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Cytopathology

 

 

Welcome to the Cytopathology Department of BSPS

The department provides a comprehensive Cytopathology service to the Royal Surrey County (RSCH), 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. The service includes cervical cytology; post vasectomy + fertility testing and comprehensive range of Non gynaecological cytology tests.

Our main processing laboratory is based at St.Peters Hospital with satellite laboratories at the Royal Surrey County Hospital and Wexham Park Hospital, our opening times are.

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

The Royal Surrey County Hospital: Monday to Thursday 09:00 - 15:30

Wexham Park Hospital: Monday, 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.

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.

Gynaecological Cytopathology

The Cytopathology department of Berkshire and Surrey Pathology services provides cervical screening for approximately 120,000 LBC samples from Berkshire, Surrey, Buckinghamshire, Oxfordshire, North West London and Hampshire.  

The service runs from 08:30 to 17:00 Monday – Friday and is based at St Peter’s Hospital, Chertsey.

St Peter’s Hospital,

Guildford Road.

Lyne, Chertsey

KT16 0PZ

Tel: 01932 723542

 

The department is accredited to BS EN ISO 15189:2012

 

Samples are transported, from various GP surgeries, Colposcopy clinics, and Outpatient departments, via the BSPS transport system which operates a regular service to all hospital sites within BSPS (Ashford and St Peter’s Hospital, The Royal Surrey Hospital, Frimley Park Hospital, The Royal Berkshire hospital and Wexham and Heatherwood Hospitals)

Doctors and nurses working in primary care, family planning clinics and other settings where cervical samples are taken from patients consenting to their clinical information being sent to Colposcopy when a direct referral is made, as part of the NHS Cervical Screening Programme (NHSCSP) should undertake the NHSCSP smear taker training course. As part of this training they will be given a sample taker code which should be included on the request form. The department offers laboratory visits as part of this course. Please contact margaretrashid@nhs.net to arrange an appointment.

Acceptance and Rejection Criteria

It is the smear-taker’s responsibility to ensure all samples submitted for testing meet the NHSCSP acceptance criteria (see below); the NHSCSP publication can be found at:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/669132/Guidance-for-acceptance-of-cervical-screening-samples.pdf

  • All cervical cytology samples must be received in Hologic Thin Prep Vials.
  • All cervical samples should be taken mid cycle whenever possible, since early cycle smears can contain menstrual material that may result in an inadequate test, and late cycle samples contain degenerate cells that can compromise the accuracy of the test result.
  • Care must be taken during sample collection not to spill any of the fluid in the vial as loss of fluid may result in sample rejection.
  • Ideally ICE request forms should be used at all times, where these are not available HMR101 forms printed from the Open Exeter system are an acceptable alternative.
  • Only fully labelled samples i.e. 3 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.
  • Only in date vials will be accepted.
  • Samples in a vial containing a brush head will only be reported if the test is abnormal.
  • Samples over 6 weeks old on the day of receipt will not be processed.
  • Samples from patients less than 24.5 years old will not be processed unless they are already participating in the screening programme.
  • Samples for patients over 65 will also not be processed unless the test is part of follow up after abnormal or patient missed their last test and would now wish to be screened.
  • Samples from patients who have had a negative, normal recall smear in the last 2 years will not be processed, even if patient has clinical details stating Post Coital Bleeding (PCB) or Post-Menopausal Bleeding (PMB). These patients should be referred to see a Gynaecologist.
  • Following an inadequate test result no further cervical cytology samples should be collected for a period of 3 months from the initial test date. Samples collected sooner than 3 months will not be processed.
  • HIV +ve patients should be screened annually, in order to ensure these tests are accepted the text “High Risk Patient” must be included in the clinical details section of the request form.

For all Gynaecological enquiries see below.

Enquiry

Area

Telephone Number

Clinical advice.

Dr B. Shambayati

Consultant Clinical Scientist     

01932 723051

Results

Cytology offices

RSCH  01483 571122 x4260

ASPH  01932 723542

or 01932 723068

Laboratory enquiries

Steve Blackman

Lead BMS Cytology

01932 723542

 

Laboratory Gynae Cytology (LBC) turnaround times

We aim to achieve the NHSCSP target of a minimum 98% reported within 14 calendar days (including subsequent HPV testing.

Non-gynaecological Cytopathology

Please note that:

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.

Acceptance and Rejection Criteria

  • Only fully labelled samples i.e. 3 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.
  • 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.
  •  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 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.

SPH Non-gynaecological Cytopathology

The Royal Surrey, Frimley Park, 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.

Dr B. Shambayati

Consultant Clinical Scientist     

01932 723051

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 department at RSCH and flow Cytometry by the

Immunophenotyping department at the Royal Marsden.  

 

Specimen requirements for Non-gynae samples

  • Urine

A single specimen of freshly voided mid-morning submitted in a 25ml 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.

  • 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 + endoscopy.

Washings taken at the time of bronchoscopy are preferable and should be added to the preservative container provided, a 5-10ml minimum volume is recommended. 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 washed off into another the preservative container, all of which must be clearly labelled with the patients 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. 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 provide 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.

  • FNA’s.

We provide FNA support for EBUS, 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 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 needle should be washed out into the preservative bottle 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.

 

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

Monday – pm

Tuesday – pm

Wednesday – am

Friday – am

EBUS

Frimley Park Hospital

Monday – am

 

Head and Neck/ Thyroid

Royal Surrey County Hospital

Monday – pm

 

EBUS

St Peter’s Hospital

Tuesday – am

Thursday – am

Head and Neck/Thyroid

Ashford Hospital

Wednesday – am

 

FNA – adequacy not required

St Peter’s Hospital

Runnymede Hospital

 

Ad hoc

Call on ext. 3542/3068

 

FNA – adequacy required

St Peter’s Hospital

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!

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.

Andrology Service

St Peter’s Hospital,                            Royal Surrey County Hospital                            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 invalidate the test result.

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.

        Toxicity tested container

  • Specimen transport bag.

Booking your Test

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

Royal Surrey County Hospital – 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 13.30 – 15.30

Monday – Tuesday + Thursday -Friday

9.00 – 12.00

 Monday, Wednesdays and ,Fridays

 09.00 - 15.00

 

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

RSCH: 01483 464892

SPH: 01932 723542

HWPH: 0800 0327105

Specimens to be tested at Royal Surrey County Hospital.

There are no facilities for you to produce your sample at the Royal Surrey County Hospital, you must produce the sample at home and then bring it to Cytology specimen reception in Pathology TWO at the Royal Surrey County Hospital 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.

There are no facilities for you to produce your sample at the St Peters Hospital, you must produce the sample at home and then 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.

TATs for Semen analysis

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

Cryopreservation

Cryopreservation is carried out by special arrangement via St Lukes Cancer Centre. Please contact the laboratory at the Royal Surrey County Hospital for further information on tel: 01483 571122 extn 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.