Examination of cellular material harvested from body fluids is one tool for early detection of cancer and other pathologic conditions. Some sites and specimens are easily accessed and lend themselves readily for Cytologic evaluation, thus eliminating other more invasive procedures. Other sites are more difficult to access and more expensive to obtain. Whichever the case, it is imperative that these specimens are handled with care to preserve cellular detail.

The fixatives of choice in this laboratory are Carbowax based fixatives. Carbowax is a polyethylene glycol solution, which protects the cells from air-drying during processing. Carbowax occupies submicroscopic spaces in the protoplasm of a cell and prevents shrinkage and distortion of the cell.

We use a commercially prepared fixative by TriPath Care Technologies for large volumes. Bottles of fixative from our laboratory will be labeled as: Carbowax Fixative- CytoRich Blue Preservative or Carbowax Fixative- CytoRich Red Preservative. We also supply commercially prepared spray bottles for smears. A MSDS will be provided for each type of fixative upon request.


  1. Ascites Fluids
  2. Breast Aspirations
  3. Bronchial Washing and Brushings
  4. Cerebrospinal Fluids
  5. Gastric Washings and Brushings
  6. Urines
  7. Pleural/Peritoneal Fluids
  8. Thyroid Aspirations
  9. Other assorted aspirates and fluids


All body fluids specimens must be properly identified with the following information written on the specimen container (not the lid):

  1. Patient’s first and last name
  2. Source of specimen
  3. Physician
  4. Date of specimen collection


Every effort will be made to resolve problems occurring due to labeling and/or identification. Specimens may be rejected for the following reasons:

  1. No requisition is available
  2. Inadequate identification
    1. Different names on sample, smears(s), container and /or requisition that cannot be clarified by the Physician’s office or hospital.
    2. Attending Physician cannot be identified.
  3. Specimen cite not labeled correctly. (Does not correlate with requisition.)
  4. Specimen not fixed properly
  5. Specimen received from an unauthorized source


  1. Carbowax fixatives: CytoRich Blue Preservative and CytoRich Red Preservative
    1. Supplied by the Cytology Department of WPM Pathology Laboratory
    2. See bottle for shelf life
  2. Bottle of Spray Fixative (a Carbowax type)
    1. Supplied by the Cytology Department of WPM Pathology Laboratory
    2. See bottle for shelf life
  4. Labels for containers
  5. Permanent fine tip marker or pencil
  6. 50 ml tubes or 120 ml containers OR 30 ml FNA Collection Vials pre-filled with CytoRich Red


All fluid specimens collected for cytologic examination in our laboratory need to be fixed immediately after collection in an equal amount of a Carbowax based fixative, using either CytoRich Blue for non-bloody fluids or CytoRich Red for Fine Needle Aspirations (FNA) and other bloody fluids.

  1. No minimum specimen volume is required.
  2. Aliquots of a reasonable size of no more than 120 ml are requested from large volume fluids. Please include all clotted material.
  3. An equal amount of fluid and preservative is necessary for proper fixation. With small specimen volumes, more fixative may be used for ease of handling.

The following guidelines further describe the best technique for our laboratory.

  1. ASCITES: Equal amounts of ascites fluid are should be fixed in CytoRich Blue. If a large volume is present, an aliquot of no more than 120 ml may be sent to the cytology department. Please be sure to include all clotted material.
  2. BREAST FLUIDS: All breast aspirates may be suspended in our pre-filled CytoRich Red vials that contain 20 ml of fixative. Aspirations from different sites need to be placed in individual vials and labeled as to specific site. You may request FNA Collection Vials through WPM.
  3. BRONCHIAL WASHINGS AND BRUSHINGS: Add approximately 20 ml of CytoRich Blue to the bronchial wash. You may add this directly to the collection tube. The brush(es) may be dropped into a different container that is filled with CytoRich Blue.
  4. CEREBROSPINAL FLUIDS: For ease of handling, CSF may be added to a larger volume (approx. 10 ml) of CytoRich Blue. A neutral tube works well for CSF fixation and transport.
  5. GASTRIC WASHINGS AND BRUSHINGS: An equal amount of CytoRich Blue is added immediately to gastric washings. Brushes may be dropped into containers filled with CytoRich Blue.
  6. NIPPLE DISCHARGE: Most discharges may be expressed directly into our pre-filled CytoRich Red vials. If you prefer, a couple of drops may be smeared across a slide and immediately fixed with a spray cytology fixative. NOTE: It has been our experience that even a couple of drops in a vial of fixative produces better results than direct smears. Our monolayer processing technique assures good adherence of cells to the slide.
  7. PLEURAL AND PERITONEAL FLUIDS: Aliquots of reasonable size may be removed from large volumes of fluid. Mix well and add equal amounts to CytoRich Blue. All clotted material must be submitted, also, in equal amounts of fixative for cellblock preparation.
  8. SPUTUMS: Sputums should be collected in approximately two ounces of CytoRich Blue. A sputum cup works best for this purpose because of the wide mouth. Sputa are easier to obtain in the morning right after the patient has risen. It is advisable to have the patient rinse mouth to avoid food contamination.
  9. THYROID ASPIRATIONS: Thyroid aspiration should be added to our pre-filled CytRich Red vials. Aspirations from different sites need to be placed in individual vials and labeled as to specific site. You may request FNA Collection Vials through WPM.
  10. URINES: Urines may be collected any time of the day after the first morning voiding. Equal amounts of urine and CytoRich Blue are mixed in a 90 ml or 120 ml specimen container.

Universal health precautions should always be followed when handling specimens and fixatives.


When properly fixed, all body fluids are stable at room temperature. You do not need to refrigerate a specimen with an equal volume of fixative.


All specimens should be placed into a proper, leak-proof primary container with a secure leak-proof lid that is tightly screwed on or fastened. Select the appropriate size of specimen container for the amount of fluid to be submitted. WPM Pathology Laboratory provides a variety of containers for specimen collection. Care should be taken by the person collecting the specimen not to contaminate the outside of the container.

Properly identify the container using the instruction listed above.

When multiple specimens are to be examined and diagnosed individually, each specimen must be submitted in a separate, appropriately labeled container.

Before being transported to WPM, the primary is to be placed into a secondary container (specimen transport bag), which will contain the specimen if the primary container breaks or leaks in transit to the laboratory, unless the specimen is too large. WPM provides specimen transport bags (biohazard) for use as a secondary container.

Transport to WPM, along with a properly filled out WPM SURGICAL PATHOLOGY & NON-GYN CYTOLOGY request form.


Specimens are processed upon receipt, and test results are reported to clients after they are released. Most body fluids will have a report issued within one or two working days after receipt. Specimens requiring special stains, immunohistochemistry, or outside pathology consultation will require more time.

Selected test results are telephoned as soon as they are available. Reports may be faxed as soon as they are available, and followed up with a hard copy via courier or mail. Reports also are available by secured Internet site for those wising to use this option. Clinicians also may call for results.


ASCITES: CytoRich Blue and all clotted material

BREAST FLUIDS: Pre-filled FNA Collection Vials- CytoRich Red




NIPPLE DISCHARGE: Pre-filled FNA Collection Vials- CytoRich Red or spray cytology fixative

PLEURAL AND PERITONEAL FLUIDS: CytoRich Blue and all clotted material

SPUTUMS: CytoRich Blue

THYROID ASPIRATIONS: Pre-filled FNA Collection Vials- CytoRich Red

URINES: CytoRich Blue

contact us

  • WPM Pathology Laboratory
  • 338 N. Front St.
  • Salina, KS 67401
  • 785.823.7201