[Histonet] Re: Non-gyn cytology prep - amount processed?

[Beth Cox]

Hi Cathy,

Your message came through a little garbled, but I think I get the jist 
of it. 

Standard procedure for large volume cytology fluid specimens is to mix 
the specimen well, and then take off a 50 ml aliquot to centrifuge down 
and make the slides and cell block.   If the specimen is not mixed, you 
are likely to miss the settled malignant cells.  It is not prudent (or 
recommended!) to centrifuge down the entire specimen.  If a specimen 
were extremely sparsely cellular, I might occasionally spin down two 50 
ml aliquots.

I agree that if a specimen has set for a while and settled naturally, 
pouring off the supernatent and using the concentrated precipitate for a 
50 ml aliquat can be a nice bonus.  BUT, there should have been 
malignant cells in the WELL-MIXED original aliquot.   What prep 
procedures are you using for the slides??   ThinPrep processing can be 
subject to problems with these kind of specimens because sometimes the 
filter becomes 'clogged' with fibrin and protein, and the processor 
thinks it has cells, but not much is there.  ThinPrep may not be the 
best choice for body fluid specimens.

A well done cell block should also have shown cells in it.  If you are 
simply scraping loose cells into a lens paper to process and try to 
embed for a cell block, I'm not surprised if you lost the cells and only 
recovered the more prominent fibrin.  It's always a good idea to use 
some method to actually hold (block!) the cells together - such as agar, 
thrombin-prothrombin, or albumin clot.

Beth Cox, SCT/HT(ASCP)
_____________________________________

Message: 3
Date: Thu, 11 Dec 2008 10:10:31 -0800
From: Cathy.Crumpton <@t> tuality.org
Subject: [Histonet] Non-gyn cytology prep - amount processed?
To: histonet <@t> lists.utsouthwestern.edu
Message-ID:
	<OF6CE74DE0.44DC7092-ON8825751C.0063D701-8825751C.0063D708 <@t> tuality.org>
	
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   Hi  all,  for those of you who also work with cytology - what is   procedure  for  fluids  that  have  a large volume?  How much of the    fluid do you process?

   I  am  wanting to compare our polic   instance  this  week  where  we received   processed  100  mL  of that after making sure it   first  cell blocks only contained fibrin, but the   malignant  cells.   When we went back to the contai   settled  after  24  hours so we poured off the top part of t   and  only  processed  the gunk at the bottom.  The second time t   were  malignant  cells in the cell block.  My pathologist is pushin   for us to process 100% of the fluids, 100% of the time, saying what we
   cu   get those