GYNECOLOGIC SPECIMENS

(Conventional Pap Smear)

Indications

Sampling of the superficial cells of the cervix, endocervix and/or vagina to detect premalignant and malignant lesions of the uterine cervix and other abnormalities of the reproductive tract.

Requisition form

Submit all patient information following the procedure for “Completing a Gynecologic Cytology Requisition” (page 27).

Supplies

Vaginal speculum, *plastic spatula and *cytobrush, *clean glass slide (single end frosted), black lead pencil, fixative (spray fixative or *95% ethyl alcohol), *LMC gynecologic cytology requisition form, *slide container for transport, *biohazard bag for specimen transport. (*items provided by LMC)

Collection Procedure

In premenopausal patients, obtain specimen during second half of menstrual cycle (if possible) to avoid obscuring blood. Instruct the patient not to douche or engage in sexual intercource within 24 hours of the procedure.

1. Print the patient’s name (last, first) on the frosted end of the glass slide with a black pencil before beginning the procedure. The laboratory CANNOT accept unlabeled slides.

2. Place the patient in the lithotomy position. Using a speculum lubricated with warm water, expose the cervix as fully as possible. DO NOT use lubricant as this will interfere with the cytologic evaluation.

3. If excess mucus, exudate or blood is present at the cervical os, remove with a folded gauze pad or large cotton-tipped swab. Obtain a sample of the ectocervix and transition zone (if visible) by rotating the plastic spatula 360 degrees around the cervical os. Hand the spatula with the collected specimen to an assistant so that the cytobrush can be used to sample the endocervical canal. Rotate the cytobrush one half turn and hand to the assistant.

4. Quickly smear the material from the spatula on one end of the pre-labeled glass slide and then rotate the cytobrush to deposit material on the other half of the glass slide. Immediately immerse the slide in fixative (95% ethyl alcohol) or use spray fixative. If using spray fixative, hold the container approximately 12 inches from the slide to avoid “spray” artifacts that can interfere with cytologic evaluation.

5. If using spray fixative, allow the slide to dry completely before placing the slide in the dry slide container for transport to the laboratory. If using wet fixative (95% ethyl alcohol), secure the lid to the plastic container and send the specimen, in the fixative, to the laboratory.

6. Use the specimen collection biohazard bags provided by LMC. Place the completed requisition in the outside pocket and the properly labeled slide (in its container) in the zip lock portion of the bag. Send to Laboratory Medicine Consultants for processing.