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Pap Test, ThinPrep®

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

Test Codes

EPIC: LAB6674

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 Cytologic interpretation is ASCUS/ASCH/AGC.

  2. HPV testing if the final Cytologic interpretation is Abnormal.

  3. HPV cotesting- This option requires placing an order for HPV DNA detection (LAB6847). 

• 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:
  • Dearborn: 313-436-2369
  • Farmington Hills: 947-521-8249
  • Grosse Pointe: 313-473-1801
  • Royal Oak: 248-898-9035
  • Taylor: 313-295-5365
  • Trenton: 734-671-3868
  • Troy: 248-964-9050
  • Wayne: 734-467-4275
  • 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 an EPIC specimen label 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 “CYTOLOGY PAP TEST (THIN PREP)” and fill in all appropriate fields. Label specimen container and requisition with EPIC specimen 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. Place an EPIC specimen label on the requisition.

Physician Office/Draw 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

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.

Inpatient Specimen Preparation

Farmington Hills

• Deliver the specimen directly to the Anatomic Pathology Department.
• After 4:30 pm and on weekends/holidays, deliver to Laboratory Central Processing.

Grosse Pointe

• Deliver the specimen directly to the Clinical Pathology Specimen Processing area (lower level).

Royal Oak

• Deliver specimen directly to the Cytology Laboratory (Research Building, lower level)
• Monday – Friday, 6:00 am – 4:30 pm or to Clinical Pathology Specimen Receiving (located on the first floor of the Beaumont Laboratory Research Building).
• Specimens are also picked up from the surgical floors, Endoscopy and Clinical Pathology Monday – Friday, 8:00 am – 7:00 pm, Saturday, 7:00 am – 11:00 am, NT and Endoscopy ONLY.

Troy

• All specimens must be delivered to the Specimen Reception department (tube station #201; phone number: 248-964-8030, or x48030).
• Specimens are also routinely picked up throughout the day from the surgical floors and Endoscopy, Monday – Friday, 8:00 am – 4:00 pm.

Dearborn

• Deliver the specimen to the main lab drop off window and sign in. Open 24/7.
• Deliver directly to Cytology, Monday – Friday, 7:00 am – 4:30 pm. 
• Deliver directly to Histology lab, Monday – Friday open 24 hours, Saturday 8:00 am – 12:00 pm, closed on Sunday.
• Specimens are also picked up throughout the day from the surgical area and endoscopy. Monday – Friday, 6:00 am – 4:30 pm, Saturday 8:00 am – 12:00 pm.
• When the Cytology lab is closed specimens must be delivered to the main lab window and signed in.

Taylor

• Deliver to histology 8:00 am – 2:00 pm. 
• After hours:  Deliver the specimen to the main lab. Open 24/7.

Trenton

• Specimens are picked up from Emergency Dept., Interventional Radiology, and operating rooms from 8:00 am – 2:00 pm.
• After hours deliver specimens to the main lab. Open 24/7.

Wayne

• Specimens are picked up from Emergency Dept. and Interventional Radiology from 8:00 am – 2:00 pm.
• After hours deliver specimen to the main lab. Open 24/7. 

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

Royal Oak Cytology Laboratory

Farmington Hills, Grosse Pointe and Troy paps are sent to Royal Oak Cytology Laboratory for preparation and screening. Pap final results are issued at Royal Oak, Farmington Hills, Grosse Pointe and Troy.

Dearborn Cytology Laboratory

Taylor, Trenton and Wayne specimens are sent to Dearborn Cytology Laboratory for preparation, screening and issuing final results.  

Performed

Monday – Friday, 6:00 am – 4:30 pm. (Royal Oak).
Monday – Friday, 7:00 am – 4:30 pm (Dearborn).
 
Most results are available within 48 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 pm on Friday will be processed the following Monday and resulted on Tuesday. Specimens received after 3:00 pm the day before a holiday will be processed the next working day and resulted out within 48 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 Codes

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

Contacts

Last Updated

3/17/2021