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Patient Prep: Body cavity fluids are commonly evaluated for the presence of malignant cells from metastatic disease. Body cavity fluids in general are relatively easy to obtain and are relatively difficult to compromise. However, in some instances, due to a large number of inflammatory cells, specimens may degenerate rapidly. In addition, if large amounts of protein are present, the specimen may clot, trapping diagnostic cells within the clot. These fluids include pleural, peritoneal, pericardial, synovial, and pelvic washing.
Collect: Body Cavity Fluids
Indications: Detection and characterization of malignant cells in body cavity fluids.
Specimen Required: 10 mL (or more) of fluid obtained from an appropriately performed paracentesis.
Supplies: Standard paracentesis equipment. Clean collection container of appropriate size. Fixative (50% ethyl alcohol).
Collection Procedure: Using standard paracentesis technique, obtain a fluid specimen from the desired body cavity. If necessary, move the patient into multiple positions to suspend cellular material in the fluid. A minimum of 10 mL of specimen is desirable for optimal cytologic evaluation. If other studies are required, withdraw a fraction of the specimen and submit it to the appropriate laboratory separately, following their guidelines for specimen collection. Heparin may be added to the specimen to reduce clotting. Place 3 units of heparin per mL capacity of the collection container. Agitate the container to coat the sides with heparin. Rinse the paracentesis instrument with a small amount of heparin to prevent clotting of specimen before it is put into the collection container. Add specimen to the heparinized container. Gently agitate to thoroughly mix the specimen and heparin. Label the container with the patient's first and last name, date of birth, specimen type, and collection date. Submit the specimen to the Cytopathology Laboratory along with the completed Cytology test request form. If transport of the specimen will be delayed more than 24 hours, add an equal volume of 50% ethyl alcohol (if sample size is too large to accommodate this volume, a well mixed aliquot of the specimen with an equal volume of fixative may be utilized). If transport time will be less than 24 hours, or fixative is not available, the specimen should be refrigerated or kept on wet ice until transport to the lab.
Pelvic Washing
Indications: Detection and characterization of malignant cells in pelvic washing.
Specimen Required: 10 mL (or more) of fluid obtained from an appropriately performed washing.
Supplies: Standard suction equipment. Clean collection container of appropriate size. Fixative (50% ethyl alcohol).
Collection Procedure: Using appropriate sterile technique during intra-abdominal surgery, instill a physiologic solution into the pelvic cavity. Lavage the area of interest. Aspirate the solution and place in a clean container. Label the container with the patient's first and last name, date of birth, specimen type and collection date. Submit the specimen and completed Cytology test request form to the Cytopathology Laboratory. If transport of the specimen will be delayed more than 24 hours, add an equal volume of 50% ethyl alcohol. If transport time will be less than 24 hours, or fixative is not available, the specimen should be refrigerated or kept on wet ice until transport to the lab.
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