In this section
All specimens should be sent to the laboratory in an appropriately labelled specimen pot that is large enough to easily accommodate the specimen. It is unsafe practice to label specimen pots in advance of a procedure.
Factors affecting performance
The following is a list of factors known to significantly affect the performance of examination and interpretation of results:
- Failure to follow the specimen acceptance policy will result in a delay to specimen processing and reporting.
- Failure to supply adequate clinical information may result in a delay to requesting of specimen investigations and reporting.
- Failure to label requests as urgent or HSC205 will result in a delay to specimen processing and reporting.
- Failure to fix specimens appropriately (depending on specimen type) and in a timely manner will adversely affect specimen integrity and subsequent examination.
- Failure to follow instructions for the specific specimen requirements will prevent necessary examinations from being performed.
- Failure to disclose high risk status of the specimen will put staff at unnecessary risk of infection.
- Specimens for cytology being placed into 10% neutral buffered Formalin as opposed to being sent fresh, in saline or cytological fixative as appropriate for the sample type and test required
- Failure to ensure timely transport to laboratory for fresh samples that require rapid processing (e.g., CSF)
Should any of these factors affect the issuing of a final report, then an incident may be raised in Ulysses. If a final report is able to be issued, factors that may have affected this result will be included in this report.
Specimen fixation
Depending on the type of sample Cytorich Red fixative may be used to fix the specimen. See sample type table below.
High risk specimens
All specimens from patients who are identified as (or are likely to be) in the high-risk category must be clearly labelled to ensure the health and safety of all staff. The following are common hazard group 3 pathogens considered high risk (this list is not exhaustive): HIV, AIDS, TB, Hepatitis B and Hepatitis C.
Haematological Cancer Diagnostics (HCD)
Cellular Pathology samples with a suspected diagnosis of lymphoma are sent to Cellular Pathology as for any other specimen. The request form should clearly indicate the suspicion of lymphoma. A consultant pathologist will examine initial slides and determine whether the case is to be sent to the HCD.
Diagnostic cytology samples
We currently use a mixture of direct spreads, cytospins and cell blocks in our sample preparation. All samples are prepared in Containment level 3 rooms with Class 1 microbiological safety cabinets. Our research activity at the Oxford Road site includes:
- Protector study- Preventing Ovarian cancer through early excision of tubes and late Ovarian Removal
- DETECT –Research project to screen women presenting with post- menopausal bleeding for evidence of endometrial carcinoma
Diagnostic cytology specimens are either fluid based or received as smears of fine needle aspirations (FNA) or imprints of tissue biopsies on glass slides.
Specimens should be sent in sample containers of an appropriate size to adequately hold the specimen. Some specimens are received fresh, with no additives and therefore should be delivered to the department as soon as collected to prevent deterioration of the sample (see table below). Other specimens are received in cell collection fluid or a preservative such as cytorich red. These preservatives assist with preservation of the cells within the sample. In the case of thyroid aspirates some slides should be fixed using the alcohol based fixative spray and some air dried. The air dried slides are for Giemsa staining.
Cytorich red and alcohol spray fixative (for tongue and buccal smears) are both available from by contacting the cytology laboratories.
Molecular testing
The Diagnostic Cytopathology department can facilitate a number of molecular tests on cytology samples due to our close working relationship with the Manchester Centre for Genomic Medicine, The Christie Hospital NHS Foundation Trust and other external providers. We strongly recommended that the clinicians convey any requests for molecular tests to the attending BMS for any FNA cytology samples or to the consultant cyto/histopathologists for any exfoliative cytology samples, either by indication on the request card or by telephone.
Third party providers
On occasion and to support the timely reporting of results Third party reporting providers may be utilised to support the Diagnostic Cytopathology service. Report will state if a case has been outsourced/reported by a third party provider.
(Last reviewed February 2025)