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Cytology

Laboratory Location: UHND

Cytology is located within the Pathology department, located on the Lower Ground floor, between lifts and stairs C and D.
Stairway and lift C are nearest access to both Sample Reception * and Visitors Entrance** on plan.

Laboratory opening hours - 9.00am - 17:30 Monday to Friday.

NON GYNAECOLOGICAL CYTOLOGY

Investigations for malignant cells

Fresh specimens should be sent to the laboratory as soon as possible to minimise deterioration of the cell content as interpretation may be adversely affected if there is significant delay. Specimens which are fixed prior to receipt by the laboratory (i.e. bronchial brushes) are not however critically affected by delays. Advice is always available from the laboratory - Extension (3)2456.

Turnaround time

We aim to provide 80% of results within 48 hours of specimen receipt in the laboratory unless a second opinion and / or ancillary tests are required. Urgent specimens will take an absolute minimum of 2 hours to be reported if fresh upon receipt. (Some fine needle aspirates and specimens received fixed may be available for reporting sooner.)

You will need to carefully discriminate between routine and genuinely urgent cases. The latter disrupt normal laboratory practice with significant knock-on effects for other specimens. For urgent requests submit an extension/bleep number for reply.

GYNAECOLOGICAL/CERVICAL CYTOLOGY

Turnaround time for cervical cytology has a mandatory NHS target of 98% within 14 days from the date the specimen is taken to the patient receiving the result from the screening office.

Sampling procedure:

  • Insert the central bristles of the brush into the endocervical canal so that the shorter outer bristles fully contact the ectocervix.
  • Using pencil pressure, rotate the brush FIVE TIMES in a clockwise direction.
  • In order to ensure good contact with the ectocervix the plastic fronds are bevelled for clockwise rotation only.
  • A high cellular yield will be achieved with correct use of the brush.
  • Simply remove the head of the brush from the stem by light pressure which will detach into the vial of fixative*. Leave the head in the vial.
  • Screw on lid and label the vial**.
  • Fill out Cellular Pathology form with patients details.

It is essential that the sample is placed in the vial at once in order to achieve immediate fixation. Do this before you remove the speculum.

* NB Check vial expiry date before use.

** The department operates a zero tolerance policy on unlabelled vials, these will be discarded and surgeries notified.

 

 

 

REFERRAL CENTRES

Occasionally, a second or expert opinion is required. The following list gives the names and addresses to whom such samples are referred.

Breast

Dr Josie Shrimankar, Consultant Histopathologist, North Tees University Hospital, Hardwick, Stockton on Tees, TS19 8PE

Gastro-Intestinal

Dr Mark Bennett, Consultant Histopathologist, Department of Pathology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP

Gynaecological

Dr Paul Cross, Consultant Histopathologist, Queen Elizabeth Hospital, Sheriff Hill, Gateshead

Heart & Lung

Dr Mary Sheppard, Consultant Histopathologist, Department of Pathology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP

Hercep Testing

Dr J D Hemming, Consultant Histopathologist, Queen Elizabeth Hospital, Sheriff Hill, Gateshead, NE9 6SX

Liver

Professor A Burt, Consultant Histopathologist, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, 
NE1 4LP

Lymphoma

Dr B Wilkins/Dr K Wood, Lymphoma Team, Department of Pathology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP

 

 

 

 

 

 

CYTOLOGY SPECIMEN REQUIREMENTS

CYTOLOGY FOR MALIGNANT CELLS

This information is also available in the general test directory.

(a) Sputum

Specimen: Fresh early morning deep cough sputum is required, i.e. first sputum production of day, before the patient has eaten or cleaned teeth, to reach laboratory within two hours. Recommended a series of three early morning specimens on consecutive days.

(b) Serous Effusions

No anticoagulant or fixative.

Specimen: Fresh. Large volumes of fluid should be physically mixed and a representative universal container of fluid sent. Any clots present should be sent in the fluid as these often contain large numbers of cells. Specimen to reach the laboratory within two hours. (If necessary may be kept overnight in the fridge but sub-optimal results may be obtained.)

(c) Urine

NOT Boric Acid universal.

Specimen: Fresh. Specimen must not be first urine of the day. A whole specimen of urine should be collected after the patient has walked around (if mobile) for a little while. Specimen must reach laboratory as soon as possible as urine is hostile to the cells and degeneration is very rapid. They must be in a white top universal (20ml).

(d) Fine Needle Aspirates (All sites)

Specimen: Contents of aspiration needle should be blown with syringe onto an appropriate number of slides, spread quickly (as blood film) to produce monolayer and AIR DRIED AS RAPIDLY AS POSSIBLE which usually means wafting the slides in the air. Slides should then be sent in dry slide container to the laboratory as soon as feasible. If fluid is aspirated this should be sent to the laboratory in a sterile universal container as soon as possible. The discarded needle can be placed in the Cytolyt for a needle rinse preparation. Technical advice is available - Extension (3)2456.

(e) Bronchial Brush Specimens

Specimen: The brush should be immediately cut and dropped into a container of Cytolyt - supplies of Cytolyt should be available on all endoscopy sites.

(f) Bronchial Lavage/Trap Specimens

Specimen: Fresh. Lavage and trap specimens should be collected and sent to laboratory within two hours.

 

 

 

 

 

 

PATHOLOGY REQUEST FORMS AND SPECIMENS - 2

Minimum Requirements

Samples should be sent to the laboratory fully labelled in a safe manner. 
Samples should be in a separate transport bag with the completed request form attached.
Samples can only be accepted for routine processing if there is no leakage, correct labelling, accompanying request form, no indication of high risk and appropriate container used.  Rejection of samples will depend on: -

  • Ability to obtain a repeat sample e.g. histology samples
  • The health risk to staff
  • Ability to correctly identify the patient

To ensure samples and form can be uniquely linked to a patient and historical data minimum labelling for the form and sample is: -

MINIMUM IDENTIFICATION FOR THE FORM:

Routine samples

  •  Full name or other unique coded identifier
  • Date of birth
  • Hospital Number or NHS Number
  • Address for GP samples
  • Source of request
  • Consultant / Requesters code for OPD or Clinic requests
  • Date and time of collection

For confidential samples

  • Unique coded identifier
  • Source of request
  • Date and time of collection

Additional information expected. Requester's code and signature.
Hospital number mandatory for transfusion related requests

 

 

'The treatment I have received from all the staff has been excellent and could you extend my thanks to them all. A very thankful and relieved patient'.

Patient, Dermatology Outpatients Department, University Hospital of North Durham