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Liquid Based ThinPrep™ Pap Test
Non-GYN Cytology Specimen Collection
Histology Specimen Collection



Complete patient requisition and be sure to include patient's name, date of birth, Social Security number, last menstrual period (LMP), postmenopausal patient (PMP), surgical biopsies, abnormal vaginal bleeding, previous malignancy, drug therapy, and all other pertinent clinical information.

Collection: Endocervical Brush/Spatula Protocol

  1. Obtain an adequate sample from the ectocervix using a plastic spatula.
  2. Rinse the spatula as quickly as possible in the ThinPrep™ vial by swirling vigorously 10 times, and discard the spatula.
  3. Obtain an adequate sampling from the endocervix using an endocervical brush device. Insert the brush into the cervix until only the bottom-most fibers are exposed. Slowly rotate the brush 1/4 to 1/2 turn in one direction. DO NOT OVER-ROTATE THE BRUSH.
  4. Rinse the brush as quickly as possible in the ThinPrep™ vial by rotating the device in the solution 10 times while pushing against the wall of the ThinPrep™ vial. Swirl the brush vigorously to further release additional material. Discard the brush.
  5. Tighten the cap on the ThinPrep™ container so that the torque line on the cap passes the torque line on the vial.
  6. Record the patient's name and ID number on the vial, and place it and the requisition form in a specimen bag for courier pickup and transport to the laboratory.

Store specimen at room temperature. Specimens must be processed within 21 days of collection.

All specimens designated for Cytology should be sent either as a “fresh” specimen or preferably placed in Cytolyt solution, a preservative. However, if part of a submitted specimen is intended for a culture, then it must be sent as a “fresh” specimen. Preferably, part of it can be sent fresh and part in a preservative for cytology; make sure to label each container. Specimens that might encounter this issue include urine, breast and respiratory specimens but not to the exclusion of others.

There are two basic ways in which Cytolyt solution can be utilized for specimen collection. They are as follows:

  1. The first method is to expel the contents of the syringe, from the FNA onto one slide, then using another slide, press the two together and draw the slides apart in opposite directions, thereby smearing the sample across both slides. This will make two “sister” slides. Quickly place the slides into 95% alcohol (the red top containers) or spray fix. Use of 95% alcohol containers is the preferred method.
  2. The second method has two parts:
    A. First make slides by smearing the contents from a FNA onto one slide, then using another slide, press to two together and draw the slides apart in opposite directions, thereby smearing the sample across both slides. This will make two “sister” slides. Quickly place the slides into 95% alcohol (the “red top” containers) or spray fix. Use of the 95% alcohol containers is the preferred method.

    B. Secondly, wash the needle in the Cytolyt solution to transfer any additional specimen for later preparation via the ThinPrep process (see number 1 for a more in depth explanation).
  3. Air-Dried Slides: Certain specimens designated for Cytology often will have both alcohol fixed and air-dried slides for processing. This can be of great benefit for Thyroid and Breast Cytology. Usually, when making a slide from an FNA (see 2A) one of the two sister slides will be placed in 95% alcohol and the other slide will be allowed to air-dry and then placed in a cardboard slide holder to transport to the lab. It is important to label the slides in such a way that it is apparent which slides are “sister” slides when more than one group of “sister” slides are prepared (which is very common). For instance, label one group as “1” or “A” and then the second group as “2” or “B.”

Note: Never use formalin for specimens slated for cytology processing. Formalin should only be used for specimens designated for histology.
In addition, if your facility has depleted it’s supply of Cytolyt and “red tops”, a “fresh” specimen can be sent to our facility either within the syringe (for FNAs) or in a specimen cup (such as urine specimens). However, it is important that a “fresh” specimen be kept refrigerated until courier pickup and packed in ice for transport.
Please contact the Cytology Department for any further questions concerning the collection of specimens for cytology at (910) 362-9511.

Routine Histopathology
1) Specimens that are submitted for routine histopathologic examination should be promptly placed in 10% neutral buffered formalin by the submitting physician. Bone marrow biopsies should be placed in Hartman’s solution, which is provided by our facility.

2) The specimen container should be of adequate size to contain the tissue sample and hold enough fixative to entirely surround the specimen (for adequate fixation the optimal ratio of the fixative volume should be at least 15-20 times greater than the tissue volume). Please contact the laboratory for the appropriate size containers available to suit your needs.

3) The specimen container should be labeled with the patient’s name, anatomic site where the specimen came from and collection date. The specimen container should then be placed in a plastic biohazard bag. A pathology requisition provided by WPA should accompany the specimen. The following information should be included on the requisition forms:

  • Patient’s name
  • Date of birth
  • Social Security number
  • Date the specimen was collected
  • Submitting physician
  • Any special instructions for reporting results and clinical information including history and clinical diagnosis
  • Billing information

Special Studies
Tissue for frozen section evaluation and lymph nodes for lymph node protocol should be submitted fresh in a sterile container and delivered to the laboratory within 10-15 minutes of collection. If unable to deliver within the time frame specified, the specimen should be kept cool and moist on saline moistened gauze and brought to the laboratory as soon as possible.

Tissue cultures, flow cytometry, cytogenetics, gene rearrangement studies and electron microscopy are available and will be sent from our facility to the appropriate reference lab. Directions for submitting tissue samples for special studies may be obtained by calling the laboratory direct.

Direct Immunoflourescence is available on skin and mucosal biopsies. The specimen should immediately be placed in Zeus Scientific Tissue Fixative supplied by WPA. The specimen can be picked up by the courier as other specimens are picked up daily. They should arrive in the laboratory within 24 hours of removal from the patient. If held overnight by the submitting physician, please refrigerate sample in the IF Tissue Fixative.

Please contact the Histology Department for any further questions concerning the collection of specimens at (910) 362-9511.


Wilmington Pathology Associates, P.A.
Serving southeastern North Carolina since 1976
(P) 910.362.9511  (F) 910.362.9512
1915 South 17th Street, Suite 100
Wilmington, NC 28401

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