Specimen Requirements

Patient With Cervix

1. Write patient’s full first and last name, date of birth, date of collection, and specimen source on frosted-end of a microscopic slide using a lead pencil.

2. Obtain an adequate sampling of endocervix and cervix using a broom-type collection device or a combination endocervical brush/spatula. If using an endocervical brush, obtain an adequate sampling from endocervix using endocervical brush. Insert brush into cervix until only bottommost fibers are exposed. Slowly rotate 1/4 to 1/2 turn in 1 direction.

3. Roll brush down slide using minimal pressure. Use spatula to scrape cervix, and add this specimen to slide. Using spatula, thinly spread specimen over lower 2/3 of slide.

4. Spray-fix specimen within 2 to 3 seconds.

5. Complete a gynecologic cytology requisition form. Include the following information:

A. Patient’s full first and last name

B. Date of birth

C. Medical record or Social Security number

D. Date of collection

E. Submitting physician’s name. Include names of physicians to receive cytology report copies.

F. Specimen source

G. Date of last menstrual period

H. Hormonal status

I. Exogenous hormone therapy

J. Presence of IUD

K. DES exposure

L. History of cervical abnormality, cervical malignancy or extragenital malignancy

M. History of chemotherapy

N. History of radiation therapy

O. History of gynecologic surgery, cryosurgery, electrocautery or laser surgery

P. Current abnormal findings or patient complaints

Q. High-risk factors for cervical cancer

6. Place slide into a cardboard mailer in a plastic biohazard bag and insert gynecologic cytology requisition form into separate paper pouch.

7. Deliver to Histology Department.

8. Specimen rejection criteria is based on improper specimen labeling, collection, handling, or submission:

A. No gynecologic cytology requisition form

B. Name on requisition does not match name on slide

C. Unlabeled specimen container or slide. Two patient identifiers are required on specimen container or written on frosted-end of microscope slide

D. Broken slide that cannot be reconstructed

E. Slide not spray-fixed

F. Slide stuck to cardboard mailer

G. No physician’s name

 

Patient Without Cervix or Hormonal Index

1. Write patient’s full first and last name, date of birth, date of collection, and specimen source on frosted-end of a microscopic slide using a lead pencil. Write M.I. on frosted-end of slide.

2. Obtain an adequate sampling of vagina using a wooden spatula. If collecting a specimen for hormonal evaluation, only scrape lateral vaginal wall.

3. Spread sample thinly over lower 2/3 of slide.

4. Spray-fix specimen within 2 to 3 seconds.

5. Complete a gynecologic cytology requisition form. Include the following information:

A. Patient’s full first and last name

B. Date of birth

C. Medical record or Social Security number

D. Date of collection

E. Submitting physician’s name. Include names of physicians to receive cytology report copies

F. Specimen source

G. Date of last menstrual period

H. Hormonal status

I. Exogenous hormone therapy

J. Presence of IUD

K. DES exposure

L. History of cervical abnormality, cervical malignancy or extragenital malignancy

M. History of chemotherapy

N. History of radiation therapy

O. History of gynecologic surgery, cryosurgery, electrocautery or laser surgery

P. Current abnormal findings or patient complaints

Q. High-risk factors for cervical cancer

6. Place slide into a cardboard mailer in a plastic biohazard bag and insert gynecologic cytology requisition form into separate paper pouch.

7. Deliver to Histology Department.

8. Specimen rejection criteria is based on improper specimen labeling, collection, handling, or submission:

A. No gynecologic cytology requisition form

B. Name on requisition does not match name on slide

C. Unlabeled specimen container or slide. Two patient identifiers are required on specimen container or written on frosted-end of microscope slide

D. Broken slide that cannot be reconstructed

E. Slide not spray-fixed

F. Slide stuck to cardboard mailer

G. No physician’s name