Sputum Cytology

Principle of Examination

Respiratory cytology is performed primarily for the diagnosis and classification of benign and malignant lung tumours.  Sputum cytology  is recognised to be a specimen of limited or no clinical value, and hence should be rarely received.

Specimen Requirements

If cytological diagnosis is required then it is recommended that three separate consecutive deep cough specimens are sent to the laboratory. Where sputum production is poor, it can be increased artificially by inhalation of an aerosol irritant solution. These are induced sputum specimens which are also useful for investigations of opportunistic infections such as Pneumocystis jirovecii (previously known as Pneumocystis carinii) in immunosuppressed patients.

When sending early morning sputum specimens for cytology, please:

• Use 50ml universal containers.
• There should be adequate clinical information provided on the request, which should clarify the indication for a cytological examination.
• Collect three specimens on consecutive days and complete three requests.
• Indicate the date and time of the specimen on each request.
• A good deep cough specimen is required.
• No food or drink should be taken prior to sputum collection.
• Indicate on the request if there is a history of relevant foreign travel.
• Send a separate specimen and request to Microbiology if a microbiological investigation is required.

To ensure best results, we request that as much fresh specimen be sent to the laboratory as possible, within 24hrs of collection.  Fresh or unfixed specimens must be received on the same day as collection.

Specimen Delivery and Labelling

All Trust specimens must be requested on Epic and labelled with an Epic label. All GPOCS requests must be labelled with a GPOCS label. All other requests must have a request form.

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.