Cytology, Urinary Tract


Sunquest Code:NGNCTCoPath Code:NGYN
Epic Code:LAB1001Epic Name:Cytology Non Gyn
Synonyms:Urine Cytology; Decoy Cells; Voided Urine; Catheterized Urine; Urinary Bladder Washing; Urethra Washing; Ureter Washing; Renal Pelvis Washing
Methodology:Preparation, staining and microscopic evaluation
Turnaround Time:Performed Mon-Fri, 0800-1500; results are reported within 1-2 days.
Special Instructions:Provide pertinent clinical history.


Collection Instructions

Specimen:Voided urine, catheterized urine, bladder washing, ureter washing, and renal pelvic washing
Optimal Volume:10 mL or more (Cytology NGNCT only) and 35  mL or more (Cytology NGNCT with FISH)
Container:Plastic leakproof container, sterile (ThinPrep UroCyte urine collection kit)
Collection Instructions:
Use ThinPrep Urocyte urine collection kit only if NGNCT order states "Urine Cytology with FISH".

Urine Cytology NGNCT Only:
  • Add an equal amount of 50-100% ranged ETOH (If ETOH is not available, specimen must be received in lab during business hours, Mon-Fri 0800-1500). Record on the specimen container that fixative has been added.
  • Clean catch voided (preferred) or catheterized urine
  • A first morning voided specimen is not suitable.
  • For ureteral specimens, always sample both ureters so other ureter can be used as a control.


Urine Cytology NGNCT with FISH:
  • Clean catch voided, catheterized urine, bladder and ureter washings ONLY.
  • It's recommended that at least 35 mL of urine is collected to ensure adequate sampling.  If a urine sample is 35 mL or less, Cytology order (NGNCT) will be cancelled, and FISH order will be performed only (FISHCT).  Submission of a suboptimal volume (less than 35 mL) may result in insufficient cellular material required to render a diagnosis.
  • Collect in Thin Prep Urocyte urine collection kit container available from UMMC Client Services (612-273-7838). Note: Do not collect urine after cystoscopy to avoid lubricant contamination.


Intraoperative washings/brushings of urinary bladder, urethra, ureters or renal pelvis:
  • Add an equal amount of 50-100% ranged ETOH (If ETOH is not available, specimen must be received in lab during business hours, Mon-Fri 0800-1500). Record on the specimen container that fixative has been added.
  • Always sample both ureters so other ureter can be used as a control.
Causes for Rejection:Undue delay in transport; incorrect fixative used (exception: ureteral or ureteral brushing specimens will be processed but may be suboptimal).


Processing and Shipping

Specimen Processing:Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature.
Stability:Specimen must be processed ASAP. Store in refrigerator.
Test Performed at or Referral Lab Cytology  (UMMC-East Bank, St. Joseph's)


Interpretive

Reference Range:Reported as negative for High Grade Urothelial Carcinoma to High Grade Urothelial Carcinoma,
Use:Establish the presence of primary or metastatic neoplasms, characteristic viral cytopathic effects that include Human polyoma virus, Herpes simplex virus, usually type II, but also type I, cytomegalovirus and human papillomavirus (HPV).


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