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Cytology, Anal PAP

Additional Codes

48544

Reporting Title

Cytology, Anal PAP

Methodology

Papanicolaou Stain

The use of anal cytology in evaluation of HPV-related lesion is a relatively new tool. Its usefulness is still being investigated although studies indicate possible benefit in the screening of persons at risk for HPV-related anal carcinoma. The target of anal sampling includes the anal canal including keratinized and non-keratinized portions and the anal transformation zone.

Cellularity and cellular constituents of an adequate anal specimen have not been well defined. Cellular composition of these preparations includes anucleate, nucleated, and metaplastic squamous cells and rectal columnar cells. Lack of cell preservation and contamination with bacteria and fecal matter may compromise evaluation. A specimen composed predominantly of anucleated squamous cells may not be satisfactory for evaluation. Liquid-based collection may increase cell yield and allow for more accurate evaluation, as well as reduce compromising factors such as poor fixation or obscuring fecal matter.

Performing Laboratory

OhioHealth Laboratory Services-Cytopathology

Specimen Requirements

Note:  No specific literature exists regarding appropriate sampling device for anal cytology. Both Dacron® fiber swabs and cytobrushes have been used for sampling. Dacron® swab is reportedly better tolerated by patients than cytobrush. Dacron® swab is recommended over a cotton swab because it releases cells more readily.

1. For liquid-based preparations, specimen should be collected using a cytobrush or Dacron® swab and submitted in PreservCyt® vial.

2. Label holder/vial with patient’s name (first and last), date of birth, and type of specimen.
3. Maintain sterility and forward promptly at ambient temperature.

Note:  

1. Please complete a “GYN CYTOPATHOLOGY REQUEST” form and include the following:

A. Patient’s name (first and last)
B. Date of birth
C. Date of collection
D. Source of material (Indicate source as “other” and write in “perianal.” Perianal sampling is not sampling of the anal canal and should be designated as a “perianal” rather than anal sample)
E. Physician’s name
F. Pertinent clinical information including previous malignancy, drugs, radiation therapy, and history of alcohol abuse
2. Place specimen in a plastic specimen bag with request form inserted into pocket separate from specimen.

Specimen Transport Temperature

Ambient/Refrigerate OK/Frozen NO

Reference Values

Negative for intraepithelial lesion and malignancy

Day(s) Test Set Up

Monday through Friday

Test Classification and CPT Coding

88112