Allina Laboratories

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ANAL CYTOLOGY=

(NonGyn Cytology)

ANAL SMEAR Epic CYTOLO= GY/LAB6301 Star 6301

ANAL THINPREP® FOR CYTO= LOGY Epic CYTOLOGY/LAB6301B Star 6301

FOR ANAL HPV ONLY Epic L= AB6595

DEPARTMENT= : &= nbsp; Cytology=

&n= bsp;

CONTAIN= ER: &= nbsp; &nbs= p; Smear: Clean frosted-end glass slide labe= led with patient’s name, date of birth, and source using pencil, not ink or marker.

        &= nbsp;           &nbs= p;           ThinPrep: ThinPrep® vial labeled with two patient identifiers and source (Hospitals obtain from Lab Pathology Departm= ent; Clnics from Allina Ref Lab).<= /h2>
&n= bsp;

INSTRUC= TIONS:        &= nbsp;        For Anal Smear (Specify Anal Smear for Cytology):

1.   = Have spray fixative (used to fix ce= rvical smears in women) or a small jar of 95% ethanol present prior to the start of the exam.

2.  &n= bsp; Insert a water-moistened Dacron fiber swab (preferred over cotton swab because it releases its cell yield more easily and the plastic handle is less likely to splinter or break) or cytobrush into the anal c= anal 5-6 cm.

<= span style=3D'font-size:10.0pt'>(A swab of the peri-= anal skin is an unsatisfactory sample for anal cytology evaluation). Use a twirling motion and gentle pressure on the anal canal walls to maximize cell yield.<= /p>
3.  &n= bsp; Spread material on labeled slide and spray fix immediately or place slide immediat= ely into 95% alcohol for 10 minutes.

4.  &= nbsp; Allow slide to dry thoroughly; then place in slide holder for transp= ort to lab.

For Anal ThinPrep : <= /span>Indicate if specimen is for Anal ThinPrep ONLY, Anal ThinPrep AND HPV, or HPV Only.<= span style=3D'mso-spacerun:yes'> FOR ANAL HPV ONLY collect specimen in Digene vial using the brush provide= d.

1.      = Have ThinPrep® vial (or Digene vial) available and labeled prior to start ofexam.

2.      = For ThinPrep® co= llection: = Follow step 2 above.

=                 = After collecting the specimen, place swab/brush directly into container of Cytolyt™, vigorously swirling the swab/brush while pressing against the wall of the container.

  &nbs= p;             = Discard Dacron swab/ brush and re-cap the ThinPrep vial= .

= 3.  &= nbsp; For Di= gene HPV collection: Use the b= rush provided with the Digene vial to collect the specimen. Place brush in vial= .

4.   = Send ThinPrep vial or Digene vial to lab.

HPV test on anal specimen will be sent to Mayo.<= o:p>

<= span style=3D'font-size:10.0pt'>REPORTING

<= span style=3D'font-size:10.0pt'>INTERVAL: &= nbsp;           &nbs= p;             = Within 48 hrs of receipt for Cytology. Separate report for HPV test.

<= span style=3D'font-size:10.0pt'>

<= span style=3D'font-size:10.0pt'>REFERENCE

<= span style=3D'font-size:10.0pt'>VALUES: &nb= sp;            =             &nb= sp;    See pathology report.

<= span style=3D'font-size:10.0pt'>SPECIMEN

<= span style=3D'font-size:10.0pt'>REJECTION: =             &nb= sp;           Unla= beled specimen.

<= span style=3D'font-size:10.0pt'>

<= b>CPT 88160 Smear    CPT 88112 ThinPrep

<= span style=3D'font-size:10.0pt'>

<= span style=3D'font-size:10.0pt'>Reviewed by:

10/99 Linda Wennerstrom, CT (ASCP)            =         &= nbsp;       2/01 Linda Wennerstrom, CT (ASCP

2/00 Li= nda Wennerstrom, CT (ASCP)   &nb= sp;                   &= nbsp;       2/02 Linda Wennerstrom, CT (ASCP)

2/03 Li= nda Wennerstrom, CT (ASCP)   &nb= sp;            =             &nb= sp; 6/05 Revised: Linda Wennerstrom, CT (ASCP)

2/04 Li= nda Wennerstrom, CT (ASCP   &nbs= p;            &= nbsp;           &nbs= p;   6/06 Revised: Linda Wennerstrom, CT (ASCP)

2/05 Li= nda Wennerstrom, CT (ASCP   &nbs= p;            &= nbsp;           &nbs= p;   10/07 Revised: Linda Wennerstrom, CT (ASCP)