Geisinger Medical Laboratories Cytopathology Specimen Collection Instructions
Gastrointestinal Specimens
The adequacy of a gastrointestinal specimen is determined primarily by the presence of well-preserved epithelial cells indicative of the type of epithelium present at the gastrointestinal site sampled. All GI specimens will tend to deteriorate rapidly due to enzymatic activity which is present throughout much of the GI tract. In addition, these specimens are easily contaminated by epithelia from sites proximal to that being sampled.
General Information for all Gastrointestinal Specimens
As all GI specimens will rapidly deteriorate in the fresh state, collection of the specimen in Saccomanno fixative is requested. The specimen should be refrigerated or placed on wet ice until transport even if for a shorter period of time.
Brushings (Esophageal, GE Junction, Gastric, Duodenal, Bile Duct, Other)
| Indications: | For detection and characterization of endoscopically visible gastrointestinal lesions; for the identification of some microbiologic pathogens (primarily Herpes, CMV, and Candida). |
| Specimen Required: | Endoscopically-directed brushing sample of the identified lesion. |
| Supplies: | Standard endoscopy equipment (Coplin jar with either Saccomanno fixative or 95% ethyl alcohol), slide. |
| Collection Procedure: | Instruct the patient to fast overnight or for a minimum of six hours prior to the procedure. Using standard endoscopy technique, identify the lesion in question and obtain a brushing sample of the lesion. |
| NOTE: | It is important to brush the edges of an ulcer, as well as the floor, in order to obtain diagnostic material. |
| Upon withdrawing the brush, roll across a glass slide (label side up), depositing as much specimen as possible on the slide. Spray fix with Cytology fixative or drop immediately into Coplin jar containing enough 95% ethyl alcohol to cover specimen and slides. Slide(s) must be labeled in pencil with patient name. Submit slides in slide mailer (if spray fixed) or in Coplin jar with completed Cytology requisition to the Cytology Lab. |
Washings (Esophageal, Gastric, Other)
| Indications: | For detection and characterization of endoscopically ill-defined or invisible gastrointestinal lesion; for the identification of some microbiologic pathogens (primarily Herpes, CMV, and Candida). |
| Specimen Required: | Endoscopically obtained washing (preferably at least 10 mL) of the region of the suspected lesion. |
| Supplies: | Standard endoscopy equipment. Clean plastic specimen container(s). Fixative (Saccomanno fixative). |
| Collection Procedure: | Instruct the patient to fast overnight or for a minimum of six hours prior to the procedure. Using standard endoscopy technique, lavage the area of interest using a physiologic solution. Aspirate the solution and place in a clean specimen container. Label the container with the correct patient information and submit the specimen and the completed cytology request form to the Cytopathology Lab. If transport of the specimen will be delayed more than 4 hours, add 50 mL of Saccomanno fixative or 50% ethyl alcohol. If transport time will be less than 4 hours, or fixative is not available, the specimen should be refrigerated or kept on wet ice until transport to the lab. Reviewed/revised: 1/20/2011 |
