Specimen Collection


A. PURPOSE:

The purpose of this manual is to offer guidelines for submitting specimens to the laboratory. These guidelines are intended to ensure that when the specimen is received in the pathology laboratory, that it can be optimally processed, and an accurate and timely diagnosis can be rendered.

B. SPECIMEN ACCEPTANCE:

Specimens can only be accepted in the laboratory if submitted either with a prescription from a physician or licensed healthcare practitioner or with a laboratory requisition.

C. REQUISITION AND LABELS:

    1. The requisition should include all of the patient’s pertinent demographic information, and must include the date of         birth.

    2. One requisition may accompany multiple specimens; however, each specimen must be placed in a separate bottle         and designated separately on the requisition.

    3. Each bottle should be labeled with the patient’s name and location of the specimen or the appropriate barcode label.         The requisition should list each specimen separately as to location and type of specimen.

    4. As much clinical information as is available should be submitted with the specimen, including clinical impression,         endoscopic findings, type of surgical procedure, pertinent laboratory data, etc.

D. COLLECTION PROCEDURES:

    1. CYTOLOGY SPECIMENS:

        a. FLUID CYTOLOGY:

            i. Type of Specimen: Voided and catheterized urine, bladder washings, bronchial washings, bronchial alveolar                lavage, sputum, body cavity fluid, cyst fluid, cerebrospinal fluid, synovial fluid.

           ii. Collection Requirements: Fluid specimens should be submitted in a sealed, clean, sterile container without                fixative. Gross bloody fluids should be anticoagulated with heparin, and smaller quantities of fluid which have a                tendency to clot (synovial fluid) should be collected in a heparinized blood tube.

          iii. Special Requirements: Capped syringes should not be submitted. Fluid should be transferred from the syringe to                a sealed container. If the specimen cannot be submitted within 24 hours, it should be refrigerated.

        b. FINE NEEDLE ASPIRATIONS AND BRUSHING CYTOLOGIES, INCLUDING TZANCK PREPARATIONS:

           i. Collection Requirements: Material which has been aspirated, brushed or scraped should be smeared on clean               glass slides and fixed immediately in ethanol or with a spray fixative. If the slides or smears cannot be fixed,               they should be labeled as “air dried.”

Each slide submitted must be labeled with two patient identifiers and site.
Acceptable forms of identification include: patient name, medical record number, date of birth and
surgical accession number.

    2. SPECIMENS FOR FLOW CYTOMETRY:

        a. Type of Specimen: Any tissue can be submitted for flow cytometry, including lymph nodes, skin biopsies, GI             biopsies, core biopsies, fine needle aspirations, bone marrow aspirations or peripheral blood.

           i. Collection Requirements: Tissue for flow cytometry must be submitted fresh without formalin or placed in RPMI               tissue culture media for transport to the laboratory. Bone marrow and peripheral blood samples should be               submitted in yellow or purple top blood collection tubes. All media and transport containers for flow cytometry               specimens can be obtained in advance by calling the Laboratory directly.

          ii. Special Requirements: The laboratory should be contacted 24 hours in advance of the biopsy so that a STAT               pickup and delivery can be arranged.

    2. SPECIMENS FOR UROVYSION (FISH) TESTING:

        a. Type of Specimen: Bladder washings, urethral washings, renal pelvic washings, voided urine, etc.

           i. Collection Requirements: Clean-catch midstream sample is necessary if the specimen is voided. The specimen               should be placed in a urine collection container with the appropriate fixative (absolute alcohol) in a 2:1 ratio. If a               Mark and Kambour Laboratory Collection Kit is obtained, the container should be filled to the top of the line of
              the collection container.

    2. SURGICAL PATHOLOGY SPECIMENS:

        a. Type of Specimen: Any surgical specimen requiring histologic sectioning for microscopic examination, e.g.,             needle biopsies, skin biopsies, endoscopic biopsies, etc., or large surgical specimens.

        b. Collection Requirements: All specimens should be submitted in 10% buffered formalin and in an appropriately             sized container, as indicated above. Specimens from separate sites should be submitted in separate containers             and labeled appropriately.

        c. Special Requirements: If any special studies are required, e.g., microbiologic culture, frozen section, flow             cytometry or chemo sensitivity or genetic assays, the specimen should be submitted fresh, without formalin,             immediately to the Laboratory with specific instructions as to the type of testing requested indicated on the             requisition.

    2. SURGICAL SPECIMENS FOR GROSS EXAMINATION:

        a. Type of Specimen: Orthopedic hardware, foreign bodies, catheters, projectiles, calculi from the GU or GI tract.

        b. Collection Requirements: Specimen should be submitted without formalin in a clean container appropriately             labeled as above. If there is tissue submitted with the hardware or device, formalin should be added to the             container.

        c. Special Requirements: If stone analysis is required, an order to that effect should be submitted on the requisition             form. Specimen will be sent for chemical analysis to Louis C. Herring and Company Laboratory.