Cytology Bronchoscopic Specimens

Submit specimen with a Pathology requisition.
Label specimen container with patient's complete first and last name, date of birth, date and time of collection, and specimen source.

AP004

•Send the specimen to the Laboratory in an appropriate closed, labeled container with the appropriate fixative for the tests requested. If you are unsure of the proper fixative, contact the Histology laboratory at extension 3405 for clarification. • Specimen source If submitting multiple specimens, the label must match the requisition as A, B, C, D, etc. Label specimen container with patient's complete first and last name, date of birth, date and time of collection, and specimen source. Optimally, the specimens should be submitted to the laboratory unfixed or placed in Cytolyt fixative. After collection, the material must be sent to the laboratory as soon as possible. Cellular autolysis begins immediately after the sample is collected (e.g., urine or bloody serous effusion). Collection of each type of specimen is presented here for correct procedure. Diagnostic cytology is based on three basic sampling techniques: (1) collection of exfoliated cells, (2) collection of cells removed by brushing or similar abrasive techniques, and (3) aspiration biopsy or removal of cells from non-surface bearing tissues by means of a needle, with or without a syringe. If there is an unavoidable delay encountered in the delivery of the specimens (e.g., weekend, etc.), specimens must be refrigerated or preserved with Cytolyt fixative. Specimens can be refrigerated for a week or more and still be satisfactory. DO  NOT freeze the specimens. Freezing will fracture cells.

1.Cytologic examination of Bronchoscopy specimens DO NOT replace a histologic study of a biopsy. 2. Specimens may be obtained during bronchoscopy by aspiration of secretions, direct smears of suspicious areas, bronchial washing, and bronchoalveolar lavage. The findings at bronchoscopy are usually not predictable. The operator must be prepared to obtain material by means most appropriate at the time of examination to obtain adequate material. 3. Technique: The surface of suspicious areas is 1) aspirated; 2) swabbed; and then, 3) biopsied. If secretions are insufficient, or a lesion is not visualized, lavage bronchus in question. Sometimes, rinsing the biopsy forceps in the normal saline solution, which has been used for the bronchial lavage, provides additional material for examination. For full diagnostic value, all material should be identified as to the site of origin. 1. Aspirations a. Aspirate secretions as encountered. b. Label containers with patient's name and site of origin (e.g., left bronchus, etc.) c. Set aside until completion of procedure. 2. Wang Needle Aspirations a. Aspirate fluid in a clean container with CytoLyt fixative. b. Label container with patient's name and site of origin. c. Set aside until completion of procedure. 2. Direct smears a. Swab the surface of suspicious area completely. b. Withdraw the swab; quickly roll it on a clean, labeled glass slide, which is held over an open bottle of 95% ethyl alcohol fixative. Immediately drop the slide into the fixative. Note: Immediate fixation is essential to avoid drying which occurs rapidly after the material is spread onto the slide. c. Do likewise in other suspicious areas using a fresh swab and another clean labeled glass slide. d. Label slides with patient's name and site of origin. e. Set aside until completion of procedure. 3. Bronchial Washing and Bronchoalveolar Lavage a. Turn patient so that bronchus in question is on dependent side. b. Fill the bronchus to the carina with normal saline solution. c. Allow the saline solution to stay in contact with bronchus as long as possible. d. Aspirate the washings and label container with fixative name and label as to site of origin. e. Set aside until completion of procedure 4. Bronchial Washing and Bronchoalveolar Lavage a. Turn patient so that bronchus in question is on dependent side. b. Fill the bronchus to the carina with normal saline solution. c. Allow the saline solution to stay in contact with bronchus as long as possible. d. Aspirate the washings and label container with fixative name and label as to site of origin. e. Set aside until completion of procedure. 5. Post-Bronchoscopy Technique a. Before bronchoscope is withdrawn, give patient a clean sputum container with Cytolyt fixative. Refer to Sputum collection. 6. After Procedure is completed Immediately upon completion of procedure, bring the properly labeled specimen and smears with patient's name and site of origin along with completed cytology requisition form to the laboratory.