Cytopathology

The Cytopathology laboratory is located on the 1st Floor of SSRB. It receives samples between 9.00 a.m. and 5.30 p.m.

All specimens sent to the lab must be accompanied by a properly fi lled cytology requisition form. The identity of patient and the requestor, the relevant clinical details, site and type of sample and date of sample collection must be mentioned in the form.

The specimens should be properly labelled with identity of the patient clearly defined.

Various specimens received by the cytopathology lab are:

1. Cervical/vaginal/anal sample – liquid-based cytology and conventional cytology
2. HPV – DNA high-risk (with 16 and 18 genotyping) – on cervical sample/ anal sample
3. Body fl uids (pleural/pericardial/ascitic/peritoneal washings/CSF/ endometrial aspirate)
4. Respiratory – sputum, endotracheal aspirations, bronchial washings and bronchoalveolar lavage
5. Brushings – CBD and bronchial
6. Urine – voided, ureteric and barbotage, 3 consecutive days sample
7. Synovial fl uid – cytology, urate crystals
8. Slides from outside the hospital for review
9. Fine-needle aspiration (FNAC): in cytology lab for palpable masses
10. Ultrasound and CT-guided FNAC smears for non-palpable and deep masses
11. Endoscopic ultrasound-guided FNA/FNB (EUS-FNA, FNB)
12. Endobronchial ultrasound-guided FNA (EBUS-FNA)

Their collection procedure are given below:

• Cervical smears: almost all the cervical smears at SGRH are now processed by liquid-based cytology (LBC). The cervex brush and BD sure path vial is needed to take the sample. After taking the sample, put the detachable cervex brush head into the LBC preservative vial, cap the vial and send to the lab with the duly fi lled requisition form. The clinical details must include age, date of collection, symptoms, LMP date, signifi cant past history, P/V and P/S examination fi ndings. Label the specimen correctly. The vial can be kept at room temperature. For conventional preparation, put the cervical smear in a coplin jar containing ethanol which should cover the slide.
• High-risk HPV DNA test with HPV 16 and HPV 18 genotyping: Same sample in BD Surepath vial for cervical cytology (LBC) is used for the test.
• Body fl uids (pleural/ascitic/pericardial/peritoneal): To be sent to the lab fresh and without any fi xative in a clean container. A minimum of 25 ml is required for optimal cytological examination, larger volume is preferable. To prevent clot formation if sample is bloody, heparin (3 units per ml of fl uid) is to be added to the haemorrhagic fl uid by the person collecting it. Send to the lab with duly fi lled requisition form for processing avoiding delays.
• CSF: Specimen to be sent immediately to the lab without any delay and without any fi xative.
• Sputum: Patient should be instructed to collect morning specimen in a wide-mouthed bottle. Preferably he/she should be fasting and collect over a period of 2 hours. Patient should be given directions to cough deeply and to expectorate the sputum.
• Bronchial washings/bronchoalveolar lavage: Send the material without any fixative in a clean container to the lab.
• Brushings (CBD, bronchial): All smears to be immediately wet fi xed in 95% ethanol in coplin jars. The jars should be at least ¾ full.
• Urine:
  • Voided specimen: Ask the patient to empty his bladder and drink plenty of water or fluids over next 2 hours. At the end of 2 hours have the patient void urine in a clean container. Send it to lab immediately. Repeat it for 3 successive days
  • Catheterized specimen: Send to lab immediately.
• Slides for review (from outside the hospital): Slides must not be broken and should have unique identifying number or name of the patient. It must be accompanied by photocopy of original pathology report.
• FNA
  • Palpable lumps: FNA of palpable lumps is carried out by cytopathologists in the cytology lab FNA room (patient to come to 1st Floor SSRB, pathology reception). Patient can be sent to the lab between 9.00 a.m.–4.30 p.m. with fi lled requisition form stating clearly the site to be aspirated. No prior appointment is needed and the patient can walk in.
  • Guided FNA: FNA is done by radiologists/clinicians (USG/CT/ EUS/EBUS-guided). Half of the slides should be air dried and half immediately wet fi xed in 95% ethanol in a coplin jar. Cell block to be put in formalin container. Sample for LBC to be taken in tube with LBC fi xative (4 ml). Send to lab with proper identifi cation and duly fi lled request form with relevant details and clinical history. The EUS and EBUS FNA requisition form must have the EUS and EBUS report attached.
• Reporting of results:
  • Turnaround time is 24 hours from receiving the sample at the pathology reception. If special stains or IHC is required to be done the reporting may take 48–72 hours.
  • For cervical smears it is 48 hours and for HPV DNA test it is 10 days
  • The reports are available at the pathology reception after reporting, extension no: 2130.

Address: SSRB 1st Floor, Ext: 2130