Cytology Washings

PRINCIPLE OF EXAMINATION

Cytology washing is a type of exfoliative cytology that includes bronchial washings, ureteric washings, peritoneal washings and oesophageal washings. These samples are received following a procedure either for the diagnosis, classification and/or staging of benign and malignant tumours or to identify infections.

Washings are performed by instilling a sterile solution (usually saline) into targeted areas of the body e.g. peritoneal cavity, ureters or bronchial tree and recollecting the fluid.

This fluid is sent to the cytology department for processing. It is important that specimens are sent to the laboratory quickly following collection as they are unfixed. Specimens that are not sent to the laboratory quickly are at risk of cellular degeneration or a bacterial overgrowth which may lead to an inadequate result.

Washings may be paucicellular as they are not directly sampling a site, but exfoliating loose cells and collecting cells shed into the sterile fluid. Lack of diagnostic cellular material within a sample can also lead to an inadequate result.

SPECIMEN REQUIREMENTS

• To ensure best results, we request that as much fresh specimen is sent to the laboratory as soon as possible, and within 24hrs of collection.
• Send aspirated fluid in an appropriate universal container.  Do not send drainage apparatus as this will not be processed
• Send a separate specimen and request form to Microbiology if a microbiological investigation is required

The request should state:

• Three patient identifiers
• Specimen type i.e. ‘bronchial washings,’ ‘oesophageal washings’ etc
• Date and time of sample collection
• Requesting clinician
• Patient location – inpatient/outpatient and ward
• All relevant clinical information – including if there is a history of relevant foreign travel

Specimen Delivery and Labelling

All Trust specimens must be requested on Epic:

• Clearly label sample vial with an Epic label
• Clearly label sample vial with specimen type i.e. ‘bronchial washings,’ ‘oesophageal washings’ etc
• Clearly label sample vial with the date and time that the sample was taken

URGENT SPECIMENS: Please label urgent specimens clearly; an explanation as to why the specimen is urgent is helpful. On receipt, laboratory staff will notify the pathologist who will report the specimen as soon as possible.

HIGH RISK SPECIMENS: Requests must indicate if a specimen is high risk. Please indicate details of the risk, eg: TB, blood-borne virus, MPOX etc.

Turnaround Time

The Laboratory aims to comply with The Royal College of Pathologists Key Performance Indicator (KPI 6.4) for Cellular Pathology reporting turnaround times with 90% of all cases reported within 10 calendar days.