Cellular Pathology – Cytology and Andrology

Cytology is the study of cells. Cells may be shed by the body naturally for example in urine, or obtained from body organs/cavities by the use of a fine needle.  Cell preparations are stained and examined microscopically for changes which may indicate disease. The disciplines within Cytology are Non-gynaecological cytology, Andrology and Synovial fluid for crystals.

Cell Pathology - Cytology Department Equipment Cell Pathology - Cytology Department Equipment

Cell Pathology - Cytology Department Equipment

We are a UKAS accredited laboratory no 9009 and conform to standards ISO 15189:2012.

Laboratory Location and Working Hours

We are located on the first floor of the Pathology building. The Cytology laboratory is open Monday to Friday, 9.00 am – 5.00 pm. It does not open at weekends. Tel 01253 956953 (ext 56953).

The majority of Non Gynaecological samples and Synovial fluids are generated in the hospital and are delivered to the laboratory by hospital staff. Samples from GP surgeries arrive by van transport. If samples are received in Cytology by 2.00 pm, they are usually processed the same day.  If they arrive later, they are refrigerated and processed the following day.

Andrology samples are brought to the laboratory by the patient. Information can be found in the Post Vasectomy and Fertility Investigations packs issued by the laboratory to service users.

Services Provided by Cytology

  • Non Gynaecological Cytology is a diagnostic service and we currently process around 2500 samples a year. We look for the presence of abnormal cells in patient samples from various body sites. Obtaining a specimen for cytological analysis is often performed by using a relatively non-invasive procedure, which can be done in a clinic setting, for example a fine needle aspirate. The specimens are processed and then analysed by our Consultant Pathologist staff. Non-Gynaecological Cytology serves as a valuable diagnostic tool to assist in the diagnosis or confirmation of a variety of pathologies, it may determine the course of treatment required, and facilitate the monitoring of disease.
  • Synovial fluid specimens are examined for the presence of the two most common crystals identified are Monosodium urate which is indicative of gout, and Calcium pyrophosphate which may indicate pseudogout.
  • Andrology seminal fluid samples received may be tested for sperm clearance following a post vasectomy operation, or an assessment of the number and quality of sperm as part of an investigation into fertility.

Andrology

The Cytology department processes approximately 690 seminal fluid samples per annum. The types of test performed are:-

  • Post vasectomy – Seminal fluid samples are examined post vasectomy, at a specified interval set by the clinician for the presence/ absence of sperm
  • Vasectomy reversal – this test is to check if a reversal of a vasectomy operation has been successful
  • Fertility investigations – the seminal fluid sample is assessed for the number and quality of sperm
  • Haematospermia– this test detects if there is blood in the seminal fluid sample which could be due to a number of causes.

The Andrology appointment system.

Please note that there is an appointment system for Andrology testing. The number to call for an appointment is Pathology front reception is 01253 956847 or extension 56847.

Patient information packs for post-vasectomy testing and fertility investigations

There are two packs available, one for the post-vasectomy test and one for fertility investigations. They may be obtained from Pathology reception on 01253 956847 extension 56847. The packs contain a screened specimen container, a plastic bag to transport the sample and a patient information leaflet. The leaflet explains in detail how to make an appointment, produce the sample and how to transport and deliver it to Pathology reception.

Important Documents to bring to front reception with the semen sample.

1 A fully completed request form.

The GP/clinician must issue a fully completed test request form to the patient in addition to the pack. The request form must have as minimum three identifiers linking the form to the sample container:-

  • Full name.
  • Date of birth
  • Hospital/NHS number.

It is advisable to use the Cyberlab system to generate a barcoded electronic request form. Seminal fluid analysis requesting is found under Non-Gynaecological Cytology. Use the search engine, input seminal and this should take you to the place on the system to request the test.

The screened container label must be completed using an ink pen. The Cyberlab request form has sticky printed labels which may be used to label the container.

2 The Patient Sample details slip

Once the sample has been taken, the patient must fill in the short sample details questionnaire found at the back of the patient information leaflet. The slip must be brought to front reception with the sample. The questions are:-

  • Is the sample complete?
  • What is the abstention period prior to taking the sample (two up to seven days)?
  • What time was the sample taken?

If the laboratory does not know this information, it cannot be confident that the test results are correct, and the patient may have to produce a repeat sample.

Transporting the semen sample

Semen samples are to be kept warm and delivered by the patient, within an hour of being taken to Pathology front reception.  Please note: – It is not advisable for the patient to take the sample to the GP for van transport. The delay in reaching the laboratory may affect the validity of the test.

NB. There are short-stay parking spaces (up to one hour) and disabled parking spaces located in the Pathology car park for patients delivering seminal fluid samples for analysis.

Haematospermia samples.

A fresh same day sample is required.  This may be achieved by the patient delivering the sample to Pathology front reception as per the semen analysis samples previously described.

Turnaraound time for Andrology samples.

The turnaraound time for Andrology is seven days from the receipt of the sample. The report is issued to the test requester. The patient will require contact details from the clinician/GP to find out their test results. The laboratory cannot discuss test results with the patient.

Quality Assurance

Cytology is part of the Cellular Pathology department within the Pathology directorate.  It a UKAS accredited laboratory no 9009 and conforms to standards ISO 15189:2012.

National External Quality Assurance Schemes (NEQAS);

  1. NEQAS Reproductive Science run by Central Manchester University Hospitals
  2. NEQAS for Cellular Pathology Technique (NEQASCPT) run by The Queen Elizabeth Hospital, Gateshead. The scheme organiser is Dr Chantell Hodgson
  3. Diagnostic Non Gynaecological Cytology (NEQASCPT) Cytology is part of a pilot scheme.

The Cytology staff perform internal quality control and quality assurance procedures. The Quality Management System is monitored by the performance of regular internal quality audit.

Turnaround Times for Non-Gynaecological Cytology.

Cytology deals with urgent, GP fast track and routine samples.

The Royal College of Pathologist’s guidelines on turnaround times state that 80% of cases are to be reported within seven calendar days and 90% of cases to be reported within 10 calendar days.

In some cases further diagnostic work is required, which may delay the final report. However in such cases the laboratory/ reporting consultant may be contacted and a preliminary report may be issued. This may require the clinician to provide a phone or bleep number. Also it must be understood that the preliminary report may be subject to change pending the outcome of further tests.

Hard copy Cytology reports are printed and sent out daily to the GP/Consultant who requested the test. There are also electronic links to the report via the hospital/laboratory interfaced information systems.

Updated KM Davies 19/02/2019 More information can be obtained by accessing the Pathology SharePoint website under Pathology:Cellular Pathology Cytology.