Body Fluid Cytology

NAME OF PROCEDURE

Body Fluid Cytology

TEST CODE

NGYN

SYNONYMS

Body Cavity Fluid Cytology; Effusion Cytology, Non-Gyn Cytology, Fluids Cytology

CPT CODE

  • 88112 – Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal
  • 88305 – Level IV Surgical pathology, gross and microscopic
  • 88160 – Cytopathology smears, any other source; screening and interpretation
  • 89060 – Crystal identification by light microscopy with or without polarizing lens analysis, tissues, for only body fluids, except urine

APPLIES TO

Abdominal Fluid, Ascitic Fluid, Culdocentesis, Cyst Fluid, Gastric Washing, Pelvic Washing, Paracentesis Fluid, Pericardial Fluid, Pericardiocentesis Fluid, Peritoneal Fluid, Pleural Fluid, Synovial Fluid, Thoracentesis Fluid, and other miscellaneous fluids.

SPECIAL INSTRUCTIONS

  • Information regarding type of specimen, admitting diagnosis, and pertinent clinical history (i.e., age, clinical impression, past diagnosis, radiographic findings, and history of radiation/chemotherapy or malignancy) is essential to interpretation and should be noted on the
  • Infectious diseases suspected and special stains requested should be
  • Clinical evidence of immunosuppression should be indicated.
  • Special handling requirements (isolation) should be clearly noted on the requisition.
  • If other studies are required, submit to appropriate laboratory separately.

CONTAINER

  • Clean, leak-proof container, vacuum canister, bag, or bottle.
  • Label all containers with a minimum of two patient identifiers.

PATIENT PREPARATION

Using standard techniques, obtain a fluid specimen from the desired body cavity.  If necessary, move the patient into multiple positions to suspend cellular material in the fluid.

COLLECTION TECHNIQUE

  1. Complete requisition entirely.
  2. Label container(s) before procedure.
  3. Collect body fluid in labeled, leak-proof container.
  • Heparin may be added to specimen to reduce clotting.  Add 500 units of heparin per 100 ml of fluid anticipated (each mL heparin contains 1000 units). Gently agitate the flask as fluid is collected to mix the heparin with the fluid.

*NOTE: It is not necessary to combine peritoneal washings or gastric washings with an anticoagulant (heparin). See special instructions below.

  • Specimen may be submitted fresh/unfixed or fixed in CytoLyt.
  • Add a volume of fixative to the specimen such that the ratio of fixative to specimen is 2:1.
  1.  Seal container well to prevent leaking.
  2. Place labeled container in a sealable Biohazard specimen bag and include the requisition in the outer pocket of the specimen bag.
  3. Send the entire specimen to the laboratory as soon as possible.

**REFRIGERATE ALL CYTOLOGY SPECIMENS IF IMMEDIATE DELIVERY TO LAB/CYTOLOGY IS NOT POSSIBLE**

SPECIAL INSTRUCTIONS FOR GASTRIC WASHINGS

Patient Preparation:

The patient must be fasting overnight. Keep the patient hydrated by having him/her drink water or tea during the night, especially one hour prior to the procedure. If there is an obstruction, continuous suctions should be maintained overnight, and the patient should be kept hydrated using IV fluids. If barium has been given, the procedure must be delayed one week.

Collection Technique:

A Levine tube is introduced in the usual manner to the 75 cm mark. No lubrication is used except by moistening the tube with ice. Repeated amounts of Ringer’s solution is injected under pressure, aspirated, and discarded until the return is clear. 500 ml of Ringer’s solution is then introduced under maximum pressure and re-aspirated while the abdomen is vigorously massaged. The aspirated fluid is then placed in a clean, leak-proof container. Send the specimen to the laboratory immediately, packed in ice.   Specimen may be submitted fresh or fixed with an equal volume of CytoLyt in a 50 mL to 100 mL container.

**REFRIGERATE ALL CYTOLOGY SPECIMENS IF IMMEDIATE DELIVERY TO LAB/CYTOLOGY IS NOT POSSIBLE**

REQUEST FORM

Anatomical Pathology Requisition

  • Complete patient information section.
  • Complete the Non-Gynecologic section thoroughly.

CAUSES FOR REJECTION

  • Incomplete requisition.
  • Specimen container not labeled properly.
  • Improperly fixed specimen.
  • Gross contamination due to spillage.
  • Prolonged period (more than eight (8) hours) at room temperature.
  • Insufficient quantity for cytologic evaluation.
  • Delay in delivery for adequate preservation.

LIMITATIONS

Allowing fluid to stand for a prolonged period before processing may cause deterioration and artifact.

Cells in fluids of long duration may be degenerated on first tap and a second tap may be required after re-accumulation for best cytologic detail.

Clots may contain diagnostic cells which are unavailable for sampling.

METHODOLOGY

  • Smears and thin layer preparations are examined microscopically using the Pap stain method.
  • Cell block specimens prepared and stained using Hematoxylin & Eosin (H & E) stain method.
  • Special stains and special studies (IHC, ISH, molecular, etc.), if needed.
  • Crystal analysis upon request.
  • Cell count with differential available upon request.

ADDITIONAL INFORMATION

Information is also available on the SEPA website under Resources – Directory of Services.

Please call laboratory if you have questions.