Diagnostic Cytology

Name Of Test	Specimen/Container Requirements:	Further Information:
Respiratory: Sputum Bronchial Aspirates, Washings, Lavages, Brushings	Do not fix sample in formalin, please use saline. Please use a 30 ml white topped universal container or trap without the tubing See below for specimens requiring a differential cell count. Please send the specimen immediately. If this is not possible, the specimen(s) can be refrigerated overnight but must be delivered at the earliest opportunity the next day.	Samples to be placed in a purple specimen bag.   Brushings should be sent in preservcyt vial available from the laboratory: Cytology Department, Level 3, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9569).
Bronchial Differential Cell Counts	Specimens requiring a differential cell count must be clearly described/marked on the request form. Please use a 30 ml white topped universal container or trap without the tubing. Specimens for bronchial differential cell counts must be lavages in saline (the test requires mucoid material). Please send the specimen immediately. If this is not possible, the specimen(s) can be refrigerated overnight but must be delivered at the earliest opportunity the next day.	Differential cell counts cannot be performed on patients who are positive for COVID-19   Samples to be placed in a purple specimen bag.
Pancreatic Brushings	Do not fix sample in formalin, please use Preservcyt solution. Please send the specimen immediately. If this is not possible, the specimen(s) can be refrigerated overnight but must be delivered at the earliest opportunity the next day.	Preservcyt solution is available with advance notice from: Cytology Department, Level 3, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9569). Samples to be placed in a purple specimen bag.
Fine Needle Aspirate (FNA): Head & Neck, Breast, Lymph Node etc.	FNA specimens should be sent on 4 glass slides: 2 slides air dried and 2 slides treated with Cytofixx solution. Please send us 2 alcohol fixed and 2 air dried slides. More information can be found in the document: Fine Needle Aspirate Labelling Guide for Cytology Users FNA specimens do not need to be refrigerated Please contact Dr Van Der Horst (01413549553) if FNA demonstration s required (Head & Neck) For FNA of Breast, please send 2 air dried slides	Cytofixx solution is available with advance notice from: Cytology Department, Level 3, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9569). Samples to be placed in a purple specimen bag.
Endobronchial Ultrasound Guided Transbronchial Needle Aspirate (EBUS-TBNA) Endoscopic Ultrasound Guided Fine Needle Aspirate (EUS FNA): Pancreas, Liver	Do not fix sample in formalin, please use Preservcyt vials.	Preservcyt vials are available with advance notice from: Cytology Department, Level 3, Laboratory Medicine and Facilities Management Building, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF (0141 354 9569). Samples to be placed in a purple specimen bag.
Joint (Synovial) Fluid Analysis Gout Crystal Analysis	Do not fix sample in formalin, please send fresh and with no additives. Please use a 30 ml white topped universal container Please do not add EDTA	This test has been fully validated within the cytology department but is not UKAS accredited. Samples to be placed in a purple specimen bag.
Serous Effusions	Do not fix sample in formalin, please send fresh and with no additives. The volume of sample sent should be a minimum of 75ml if possible, but preferably no more than 150ml. Unless the sample is a peritoneal washing, for these a larger volume is required, we recommend at least 300 ml. Please send the specimen immediately. If this is not possible, the specimen(s) can be refrigerated overnight but must be delivered at the earliest opportunity the next day.	Samples to be placed in a purple specimen bag.
Urine Samples	Do not fix sample in formalin, please send fresh and with no additives. Do not send a urine sample taken early in the morning or shortly after waking (midstream, not first in the morning). The volume of sample sent should preferably be 50ml Please send the specimen immediately. If this is not possible, the specimen(s) can be refrigerated overnight but must be delivered at the earliest opportunity the next day.	Samples to be placed in a purple specimen bag.
Cerebrospinal Fluid (CSF)	Do not fix sample in formalin, please send fresh and with no additives. A volume of at least 2ml is required. Please send the specimen immediately.	Samples to be placed in a purple specimen bag.
Flow Cytometry	Do not send to Cytology Department. Send to Haemato-Oncology, Gartnavel. Samples need to be analysed by the lab within 72 hours of sample collection-This is especially important for patients with a clinical history including Lymphoma	Samples to be placed in a purple specimen bag. Samples should be sent directly to Flow Cytometry laboratory by porter/courier: Haemato-Oncology, Gartnavel General Hospital, Paul O’Gorman Building, 21 Shelley Road, Glasgow, G12 0XB (0141 3017729)

Specimen types routinely processed by the Diagnostic Cytology Laboratory include:

Serous Fluids Cytology

Ascitic fluid, pericardial fluid, peritoneal washings and pleural fluid.

Respiratory Cytology

Bronchial aspirates, bronchial lavages, bronchial brushings and sputa.

Brushings Specimens

Pancreatic biliary, ureteric and common bile duct.

Fine Needle Aspiration (FNA) Cytology

Superficial FNA’s taken from thyroid, breast, lymph node, supraclavicular and submandibular. Endoscopic FNA’s including TBNAs (Transbronchial needle aspirations) from lymph nodes or masses, FNA from pancreas, stomach or oesophagus and fine needle biopsy (FNB) from pancreas/nodes.

Cerebrospinal Fluid (CSF)

CSF and other neuropathology fluids are processed by cytology and reported by the Neuropathology Consultants.

Synovial Fluids (NB: This test is not UKAS accredited)

Synovial fluids are examined for the presence of monosodium urate and calcium pyrophosphate crystals in cytology. Synovial fluids are also examined for microscopic assessment if septic arthritis, inflammation or infection is queried. Any Synovial fluid specimens where septic arthritis is suspected must have a separate additional specimen and request form being sent to Microbiology. Bursa fluid and ganglion fluid may be examined for the presence of crystals and microscopic cell evaluation.

Other Fluids

Cyst Fluids (e.g. ovarian cyst, parotid and Thyroid)

Urine

Urine, ureteric washings and renal pelvic washings. Cytology can test for the presence of casts in urine.

Certain specimens for Diagnostic Cytology can be transported by the previously listed normal specimen transport methods as well as the internal pneumatic tube system

Specimens from the Queen Elizabeth University Hospital may be sent via the internal pneumatic tube system. Only the following specimens may be sent via the internal pneumatic tube system: Fluids, FNAs which are fluids (Not slides), respiratory specimens and CSFs. Please do not send specimens with a danger of infection via the pneumatic tube system. Please ensure all specimens are sent in leak-proof containers (white lidded, screw top universal tubes are ideal).

The Diagnostic Cytology laboratory should be contacted on 89569 before a specimen is sent through the pneumatic tube system.  The pneumatic tube extension for cytology is 1616

The Diagnostic Cytology laboratory follows the same specimen acceptance criteria as the pathology department.

Specimens that are Mislabelled/Erroneous/Have Insufficient Information

In the event that a specimen received in diagnostic cytology where the specimen and/or the request form has been mislabelled or erroneous, the team leader or appropriate biomedical scientist will make every attempt to contact the sender and clarify what has happened.

This may be by email or by telephoning the clinician given on the request form.

If the event that there is insufficient information to contact the source regarding a specimen e.g. specimen sent with no request form. The specimen will be kept for 1 week, in the hope that the laboratory will be contacted. If no contact has been made at the end of this period, the specimen will be discarded.

A cytology trakcare request form should be sent for cytology tests not a histopathology trakcare request form. The cytology department does issue reports via trakcare.

Specimens taken specifically for the diagnosis of infectious diseases should NOT be sent to Cytology, but instead be sent directly to microbiology/virology as appropriate.

Specimens which are highly suspicious of, or from known Group 3 infectious diseases must be labelled as D.O.I

Examples of Group 3 Infectious Diseases

Coronavirus (COVID-19), Human Immunodeficiency Virus (HIV), Hepatitis C&D, Mycobacterium tuberculosis, and Creutzfeldt Jakob Disease (CJD)

CSF Cytology Specimens which are highly suspicious of CJD or known CJD should be labelled as D.O.I. A specimen should be sent directly to the Edinburgh CJD unit if there is a clinical suspicion of CJD.

Group 4 Infectious Diseases

Should not be sent to Cytology for processing. E.g. Viral haemorrhagic fever.

Specimens which pose a risk from infectious diseases must:

• Be placed in a D.O.I specimen bag (ONLY send D.O.I specimens in these bags)
• Have a D.O.I label on the Specimen Container
• Indicate there is a Danger of Infection by ticking the box on the request form
• Describe the nature of the risk (known or highly suspicious of) on the request form

Urgent specimens must be clearly labelled as urgent on the specimen request form.

The request form must also have the contact information of the clinician who requires the urgent result e.g.  telephone number or page of the clinician. If a specimen is required urgently for a Multi-disciplinary Meetings (MDT), please put this on the specimen request form and the date of the MDT.

https://www.nhsggc.scot/download/fna-labelling-guide