Cytology All vault samples must be taken at colposcopy Total Hysterectomy entire cervix removed Yes Evidence of cervical disease on histology No Yes Less than 10 yrs At least 10 yrs CIN or CGIN on routine recall on routine recall Vault cytology Suggest at 6 months cancel recall then suggest cancel recall With radiotherapy Without radiotherapy CIN or CGIN completely excised cancel recall Yes No Suggest Vault cytology at 6 amp 12 months then annual cytology for 9 years If all negative routine recall Suggest cancel recall Incomplete unspecified uncertain 2 after 2 subsequent or unknown excision of negative cytology tests CIN or CGIN at 6 and at 18 months Follow up as though the cervix were still in situ i e low grade or high grade CIN follow up 1 North West Cervical Screening Quality Assurance Reference Centre Guidelines March 2009 January 2010 20 Version 004 Manchester Cytology Centre PREPARING A THINPREP LBC SAMPLE IMPORTANT NOTICE If the broom head 15 left in the vial the sam
22. st contact the department between 8 00am and 5 00pm on 0161 276 5115 5116 e Urgent specimens will be reported at least verbally within three 3 working days of receipt by the laboratory Please provide a contact number or bleep and name e This may only be a provisional report pending further ancillary tests e Itis recommended that the requesting clinician discuss such specimens with the cytopathologist between 8 00am and 5 00pm on 0161 276 5115 5116 In all cases the clinician should telephone the laboratory in advance and provide a contact name and phone or bleep number e Routine specimens will be reported within five 5 working days of receipt This may vary depending on the specimen type and if additional clinical information or ancillary tests are required e g immunocytochemistry January 2010 6 Version 004 Non gynaecological cytology sample collection Serous fluid samples Please see specimen acceptance policy on page 4 Body cavity fluids pleural ascitic peritoneal pericardial e The sample should be aspirated with a fine bore needle and a 50ml syringe e 50 100 fluid should be sent in a clean dry container with screw cap Note no Formalin or alcohol should be added to the sample as both of these can cause interference with adherence to slide and quality of staining e The fluid should be submitted as soon as possible to minimise cell deterioration so that cell preservation is not compromised If
23. t on request 0161 276 5115 e Prior to sampling decant an appropriate volume of CytoLyt transport medium into a labelled Cytol yt specimen container This volume should be adequate to cover the bristles of the brush e After sampling place brush promptly into specimen container Please ensure cap is screwed on tightly e CytoLyt transport medium must be stored in an flammable container DO NOT USE FORMALIN FIXATIVE Transbronchial FNA see FNA section January 2010 8 Version 004 Urinary tract samples Please see specimen acceptance policy on page 4 Urine including voided catheter urethral washings and ileal conduit samples Collect urine a clean dry container with a screw A 20 to 50 container is suitable An adequate urine sample is the second voided of the day preferably mid morning or random A first voided sample is unsuitable for cytology analysis Urine can be collected from catheters as well as washings from the bladder or upper urinary tract The request form must state the method of collection e If there is a delay in delivering the sample to the laboratory the urine sample should be kept in a fridge at 4 C Industrial Urine samples The preferred method for the collection of industrial urine samples 15 the same as above e Since a majority of the samples are collected at home it is recommended to put the sample into PreservCyt transport medium which should be provided by the req
24. there is a delay in delivering the sample to the laboratory the Sng should be kept in a fridge at 4 C Note the sample should NOT be frozen Cyst fluid e Cyst fluid should be put into a clean dry container with screw cap e The sample should be sent as soon as possible in order to minimise cell deterioration However if there is a delay the sample being delivered to the laboratory it should be kept in a fridge at 4 C Note the sample should NOT be frozen January 2010 7 Version 004 Respiratory tract samples Please see specimen acceptance policy on page 4 _____ _________ __________________ _ e Best results are achieved with freshly obtained sputa following chest physiotherapy with an early morning sputum before the patient has eaten e Contamination with large amounts of saliva or food leads to inadequate specimens e Multiple specimens usually x 3 may be necessary but these should be sent on 3 separate days not all taken at the same time e Send in clean dry container with screw e If examination for eosinophils is required please indicate this on the request form Bronchial lavage wash trap and bronchoalveolar lavage samples e Fresh specimen should be placed in clean dry container without fixative Delay in receipt can lead to deterioration of specimen Bronchial brush samples e Place brush into screw capped container with CytoLyt transport medium which is available from Cytology departmen
25. uesting clinician e This method prevents the degeneration of cells while the sample is being transported to the laboratory Cerebrospinal fluid CSF Please see specimen acceptance policy on page 4 e clean dry container with screw cap should be used CSF samples are liable to degenerate rapidly and as such must be prepared immediately Please contact the laboratory to inform staff of imminent arrival of a CSF sample e Latest processing time for samples is 15 30pm Mon Fri Please try to send samples at least half an hour before this time e If out of hours sampling is unavoidable storing the sample in refrigerator at 4 C may help preserve cells for up to 24 hours January 2010 9 Version 004 Fine needle aspiration cytology samples The staff in the laboratory will be pleased to advise on any aspect of sample collection please contact the department at e Manchester Cytology Centre between 8 00am and 5 00pm on 0161 276 5111 5115 5116 We may also be contacted by bleep number 0765 9503 113 Please note calls must be received by 3 45pm for FNA attendance e Christie hospital FNA clinics Monday to Friday 9 00am to 12 30pm It is recommended that the support of a BMS be utilised for optimal sample preparation Use of fine needle aspiration e Patients presenting with palpable lesions in clinics ENT maxillofacial outpatients and wards e Deep seated lesions sampled by guided techniques Ultra Sound CT e Endoscopic and
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