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Beaumont Laboratory

Pap Test, ThinPrep®

ThinPrep, Thin layer Pap specimen, ThinPrep Pap test, Liquid based Cytology, PAP TEST (THIN PREP), EPIC: LAB6674, SOFT: PAPT

Instructions

  • The Pap Test is a screening test for cervical cancer with inherent false negative results. Clinical judgement and follow-up of unexplained signs and symptoms are paramount.
  • For optimal interpretation a Pap Test should be collected near the middle of the menstrual cycle. A patient should be counseled to refrain from intercourse, douching, using tampons, or using intravaginal medication for at least 48 hours before the examination to decrease the possibility that the number of exfoliated cells will be diminished or obscured by personal lubricants or spermicides. In addition, the patient should avoid scheduling her appointment during heavy menstrual bleeding.
  • ThinPrep® specimen cellularity can be greatly reduced by excessive usage of lubricant or usage of lubricants containing carbomers during the collection of the pap. Surgilube and Pap Test Lubricating Jelly are preferred lubricants. K-Y Jelly (physician formula) and Surgel are compatible lubricants. All lubricants should be used sparingly and applied only to the exterior sides of the speculum blades, avoiding contact with the tip of the speculum.
  • For HPV testing from the same ThinPrep® Pap Test vial, please select one of the following choices:
    1. HPV testing if the final interpretation is atypical squamous cells of undetermined significance.
    2. HPV testing for any interpretation.
  • Chlamydia trachomatis and Neisseria gonorrhoeae testing can also be performed on the same ThinPrep® Pap Test vial. Testing must be ordered at the same time as the ThinPrep® Pap Test. It cannot be added after the ThinPrep® Pap Test has been performed.
  • The Cytology Laboratory can provide ThinPrep® vials and collection devices for specimen collection:
    • Grosse Pointe: 313-473-1850 or extension 1850.
    • Royal Oak: 248-898-9035 or extension 89035.
    • Troy: 248-964-9050 or extension 49050.
    • Outreach: 800-511-0488.

Specimen Collection Criteria

Collect: Cellular material from scraping/brushing in a vial containing 40 cc of ThinPrep® PreservCyt Solution. Ensure the solution is not expired prior to specimen collection.

  • Label the specimen container with the patient's full name, date of birth, hospital number, source of specimen, and date of test.
  • Specimen may be procured with a cervi-spatula and brush OR a broom like device.
  • For Endocervical Spatula and Brush:
    • Obtain an adequate sampling from the ectocervix using a plastic spatula. Rinse the spatula into the PreservCyt solution vial by swirling the spatula vigorously in the vial 10 times. Discard the spatula.
    • Obtain an adequate sampling from the endocervix using an endocervical brush device. Insert the brush into the cervix until only the bottommost fibers are exposed. Slowly rotate 1/4 or 1/2 turn in one direction. DO NOT OVER-ROTATE. Rinse the brush in the PreservCyt solution by rotating the device in the solution 10 times while pushing against the wall of the vial. Swirl the brush vigorously to further release material. Discard the brush.
  • For Broom-Like Device:
    • Obtain an adequate sampling from the cervix using a broom-like device. Insert the central bristles of the broom into the endocervical canal deep enough to allow the shorter bristles to fully contact the ectocervix. Push gently, and rotate the broom in a clockwise direction 5 times.
    • Rinse the broom into the PreservCyt solution vial by pushing the broom into the bottom of the vial 10 times, forcing the bristles apart. As a final step, swirl the broom vigorously to further release material. Discard the collection device.
  • Tighten the cap so that the torque line on the cap passes the torque line on the vial. Do not over-tighten the cap on the vial.
  • In house cytology specimens should be ordered in EPIC order entry. In the “additional orders” field input “PAP TEST (THIN PREP)” and fill in all appropriate fields. IMPORTANT: ORDER AND SIGN EACH CYTOLOGY TEST INDIVIDUALLY. THE LABORATORY INFORMATION SYSTEM CANNOT FILE MULTIPLE TESTS ORDERED IN THE SAME SESSION AND SOME ORDERS MAY BE LOST. Label specimen container and requisition with SOFT ID labels.
  • All Cytology specimens must be accompanied by a requisition and must include the patient name, hospital and visit number, date of birth, date of specimen collection, pertinent patient history, physician name and source of specimen.

Physician Office/Drawsite Specimen Preparation

Maintain vial containing sample and ThinPrep® PreservCyt Solution at room temperature (20-26°C or 68-78.8°F) prior to transport to the Laboratory.

Preparation for Courier Transport

Transport: Vial containing sample and ThinPrep® PreservCyt Solution at room temperature (20-26°C or 68-78.8°F).

Rejection Criteria

  • Improper labeling of specimen container or requisition.
  • Specimen not accompanied by requisition.
  • Requisitions not accompanied by a specimen.
  • Improper collection of specimen (such as improper fixation).
  • Any specimen received without all of the required information will result in a delay of processing until all information can be verified. (Date of service, date of birth, last menstrual period, etc.)
  • Specimens that leak outside of specimen container into transport bags.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 6 weeks
Refrigerated (2-8°C or 36-46°F): Acceptable, but not recommended
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Room Temperature (20-26°C or 68-78.8°F): 6 weeks

Laboratory

Grosse Pointe sent to Royal Oak GYN Cytology Laboratory for testing.
Royal Oak Cytology Laboratory.
Troy sent to Royal Oak GYN Cytology Laboratory for testing.

Performed

Monday - Friday, 6:00 a.m. - 4:30 p.m. (Royal Oak).
Results available within 24-36 hours of receipt in the Cytology Laboratory, if received Monday - Friday. The Cytology Laboratory is closed on weekends and holidays. Specimens received after 3:00 p.m. on Friday will be processed the following Monday and resulted within 24-36 hours.

Test Methodology

Thin layer cytologic preparation, ThinPrep® imaging system (Most ThinPrep® specimens are successfully imaged by the imaging system. However, up to 7% may be unsuccessfully imaged and require manual screening by a Cytotechnologist).

CPT Code

CPT: 88142 (88175 if imaged Pap, 88141 in the event of a professional review).
LOINC: 47527-7. 

Test Codes

EPIC: LAB6674, SOFT: PAPT

Last Updated

02/10/2017

Microtainer® and Vacutainer® are registered trademarks of Becton, Dickinson and Company.
UroVysion® is a registered trademark of Abbott Laboratories. ThinPrep® is a registered trademark of Hologic, Incorporated.

This directory currently reflects information only for specimens collected and/or processed at the Farmington Hills, Grosse Pointe, Royal Oak, and Troy campuses.