Test Code Non-Gynecologic Request Form Cytology, Cerebrospinal Fluid
Methodology
Includes routine cytologic evaluation on microscopic slides.
Performing Laboratory
Peninsula Regional Medical Center - Pathology
Specimen Requirements
Submit fresh, unfixed, cerebrospinal fluid as follows:
Collect cerebrospinal fluid.
1. Attach a patient identification label to specimen container.
2. Deliver to Histology Department immediately, preferably within 1 hour of collection. If there is delay in transport of >1 hour, send specimen refrigerated.
3. Specimen rejection criteria is based on improper specimen labeling, collection, handling, or submission:
A. Frozen specimen
B. Specimen that is contaminated on outside of collection container
C. Specimen that has leaked into plastic biohazard bag
D. No non-gynecologic cytology requisition form
E. Name on requisition does not match name on specimen container
F. Unlabeled specimen container. Two patient identifiers are required on specimen container.
G. No physician’s name
H. If rejection compromises patient care (one-time specimen such as cerebrospinal fluid or STAT request) laboratory personnel will contact a pathologist to determine if specimen will be tested.
4. Label specimen container with patient’s full first and last name, date of birth, date of collection, specimen source, and submitting physician’s name.
5. Complete a non-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. Pertinent clinical information
6. Place specimen in a plastic biohazard bag and insert non-gynecologic cytology requisition form into separate paper pouch.