Collection Manual: Endoscopic brushings for cytology

Description: Endoscopic brush samples submitted for cytologic evaluation are useful for the discovery of benign and malignant conditions of the target organ. Specimens for cytology are typically collected from the bronchial tree, esophagus, stomach, and colon. Slides are prepared from the brush and submitted with the brush for processing and evaluation.

Reagent Alcohol 95% Solution (pre-filled fixative slide-bottle. CAUTION: POISON, FLAMMABLE).
Microscope slides, requisition form, biohazard transport bag.

1. Complete a requisition form.
White copy to the lab. Lack of data may result in delay or specimen rejection.
• Clinician name, location and date of service.
• Patient demographics: Name, address, phone number, date of birth and social security number.
• Insurance information: copy of insurance card(s) or face sheet.
• Site of specimen, for example:
a) Pulmonary: RUL, RML, LLL etc.
b) Esophagus: distance in centimeters
c) Gastric
d) Colon: distance in centimeters
• Relevant patient history i.e., shortness of breath, hemoptysis, weight loss, previously diagnosed disease, CT scan or x-ray findings and suspected diagnosis.
• Related treatments including antibiotics, radiation, chemotherapy and surgery.
• Request for silver stain if mycosis or pneumocystis is suspected.

2. Label the specimens with the patient’s first and last name.
• Label the slides using a #2 pencil (ink will dissolve in processing).
• Label the slide bottle in which the brush-end is submitted.

3. Prepare slides and submit the brush.
• Prepare slides as soon as the brush is available. Delays will cause distortion of the collected cells.
• Gently roll the brush across each labeled microscope slide, spreading thinly and evenly.
• Immerse the each slide IMMEDIATELY into the fixative within the slide-bottle. A few seconds delay can cause cellular degeneration and may compromise the sample.
• Prepare at least 2 slides in this manner, more if the collected material is very thick on the brush.
• Clip off the brush and submit it in the same slide-bottle if there is room, or use a separate, labeled slide-bottle.

4. Verify that the lid is properly seated and tight.

5. Submit in a biohazard transport bag.
• Submit the jar(s) in the zip-loc portion of the transport bag and the requisition form in the outer sleeve.

6. Refrigeration is not required.