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Surgical Pathology
Pap Test Collection Guidelines
Thin Prep Imaging System
Gyn Cytology Reporting
Aptima HPV Assays
Aptima Combo 2 CT/NG Testing
Aptima Trich Assay
Testing / Treatment Recommendations
Non Gyn Cytology
Patient FAQs and FACTS
Pap Test Collection Guidelines

ACCURACY AND QUALITY

It is very important that providers fill out all the information requested on the Gyn requisitions.  This ensures the highest quality interpretation and reporting by PL's cytotechnologists and pathologists.  Examples of important information include, but are not limited to, past history of an abnormal Pap, abnormal bleeding, patient's LMP, and any hormonal therapies.  Please do not hesitate to call our Client Services department at 605-322-7212 if there are ever any questions about filling out the requisitions.

PROPER SAMPLE COLLECTION
Including Anal Pap Collection
 

Proper sample collection is very important.

  • Obtain an adequate sample using either the broom-like device or the plastic spatula/cytobrush combination. Wooden spatulas must NOT be used as pieces of the wood may get into the solution in the vial.
  • Rinse the device(s) in the PreservCyt solution by swirling vigorously in the vial 10 times. Discard the device(s). Do not leave the spatula/cytobrush or broom in the vial.
  • Tighten the cap so that the torque line on the cap passes the torque line on the vial.
  • Write the patient's name and date of birth on the vial before sending it and the requisition to the laboratory.

Listed below are printable reference guides for collection.  Simply click on the links to bring them up to print.

Anal Pap Collection Instructions

 Endocervical Brush-Spatula Collection

Broom-Like Device Collection

  Place the properly labeled Collection Vial in the biohazard bag. All specimens should be accompanied by a completed Physicians Laboratory requisition. Return the Collection Vial and requisition form to Physicians Laboratory via courier or mail.

INFORMATION AND RECOMMENDATIONS REGARDING PAP TEST COLLECTION

PRESENCE OF ENDOCERVICAL CELLS ON A PAP - Important or Not?  

If a physician is concerned about lack of endocervical cells one thing he/she may consider doing is switching from using a broom to a brush/spatula technique.  Historically, it seems that using a brush can at times increase a physician's percentage of endocervical cells.  However, in spite of proper collection techniques and devices, significant numbers of Pap tests lack endocervical cells.  At Physicians Laboratory, 25% of our Pap tests do not have endocervical cells.  Laboratories similar to ours have parallel experiences with absent endocervical cells in 15-19% of Pap tests.  Below is a more detailed article regarding this subject.  Please click on the link to open it.

Read more....endocervical cell position paper

UNSATISFACTORY PAPS

Many clinicians may be unaware of the fact that bloody ThinPrep Pap specimens are nearly always "Unsatisfactory for Examination".  The ThinPrep Pap test is wonderful for getting rid of  blood,  mucus, and inflammatory cells but when the Pap is excessively blood the blood clogs the filter during processing and the epithelial cells never make it to the slide.  We use an acetic acid technique on bloody Paps that lyses the red blood cells.  However, reprocessing doubles our supply cost and also adds additional preparation and screening time. 

The following guidelines should be applied while taking a Pap:

  • Patients should be tested during the last half of their menstrual period.  If taking a Pap during a patient's menstrual period cannot be avoided please swab the cervix with a gauze pad prior to taking the specimen.
  • Avoid using lubricant as this will clog the filter (see below)
  • Following collection immediately and vigorously rinse the collection device in the vial.  Do NOT leave the collection device in the vial.

USE OF LUBRICANTS DURING PAP TESTING

The use of lubricant during Pap test collection can increase the risk of obscuring the cell sample and also interfere with cell adherence on the slide.  It is for those reasons that Physicians Laboratory strongly recommends that lukewarm water be used to lubricate and warm the speculum.  If lubricant must be used for patient comfort, below is a list of those that have been tested and approved by Hologic.  Use of a non-approved lubricant will likely result in an increase in unsatisfactory specimens.

Any lubricant should be applied sparingly on the outer portion of the speculum taking care to avoid the tip.  The following lubricants have been tested and approved by Hologic:

Surgilube
Surgel
Pap Test Lubricating Jelly (PP024)
KY Jelly

For a complete list of approved and non-approved lubricants click on the link below.

Approved and Non-Approved Lubricants

 

HPV TESTING 

HPV testing may also be performed on the same ThinPrep® Pap sample. Either check the box provided on the requisition form regarding HPV testing or write the request on the requisition. Vials will be retained for three weeks from the time it was collected, but testing for HPV must be completed within this time. Contact Physicians Laboratory Cytology Department to order this test in addition to the ThinPrep® Pap smear and a form will be faxed to you. Your signature and the patient's diagnosis are required on this form in order to perform the test.

Chlamydia trachomatis and Neisseria gonorrhea testing

CT/NG testing MUST be ordered at the time of Pap collection. Check the appropriate boxes on the Pap requisition to order these tests. The complete Pap report will be sent when testing is completed.