Cytopathology, Pulmonary

2

The adequacy of a sputum specimen is determined primarily by the presence of alveolar macrophages indicating that the specimen obtained is a “deep-cough” specimen producing material from the lower airways. In addition, the specimen should not be obscured by oral or upper airway contaminants. Adequate bronchial brushing and washing specimens should contain large numbers of well-preserved bronchial lining cells with as little contaminating oral and upper airway material as possible.

 

Specimen Type: Bronchial brushing

Container/Tube: Container with 5-10 mL of sterile saline or Saccomanno fixative

Collection Instructions:

1. Obtain specimen using standard bronchoscopy technique, identify lesion in question, and obtain a brushing sample of lesion.
2. Remove brush.

3. Agitate brush vigorously in container with sterile saline or Saccomanno fixative.

4. Do not make smears. If possible, detach brush and leave in container.

5. Label container with at least 2 sources of patient identification (eg, bar code, patient name, date of birth, or other unique identifier), date of collection, and type and site of specimen.

6. Refrigerate specimen after collection, and send specimen refrigerated.

 

Specimen Type: Bronchial lavage/washing

Container/Tube: Clean container with no preservative

Specimen Volume: 10 mL

Collection Instructions:

1. Obtain fresh lavage/washing from region of suspected lesion.

2. Label container with at least 2 sources of patient identification (eg, bar code, patient name, date of birth, or other unique identifier), date of collection, and type and site of specimen.

3. Refrigerate specimen after collection, and send specimen refrigerated.

 

Specimen Type: Sputum; single, first-morning, deep-cough specimen

Container/Tube: Clean container

Specimen Volume: A minimum of 5 mL

Collection Instructions:

1. Optimum time for specimen collection is within 15 to 30 minutes after waking and before eating breakfast.

2. Have patient remove dentures, if applicable.

3. Instruct patient to brush his/her teeth and/or rinse mouth well with water.

4. Instruct patient to take a deep breath, hold it momentarily, and cough deeply and vigorously into container.

5. Repeat until patient coughs and is able to produce adequate sputum specimen. Nasal secretions, saliva, or 24-hour collection is not acceptable.

Note: A post-bronchoscopy sputum is acceptable by collecting a good, deep-cough specimen at any time during 24-hour period following bronchoscopy, as outlined above.

6. Label container with at least 2 sources of patient identification (eg, bar code, patient name, date of birth, or other unique identifier), date of collection, and type and site of specimen.

7. Refrigerate specimen after collection, and send specimen refrigerated.

 

Specimen Type: Sputum (serial collection); single, first-morning, deep-cough specimen

Container/Tube: Clean container

Specimen Volume: A minimum of 5 mL

Collection Instructions:

1. Obtain 1 sputum specimen, as outline above, on 3 consecutive days. Forward specimen to SaraPath Diagnostics each day. Do not retain all specimens until day 3 of collection.

2. Label container with at least 2 sources of patient identification (eg, bar code, patient name, date of birth, or other unique identifier), date of collection, type and site of specimen, and in order of collection #1, #2, #3.

3. Refrigerate specimen after collection, and send specimen refrigerated.

 

Note:

1. Complete a SaraPath Diagnostics requisition, include all relevant clinical information, and submit with specimen.

2. Verify patient name and other unique identifiers on requisition match those on specimen.

3. Specimen may be rejected and returned to originating site if any of the following conditions apply:

a. Patient or specimen identification errors or omissions

b. Incorrect specimen submitted for test requested

c. Damaged or leaking specimen

d. Sputum specimen submitted in preservative

4. Call SaraPath Diagnostics for:

a. Technical assistance - Monday through Friday, 8 a.m. to 5 p.m. at 941-362-8900

b. Courier service or supplies - Monday through Friday, 8 a.m. to 4 p.m. at 941-362-8932 or 941-362-8900

Note: STAT Specimen - Call for pick-up of STAT specimen and indicate STAT on requisition.

Weekdays