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Cytopathology

 

 

Welcome to the Cytopathology Department of BSPS

 

For HPV Primary Screening information please see separate tab on BSPS home page.

 

General Departmental information

The department provides a comprehensive Non Gynae and Andrology  service to The Royal Surrey NHS Foundation Trust  (RSFT), Frimley Park (FPH), Ashford & St.Peters Hospitals (ASPH) and Wexham Park Hospital (WPH) as well as to general practitioners, community and out-reach clinics in Central and Northwest Surrey areas.

Wexham Park and Heatherwood Hospital Non-Gynae samples should be sent to the Histology department at Wexham Park Hospital via BSPS transport network.  The samples are then forwarded to the centralised processing unit at St Peters Hospital; the reporting of Non Gynae Cytology samples remains at Wexham Park Hospital .

Royal Berkshire Non-Gynae samples are processed and reported by the Histology department at The Royal Berkshire Hospital.

Our main processing laboratory is based at St.Peters Hospital with satellite laboratories at the Royal Surrey providing Cryopreservation and Andrology services and Wexham Park Hospital providing Andrology services

Our opening times are.

St.Peters Hospital: Monday to Friday 08:30 - 17:00

Royal Surrey Foundation Trust: Monday to Friday 09:00 – 17:00

Wexham Park Hospital: Monday, Tuesday, Wednesday and Friday 09:00 - 15:00

 

Protection of personal information

The laboratory takes all necessary measures to protect personal information supplied and observes all confidentiality and data protection guidance. Please see protection of personal information section of website for further information on this.

 

Complaints

In the event of the service not meeting the users expectation, complaints can be made via email or telephone to the contact details given on the homepage. All complaints are taken very seriously and a full investigation will ensue. Please see the complaints procedure section of the website for further information on this. 

 

Non-gynaecological Cytopathology

Acceptance and Rejection Criteria

·         Only fully labelled samples i.e. 4 forms of matching ID on the request form and the vial will be accepted. Hospital numbers and NHS numbers (if known) should be recorded on the request form. Printed request forms are required for all non-gynae specimens, ICE being the preferred request form type.  

·         Specimen requirements detailed below should be adhered to whenever possible; it may not be possible to perform the full range of tests on fluid specimens smaller than the recommended volume.

·         Samples should not be split between departments. Instead a separate sample should be sent to each.

·         Body fluid waste collection containers should not be submitted for testing as they are likely to contain degenerate material that may affect the accuracy of the test result, please submit only freshly collected material.

·         Relevant and complete clinical details must be recorded on the request form; incomplete clinical information may affect the accuracy of the test result.

·         The requesting clinician’s full name must be clearly recorded on the request form, as well as the surgery, clinic or ward where the specimen was collected; missing or incomplete source data may significantly delay the communication of test results.

·         All samples should be packaged into a specimen transport bag with the request form secured into a separate section.  These are then transported to the cytology department via the BSPS transport system. High Risk Category 3 specimens should be double bagged and labelled accordingly.

 

The Royal Surrey, Frimley Health (Frimley Park and Wexham Park hospitals) and  Ashford and St Peter’s Hospital samples are now centralised and processed at St. Peter’s Hospital. The department is accredited to BS EN ISO 15189:2012.

  

A full testing service for all types of Non-gynaecological specimens, including adequacy at clinics, is provided by staff on the SPH site. The opening times for this service are 9:00 – 17:00, Monday – Friday.

St Peter’s Hospital,

Guildford Road.

Lyne, Chertsey

KT16 0PZ

Tel: 01932 723542

 

 

 

 

For all Non-Gynaecological enquiries see below.

 

Enquiry

Area

Telephone Number

Clinical advice.

 Senior Biomedical Scientists’

01932 723542

Results

Cytology offices

RSCH  01483 571122 x4260

ASPH  01932 723542

or  01932 723068

Laboratory enquiries

Steve Blackman

Lead BMS Cytology

01932 723542

 

 

·         Samples for EGFR are processed by the Molecular Diagnostics department at Royal Surrey Foundation Trust.

 

      Molecular Diagnostics Department                   01483571122 Ext 6839

      Lavis Suite                                                          Fax01483406737

      Royal Surrey Foundation Trust

      Egerton Road

      Guildford

      GU2 7XX

 

·         Samples for flow Cytometry are processed by the Immunophenotyping department at the Royal Marsden.  

 



HMDS,

Centre for Molecular Pathology

The Royal Marsden

Cotswold road

Sutton

SM2 5N6

 

 

02089156517,

02089156570

FAX 02089156761

 



 

 

Specimen requirements for Non-gynae samples

 

  • Urine, Urethral/Ureteric Washings

Urine: A single specimen of freshly voided mid-morning sample (minimum 20ml unfixed) should be submitted in a plain white top universal container. Early morning or mid-stream samples are NOT suitable for cytological assessment.

Haematuria is an indication for urologic referral, whatever the cytology result. Urine cytology is not able to exclude low grade urothelial neoplasia or renal causes.

Urethral and Ureteric Washings: Samples should be sent unfixed in a fully labelled plain white top universal container.

 

  • Sputum

Sputum should be collected on at least three occasions if underlying lung carcinoma is suspected. Sputum should be sent to the laboratory immediately following production. Early morning deep cough sputum is ideal, but contamination with food, toothpaste should be avoided. It should be noted however that Sputum specimens are rarely of clinical value.

 

  • Bronchoscopy

Bronchial washings/Bronchial Alveolar lavage: Samples taken at the time of bronchoscopy should be added to PreservCyt container or sent unfixed in saline if PreservCyt vials are not available. A 5-10ml minimum volume is recommended.

Bronchial Brushings:  At least one wet-fixed and one air-dried smear should be prepared fixing the wet-fixed smear immediately (using the fixative solution provided) and drying the air-dried smear as rapidly as possible.

 The slides should be labelled in pencil with the patient’s full name, date of birth and whether wet-fixed or air-dried. They should then be sent in separate slide boxes to the laboratory.

The brush should be thoroughly rinsed into a PreservCyt container, all of which must be clearly labelled with the patient’s details.

 

  • CSF

The sample should reach the laboratory within 30 minutes of collection.

If a sample is to be collected off the St Peters Hospital site or after 4.30 pm including weekends, please use CSF collection containers with appropriate fixative (5ml of IMS). These are available from Specimen Reception at FPH on 0845 658 9622.

 

  • Serous fluids (Ascites, Pleural, Pericardial)

Up to two universal containers with 50 ml of freshly collected fluid (without fixative) should be submitted for analysis asap, though 25 ml is usually sufficient to ensure reliable sampling and provides adequate material if further special stains are required for diagnosis.

Larger volumes collected over time in body fluid drain bags are not suitable for testing due to cellular degeneration and microbial growth.

Peritoneal washing collection devices such as VacSax’s are also not suitable since they usually leak in transit, resulting in both lost specimens and a health & safety hazard.

Please note, additional special techniques such as immunocytochemistry are frequently required in the reporting of serous fluid samples so a final result on some of these specimens will take longer than 10 calendar days.

  • Synovial Fluids

We accept fresh synovial specimens for examination for crystals; please collect in to a clean fully labelled universal container.

 

  • Cyst Fluids, Hydrocele Fluid, Haematospermia semen, Abscesses/pus wound drains

    Samples should be sent as fresh unfixed fluids collected in a clean fully labelled universal container

     

  • FNA’s

We provide FNA support for EBUS, EUS/ERCP, Breast, and Head and Neck clinics on several BSPS sites; see hospital service listing above.

In the absence of a Cytologist please use a fine needle (23 or 25 gauge) for sample collection, especially vascular organs such as the Thyroid gland. We have a clinicians guide to collecting FNA specimens available, please contact the SPH laboratory on 01932 723542 to request a copy.

At least one wet-fixed and one air-dried smear should be prepared fixing the wet-fixed smear immediately (using the fixative solution / PreservCyt container provided) and drying the air-dried smear as rapidly as possible.

The slides should be labelled in pencil with the patient’s full name, date of birth and whether wet-fixed or air-dried. They should then be sent in separate labelled slide boxes to the laboratory. The needle should be washed out into PreservCyt container provided which must also be clearly labelled with the patients details.

 Please do not send the needle; it should be safely disposed of into a sharps container.

 

  • Endoscopy  EUS/ERCP

This includes samples obtained from the gastrointestinal tract including pancreas, bile ducts, intestine, gastric and oesophagus. Fluid obtained from this procedure should be sent in a PreservCyt container which must be clearly labelled with the patient’s details.

Biliary Brushings: At least one wet-fixed and one air-dried smear should be prepared fixing the wet-fixed smear immediately (using the fixative solution provided) and drying the air-dried smear as rapidly as possible. All slides should be labelled in pencil will three patients ID’s stating whether wet-fixed or air-dried. They should then be sent in separate labelled slide boxes to the laboratory.

The brush should be thoroughly rinsed into a PreservCyt container, all of which must be clearly labelled with the patient’s details.

Stents obtained from EUS/ERCP should be fixed by putting it in a fully labelled PrecervCyt container which must also be clearly labelled with the patient’s details.

 

 

Cytology FNA Clinic Service

Fine Needle Aspiration (FNA) cytology is an accepted first line investigation for mass lesions targeted by palpation or by various imaging methods. FNA cytology has been shown to be a reliable, accurate and cost effective technique. However this accuracy depends upon obtaining adequate cellular material. To this end the best results are obtained when a pathologist or experienced biomedical scientist provide on site assessment of sample adequacy. At BSPS assistance is provided at the following clinics.

 

Clinic

Location

Time

One Stop Breast Clinic

Ashford Hospital

London Rd, Stanwell, Ashford TW15 3AA

Monday – pm

Tuesday – pm

Wednesday – am

Thursday-am

Friday – am

EBUS

Frimley Park Hospital

Frimley Park Hospital, Portsmouth Road, Frimley, Surrey, GU16 7UJ

Monday – am

 

Head and Neck/ Thyroid

Royal Surrey Foundation Trust

Egerton Road,

Guildford, Surrey, GU2 7XXust

Monday – pm

 

EBUS

St Peter’s Hospital

Guildford St, Lyne, Chertsey KT16 0PZ

Tuesday – am

Thursday – am

EUS/ERCP

St Peter’s Hospital

Guildford St, Lyne, Chertsey KT16 0PZ

Ad hoc

Call on ext. 3542/3068

 

Head and Neck/Thyroid

Ashford Hospital

London Rd, Stanwell, Ashford TW15 3AA

Wednesday – am

 

FNA – adequacy not required

St Peter’s Hospital

Runnymede Hospital

Guildford St, Lyne, Chertsey KT16 0PZ

Ad hoc

Call on ext. 3542/3068

 

FNA – adequacy required

St Peter’s Hospital

Guildford St, Lyne, Chertsey KT16 0PZ

Ad hoc

Call on ext. 3542/3068

 

Laboratory Non-gynaecological TATs

We aim to achieve the Royal College of Pathologists guideline of 90% reported within 10 calendar days, however additional special techniques such as immunocytochemistry are frequently required in the reporting of some samples so a final result on some of these specimens will take longer than 10 calendar days.

 

 

Semen analysis (Fertility + post vasectomy) BY APPOINTMENT ONLY!

The Andrology service provided by BSPS is currently suspended due to the current COVID situation

Please read through the instructions below before telephoning the laboratory to make an appointment for the delivery of your sample. Only pre booked specimens that comply with all the test criteria will be accepted for analysis, ALL OTHER SAMPLES WILL BE REJECTED.

BSPS Andrology Service:

St Peter’s Hospital,                 Royal Surrey                                 Wexham Park Hospital Guildford Road,                     Egerton Road,                                Wexham,

Lyne, Chertsey,                      Guildford,                                        Slough,

KT16 0PZ                              GU2 7XX                                          SL2 4HL                             Tel: 01932 723542                Tel: 01483 464892                            Tel: 0800 0327105

 

 

Information for Patients:

It is essential that you fully comply with the instructions on the front of the request form (see below) and complete all sections on the front page. Failure to provide all of the information requested, or use of an inappropriate container will result in rejection.

For fertility analysis please abstain from intercourse for 2 days (but no more than 7 days) prior to production of the sample

For post vasectomy samples men must ejaculate at least 24 times over at least a 16 week period, then submit a semen sample for sperm detection. They should then submit a second specimen 2 weeks later.

Please use only the toxicity tested container that has been supplied, write your full name plus the date and time of sample production on the container.

Record the period of abstinence, in days, on the request form and whether the sample is complete.

PLEASE produce samples using a fertility testing kit that consists of:

  • Appropriate paper and/or ICE request form for andrology samples which includes detailed patient information.
  • Toxicity tested container (see below).
  • Specimen transport bag.

        Toxicity tested container

Booking your Test:

Choose a hospital to book your test at, the options are: 

Royal Surrey NHS Foundation Trust – Pathology Two

St Peter’s Hospital – Pathology Specimen Reception

Wexham Park Hospital - Pathology reception

Monday 09.00 to 12.00 0nly.

 

Tuesday ,Wednesday and Thursday

09.00 – 11.30 and 14.00 – 15.30

Monday – Tuesday + Thursday -Friday

9.00 – 12.00

 Monday, Tuesday Wednesday, Friday

 09.00 – 14.30

 

Please note all of the laboratories are closed on bank holidays. Telephone your preferred laboratory using the following numbers.

RSHFT: 01483 464892

SPH: 01932 723542

HWPH: 0800 0327105

Specimens to be tested at Royal Surrey NHS Foundation Trust

There are no facilities for you to produce your sample at the Royal Surrey, you must produce the sample at home and then bring it to Cytology specimen reception in Pathology TWO building (Lavis) at the Royal Surrey at your pre booked appointment time; ensuring that the sample is no more than 1 hour old.

Specimens to be tested at St Peters Hospital

A production room facility is available at the SPH site. Phone the above SPH number to book. If you produce the sample at home, bring it to Pathology reception at St Peters Hospital at your pre booked appointment time, ensuring that the sample is no more than 1 hour old.

Specimens to be tested at Wexham Park Hospital

There are no facilities for you to produce your sample at the Wexham Park Hospital, you must produce the sample at home and then bring it to Pathology reception at Wexham Park Hospital at your pre booked appointment time ensuring that the sample is no more than 1 hour old.

Instructions for the Collection of the Sample

First wash your hands and genitals with soap and water, please ensure that you remove all soap residues and dry thoroughly. Collect the sample by masturbation directly into the special “toxicity tested” container provided.

Do Not use a condom.

Collect the entire sample, if you spill any please circle “NO” in the sample complete? box and whether it is the “FIRST” or “LAST” portion that has been lost.

Record the date and time of sample production on both the request form and sample container.

Please keep the sample warm while in transit; an inside coat pocket is ideal.

Please note that there is no out-of-hours or weekend service available for semen analysis.

Reference Ranges

WHO laboratory manual for the Examination and processing of human semen (5th edition 2010) ISBN 978 92 4 154778 9 reference values are:

• pH > 7.2

• Volume > 1.5 ml

• Concentration > 15 million per ml

• Total motility > 40%

• Progressive motility > 32%

• Vitality > 58%

• Morphology > 4%

 

TATs for Semen analysis

Results will be available within 7 calendar days from date of receipt.

If you require any clinical advice regarding Andrology please contact Dr B Shambayati - B.shambayati@nhs.net

Cryopreservation

Cryopreservation is carried out by special arrangement via St Lukes Cancer Centre. Please contact the laboratory at the Royal Surrey for further information on tel: 01483 571122 Ext. 4890/4260. A separate patient information leaflet is provided for these cases.

Measurement of Uncertainty

For information on the Measurement of uncertainty for all Cytology tests, please contact the Laboratory on 01932 723542. Please leave contact details so that a copy can be sent via your preferred method.