Cytology

Offering a routine non-gynaecological diagnostic cytology service at The James Cook University Hospital and the Friarage Hospital, the department specialises in the microscopic evaluation of cellular based specimens in the identification of benign and malignant conditions.

A range of cellular preparation methods are used to evaluate specimens received from a variety of body sites including the head and neck, respiratory tract, urinary tract, gastrointestinal tract and breast. Specimens received include fresh fluids, directly prepared smears, fine needle aspirate preparations, needle rinses, saline-washings and small brush specimens.

Gynae cytology specimens are no longer screened at James Cook or Friarage hospitals. Samples are processed at either North Tees University Hospital or York General Hospital depending on sender location.

This page includes information on:

Request forms

All patient, sender, location, specimen type and clinical details MUST be completed. Failure to do so will result in specimen processing delays.

Cytology Request Form

Specimen containers

All specimen containers must be labelled with a minimum of two clear patient identifiers. This includes the patient’s full name and one other (hospital number, DOB or NHS number) identifier. Failure to do so will result in specimen processing delays.

Fine Needle Aspirate (FNA) slides, Dab or other clinic directly prepared smears

All slides must be labelled clearly in PENCIL ONLY and include a minimum of two patient identifiers. These details must include the patient’s full name (first name and surname) and one other patient identifier (hospital number, DOB or NHS number). Failure to do so will result in specimen processing delays.

When a fixative agent (dropper or spray) is used slides must be labelled as being fixed (F) and when left to air-dry without fixative (A) to determine subsequent appropriate staining technique. Failure to do so will result in specimen processing delays.

CytoLyt® Fluid

Vials of CytoLyt solution are available from the laboratory on request. This solution is a TOXIC agent and is for in vitro use ONLY.

Test information

  • Failure to use correct method may result in inability to perform test or substantial delays in reporting
  • During laboratory working hours all fresh unfixed specimens must be sent to the laboratory without delay
  • Any specimens received out of hours will be refrigerated before next day sample processing
Test Name
Specimen Container/Slides
Further Information
General Processing Information
Ascitic Fluid Plain universal container Minimum specimen volume of 25mls 1x ThinPrep PAP slide
1x Diff-Quik slide
Cell block as determined by the laboratory
Bladder Washings Plain universal container/honey pot for larger samples Minimum specimen volume of 25mls 1x ThinPrep PAP slide
Bronchial Aspirates/Washings or Bronchioloalveolar Lavages Plain universal container (50mls trap pot) As produced 1x ThinPrep PAP slide
Brush Specimens (all sites) CytoLyt solution (available from laboratory)

Remove protective sheath from brush and place brush in to CytoLyt solution.

CytoLyt® fixative fluid is a TOXIC substance and is for in vitro use only

1x ThinPrep PAP slide
CSF Plain universal container Neuro specimens:
>2mls where possible for cytological examination
2x Diff-Quik slides
Haematology specimens: 2x unstained Cytospin slides prepared for Haematology reporting
Flow Cell Cytometry: NOT PROCESSED IN CYTOLOGY
Separate sample and request form to be sent to Haematology for flow cytometry requests
Cyst Fluid
(all sites)
Plain universal container N/A 1xThinPrep PAP slide
1x Diff-Quik slide
Fine needle aspirates (FNA’s) Directly prepared slides at clinic site
Separate slide mailers for fixed and air-dried slides should be used
Label in PENCIL only
Two patient identifiers required: Patients full name plus one other
Slides must be labelled as fixed (F) or air-dried (A) depending on slide preparation method
Fixed slides  – PAP stain
Air-dried slides – Diff-Quik stain
Needle Rinses CytoLyt® solution(available from laboratory)

At the end of the FNA procedure needles are rinsed in CytoLyt solution and sent to the laboratory for processing

CytoLyt® fixative fluid is a TOXIC substance and is for in vitro use only

1x ThinPrep PAP slide/or cell block as determined by the laboratory
Peritoneal Fluid Plain universal container Minimum specimen volume of 25mls 1x ThinPrep PAP slide
1x DiffQuik slide
Cell block as determined by the laboratory
Peritoneal Washings Plain universal container Minimum specimen volume of 25mls

1x ThinPrep PAP slide

1x DiffQuik slide
Cell block as determined by the laboratory

Pleural Fluid Plain universal container Minimum specimen volume of 25mls 1x ThinPrep PAP slide
1x DiffQuik slide
Cell block as determined by the laboratory
Sputum Plain universal sputum container
*Please see sputum comment below
As produced 1x ThinPrep PAP slide
Urine (cytology) Plain universal container Minimum specimen volume of 25mls 1x Cytospin prep
And/Or
1x ThinPrep PAP as required
Vitreous Fluid Plain universal container/syringe (with needle removed) Fresh unfixed material to be sent Specimens are sent off site for reporting

Sputum Cytology

Sputum cytology has a very low sensitivity for the detection of malignancy and a negative cytology result does not exclude cancer. If the patient has a high probability of malignancy but is unable to tolerate other investigative procedures such as bronchoscopy, three separate samples sent on different days are advised to increase the test sensitivity.

Turnaround times

Estimated turnaround times for non-gynaecological cases, excluding immunohistochemistry and other further work:

  • Reported within 5 days of collection: For urgent cytology cases where there is clinical suspicion of cancer, two week rule cases, or for urgent reporting for close MDT date
  • Reported within 10 days of collection: All other cytology cases