Re: Cytology specimens, transport fuid

From:=?iso-8859-1?q?Steve=20Machin=20UK?= <>

From Steve Machin UK

I have worked in a few labs and we never received cytology specimens, except
cervical smears, in fixative.  It is not possible to produced a good quality
Giemsa stain unless the smears are air dried rapidly before fixation. 
Pathologists expert in cytology are likely to prefer air dried smears and
Giemsa stains.  Personally I think air dried nuclei look ruined but they say
that once you become experienced in looking at this type of smear it is much
easier to identify nuclear changes.
A second point is that to streamline procedures it is simpler to perform
immunocytochemistry using the same method on all types of specimens.  Since
most of the lab work I do is on histology specimens, I prefer to use the same
immuno methods for cytology specimens too.  So what I do with cytology
specimens is, after making smears, make a clot of the leftover specimen.  This
is done by mixing the sediment with a small amount of plasma and thrombin to
form a clot.  Then I fix the clot in formalin and process to paraffin wax.  If
any immuno is needed on the specimen I do it on the clot.
The commercial cytology transport fluid I have come across contains a
preservative or fixative which makes the nuclei look as if they have been wet
fixed and so a good air dried Giemsa can not be made.  This transport fluid
also prevents the plasma and thrombin from forming a clot.
What I use as a transport fluid is phosphate buffers saline in 10% ethanol. 
There isn't enough ethanol to fix the nuclei but it helps to stop the cells
from deteriorating.  This fluid can be stored in the fridge and lasts at least
a month.
Another point relates to glass containers; they can break if dropped.
As for the size of the specimen needed, let the doctors know roughly how many
cells are on the smear examined to give them an idea of how little extra is to
be gained by examining more fluid.  When I as "roughly" I mean both approximate
number and to convey this in a robust manner.

--- THERESA ROHR <> wrote: > Hi,
> Can anyone give me some help with cytology specimens?  We have a  procedure 
> that says we do not accept large glass containers of body fluids in 
> Cytology. Is that procedure from a specific source, CAP etc. We ask that all 
> specimens should be submitted in an equal amount of fixative. We usually 
> advise the doctors who call to shake up the pint/quart container and just 
> pour a sample, 50 cc's in a container of 50 cc's of Saccomanno fixative. 
> Some of these physicians complain that we are not testing enough of the 
> fluid and might be missing something. I guess they never took Cytology 101 
> if they really think we are testing every ounce of that size specimen. Do 
> they think we cut slides on every inch of a surgical specimen? Anyhow, is 
> there anything in writing from CAP or NYS that I might be missing that would 
> help me when I get these calls? Or do any of you handle this differently? I 
> have assumed procedures left here by a Cytotechnologist before me.
> Thanks,
> Theresa Rohr, BA HT(ASCP)
> Nyack Hospital
> New York
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