ANATOMIC PATHOLOGY


Just as we have earned our reputation for pioneering new technologies and offering our clientele new opportunities for diagnostic efficiencies as they have unfolded in the clinical laboratory, so too have we applied those same principles in anatomic pathology. HLC was among the first of the West Coast laboratories to offer automated cytology screening using the AutoPap instrument from Tri-Path Imaging. The AutoPap screen, combined with manual slide examinations of all suspicious slides, performed by our trained, fully licensed cytotechnologists staff, has dramatically improved HLC's effectiveness in detecting abnormal conditions.

Our staff of expert board certified clinical and anatomic pathologists, including William Temple, M.D., HLC's Medical Director and Sylvia Suzuki, M.D., a board-certified cytopathologist, provides similar expertise and efficiency in biopsy services. Consultative services are also available, as needed, to satisfy the most demanding of practitioners.

In addition to conventional cytology we also offer ThinPrep®, a liquid-based cytology from Cytyc Corporation. This can be further enhanced with Cytyc's new computer-assisted screening where the cytotechnologist also retains final diagnostic control. The liquid-based cytology offers the clinician the ability to have additional tests for sexually transmitted diseases performed on the same specimen: "high-risk" Human papillomavirus, G.C., Chlamydia, Herpes and Cystic Fibrosis.

CYTOLOGY SPECIMENS

New technology exists, which is becoming the industry standard, to improve GYN cytology sensitivity and specificity through the liquid cell suspension-monolayer smear technique. Using liquid cell suspension collection scrapers and brooms available through the laboratory, representative cells from the vaginal vault, cervical scraping and endocervical junction are transferred from the collection broom directly to the fixative liquid container.

Traditional Papanicolaou (PAP) smears are still available and should be submitted on a frosted-end slide labeled with the patient's name. Representative specimens, thinly spread on the slide(s) collected from the vaginal vault, cervical scraping or brushings and endocervical junction. The slide must then be fixed with liquid or spray cytology fixative available from the laboratory. In the absence of fixative, 96% alcohol in water may be used as a suitable fixation medium.

Regardless of collection technique, California State Regulations and Federal CLIA Regulations require patient name on the slide itself and fixative bottle and the following information to be provided on the request form:
1. Patient's name.
2. Age and/or date of birth of the patient.
3. Last menstrual period start date (LMP)
4. Source(s) of the smear.
5. Date of previous Pap smear.
6. Clinical information (pregnancy, hormone reactions, birth control?)
7. Patient history (previous abnormal Pap's, history of HPV or other STD?)



NON-GYN CYTOLOGY

Sputum cytology specimens are ideally preserved using the new liquid cell suspension system used for GYN cytology. (Please be sure to identify the sample as a SPUTUM CYTOLOGY directly on the sample container). Alternatively, the fluid may be fixed in 50% alcohol in water and submitted in its entirety in a sterile, screw-capped container.

Aspiration specimens (fine-needle aspirates) are ideally preserved using the new liquid cell suspension system Non-GYN ThinPrep® cytology (green-colored band on vial). Please be sure to identify the sample as an ASPIRATION BIOPSY directly on the sample container. Containers must identify the source and the patient's name. Alternatively, the fluid may be submitted as a smear, fixed immediately with cytology fixative or aqueous 50% alcohol; or may be injected directly into aqueous 50% alcohol in a sterile tube.

In order to provide the highest quality service on histopathology submissions, the following information is required on the request forms:
1. Name of the patient.
2. Date of Birth.
3. Biopsy site.
4. History of lesion.
5. Is this a re-excision? (If so, please provide accession of previous biopsy)
6. Last menstrual period start date (LMP) on endometrial specimens.



HISTOPATHOLOGY (BIOPSY) SPECIMENS


Biopsy specimens are typically submitted in 10% neutral buffered formalin screw-capped containers available in several different sizes from the laboratory. When multiple biopsy containers are being submitted on the same patient, it is absolutely imperative that each vial be separately labeled with the source of each biopsy.

Never place biopsies from different anatomic sites (e.g. multiple pigmented lesions from different sites) in the same container. Each biopsy should be placed in a separate container with the site clearly identified on the container and each site must be noted on the requisition.