SITOLOGI
AND HISTOPATOLOGI
- The doctor sending the specimen writes down the patient's identity (at least name, gender, age and date of birth), identity of the sending doctor, location for collection, method of collection and time of collection, type of fixation fluid, clinical diagnosis, complete clinical description, history of previous anatomic pathology examinations ( if any) on the request form.
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For Histopathological tissue, the tissue specimen is inserted immediately (no later than 30 minutes) into a container that is large enough to cover the entire specimen without causing anatomic manipulation.
- The container is filled with fixation liquid in the form of 10% formalin buffer. The volume of fixation fluid must fill the entire network, so that it is completely submerged (at least the amount of fixation fluid is 10 times the tissue volume).
- If the tissue is large, parallel slices are made without breaking so that the fixation fluid can be absorbed evenly throughout the tissue.
- Fixation time depends on the size and type of tissue. If the tissue already shows a change in color (no longer reddish, and turns brown), and the consistency (touch) becomes rubbery-solid, then the fixation is complete (for at least 6 hours). The network must be perfectly fixed before entering the processing stage which is an absolute requirement. For the purposes of further examination, the tissue must be processed immediately before being submerged in formalin for 72 hours. Thus, the optimal time for fixation is 6-72 hours (according to the guidelines of the Collage of American pathologist).
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For specimens in the form of body fluids, the doctor or nurse at the sending unit ensures handling according to the following rules:
- Place the specimen in the form of liquid from the operation/aspiration in the appropriate container (Urine Pot) which has the patient's label attached and put it in a special plastic bag that does not leak, is not easily torn, and closes tightly. If there is too much liquid, then place it in a thick plastic bag, not easily torn and tightly closed and covered again with a plastic bag (Double). Then the sample is supplied with a cytology request form.
- If the liquid has not been sent to the laboratory, the liquid must be stored in the refrigerator with a temperature of 2 - 8 ˚C (not the freezer) for a maximum of 3x24 hours. Except for fluid originating from the brain (liquor cebri) it must be sent to the laboratory immediately.
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If immediate delivery cannot be made or a refrigerator is not available, then the liquid must be fixed in the fixation liquid by:
- Cytology of ascitic fluid, pleural effusion, thyroid nodule, etc => mix equal volume of fluid with 70% alcohol (1:1).
- Cytology of urine fluid => Mix the liquid with 50% alcohol in the same volume (1:1).
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For smear/smear specimens on slides, the doctor/nurse at the sending unit ensures handling according to the following rules:
- Immediately fix the slide by immersing it in 96% alcohol fixation solution for at least 30 minutes.
- Each slide must be coded or marked so that it is not mixed up if there is more than one patient or if there is more than one organ location.
- Write in the form the number of slides sent and the type of fixation.