Pleural Effusion/Thoracentesis for Cytology

category - CYTO

mnemonic - FLDC

Pleural Fluid, Pleural Effusion, Thoracentesis

I.1.All specimens must be accompanied by a completed manual or Meditech generated cyto-pathology non-gynecological requisition. All mandatory fields must be satisfied in order to complete the request. In the case of computer downtime use the standard cytopathology non-gynecological requisition.

The following information is required on the requisition

(a) Patient identifiers (addressographs may be used)

(i) patient's first and last name

(ii) hospital unique number

(iii) date of birth

(iv) Ontario Health Insurance Number with version code.

(b) Submitting area identifiers: Hospital site (BGH or The Willett) and the submitting department (Emergency, Ambulatory Care etc.). (c) Submitting physician's name.

(d) Date of specimen collection

(e) Pre- and post-operative presumptive diagnosis.

(f) A brief clinical history, relevant pathological and radiological findings.

(g) Specimen information

(i) specimen type/source

(ii) specimen site

I.2. The specimen container must be labeled. Addressograph labels are preferred, otherwise the following information must be provided, clearly written in ink:

(a) Minimum of two Patient identifiers 

(i) patient's full name

(ii) hospital unique number

(iii) date of birth

(iiii) healthcard number

(b) Date of specimen collection.

(c) Specimen type and site, as it is written on the Cytology Requisition form.

This information must be recorded on the side of the specimen container and not the lid. If a specimen is known or suspected to contain unique or extreme biohazard  the container shall be so marked. The referral lab does not perform cytology testing on CJD cases. In some cases the specimen may be held for processing until  CJD results are confirmed to be negative.

I.3. Document total volume of fluid received on the cytology requisition

I.4. Place specimen containers in a biohazard bag (if applicable). The requisition should be placed in the outer pouch of the biohazard bag.

I.5. Transport specimen to the Triage area of the laboratory as soon as possible.  

I.6. Inform the triage staff that you have delivered a specimen.

Monday to Friday 

Small volume specimens <40ml. Add  cytolyte fluid to specimen. 

41-90 ml. Half of the specimen is combined with equal amounts of cytolyt. the other half remains fresh for cell block preparation.

 >90 ml. Pour off into 2 labelled 90 ml sterile containers and let settle for two hours refrigerated.  For the first bottle: Gently pour off and discard the top 40 ml to retain 40 ml of cellular rich fluid. Top the bottle with cytolyt solution. The second bottle is to remain fresh for cell block preparation.

The specimen description should be recorded including, colour, quantity and any other feature worth noting.