Diagnostic Cytology

Description: 
The Cytology Unit under Histopathology at King's College Hospital processes approximately 3,500 diagnostic samples per year, which include fluid specimens, brush specimens and Fine Needle Aspiration (FNA) Cytology. The laboratory working hours are 9am to 5:30pm, Monday to Friday (excluding bank holidays). The Unit also provides a FNA service at clinics co-ordinated by hospital clinicians.
All cervical cytology samples are processed and reported at St Thomas Hospital. For inquiries pertaining to the cervical cytology, contact tel no. 02071882905 to be appropriately directed.
Sample type and Volume required: 
All diagnostic cytology specimens should be accompanied by a completed request form which must include the patient’s name and address, date of birth/NHS Number/Hospital Number, ward or clinic if seen in hospital, and sender’s name and contact details. The type of specimen and the sample site, if appropriate, should be clearly stated on the form and clinical details provided.
The container should be labelled with the patient’s first and last name and NHS number or hospital number or date of birth. The label should also include the type of specimen and site of sample, if appropriate.


Fluid Specimens:

These include urine, serous fluids, sputum, cyst aspirates, washings and CSF’s. A sample of 20ml maximum size is adequate for cytology in almost all cases. Larger volumes should not be sent to the laboratory without prior approval from the laboratory. It is appreciated that some samples, such as CSF’s, are often of low volume and smaller samples are acceptable in such circumstances.

Fluid specimens should be sent to the laboratory unfixed, without delay in a standard sterile universal sample container. The container should be labelled with the patient’s first and last name and NHS number or hospital number or date of birth. The label should also include the type of specimen and site of sample, if appropriate. The specimen and the request form should be sent to the laboratory in a plastic specimen bag.
NB. Crystal evaluation on synovial fluid samples are now performed in the Biochemistry laboratory.

Brushings and FNA Specimens:

FNA specimens and brushings should be spread on frosted end slides. The slides should be labelled in pencil (ink is washed off in processing) to include the patient's name and date of birth. If samples are taken from multiple sites, it will be necessary to number the slides to indicate the sources. The material must be spread on slides quickly, and thereafter spray fixed or air dried immediately. Slides must be put into slide transport boxes and thereafter placed in a specimen bag together with the request form for delivery to the laboratory.

Excess material can be expressed into physiological saline (balanced salt solution) and sent to the laboratory as for fluid specimens.

Cervical Cytology Samples:

All cervical cytology for King’s College Hospital, Lewisham Hospital and St. Thomas’ Hospital is now processed within the Viapath Cellular Pathology Laboratory at St. Thomas’ Hospital.

Turnaround time: 
Diagnostic Cytology specimens are normally reported within 4/5 days. On occasion, more specialised techniques may be employed to improve diagnostic value. This may incur a slight delay of between 24 and 48 hours. Where the result is required on the same day, please inform the cytology laboratory by phone. It is essential that such specimens are received in the laboratory before 4pm.
Special sample instructions: 

Samples may be rejected if there is a mismatch of demographic information between the request form and sample, incorrect fixation, or significant delays.

Samples should be sent immediately to the laboratory. Delays in transport and processing of the samples, or poor fixation may affect the results.

For consultant advice, please phone 020329934620 or 020329933045 to be appropriately directed.

Storage and transport: 
Slides must be placed in slide transport boxes and placed in a specimen bag with the request form for delivery to the laboratory. Excess material can be expressed into physiological saline (Balanced Salt Solution) and sent to the laboratory as for fluid specimens. The specimen and the request form should be sent to the laboratory in a plastic specimen bag. The samples are transported by porter or courier to the CSR department, at Viapath KCH.
Contacts:
Cellular Pathology/ Histopathology at King's College Hospital
020 3299 3045 - General Queries
kch-tr.histopathologyoffice@nhs.net
King's College Hospital
Bessemer Wing - 2nd Floor
Denmark Hill
London SE5 9RS
For clinical advice or interpretation of results, please contact the laboratory in the first instance.

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Last updated: 17/07/2017