Cytology - Anal Pap Test
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| WSLH Department: | Cytology |
| WSLH Test Code: | 93801 BRUSH |
| Day(s) Performed: | Monday-Friday |
| Turn-around Time: | 7 days |
| Recommended Uses: | Evaluation of rectal smear for premalignant, malignant, infectious, and inflammatory changes in patients of all genders, including men who have sex with men (MSM), those with previously identified HPV related lower anogenital tract disease, and those with HIV infection, immunosuppression or immunocompromising conditions. |
| Contraindications: | Caution should be taken in patients with known anal fissure or abscess, recent anal surgery or acute injury |
| Additional Tests Performed: |
| Patient Preparations: | If possible, advise the patient to avoid receptive anal intercourse or the use of intra-anal preparations/medication before the examination. |
| Specimen Requirements: | Collected cellular material is transferred to 20mL ThinPrep Pap test vial. Patient's full legal name, DOB and DOS must be written on the vial. |
| Specimen Handling & Transport: | Tightly seal the ThinPrep Non-GYN test vial and place in biohazard bag. Add one absorbent cloth to the bag. Place requisition form with HPV order in biohazard bag sleeve. Transport via courier or shipping carrier with a tracking option strongly preferred. Store at controlled room temperature. |
| Collection Kit/Container: |
Brushings Kit #16 and Mailers
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| Collection Instructions: | Container identification may be affixed with a label or hand printed and MUST include: full legal name of patient, DOB and DOS. Synthetic tipped swab should be used, do not use a GYN kit for this collection (do not use a BROOM or SPATULA). Obtain an adequate sampling from the anal-rectal transition zone using one of the following methods: An anal-rectal cytology specimen is collected using a synthetic tip swab (Darcon swab). Moisten the swab with sterile saline and insert 2-3 cm into the anal canal. Slowly rotate the swab in one direction with gentle pressure on the walls as the swab is slowly being withdrawn. Care should be taken to ensure that the anorectal transition zone is sampled. Once removed, vigorously rotate the swab in the PreservCyt� vial 10 times while pushing against the wall of the ThinPrep� vial. Swirl the swab vigorously to release additional material. Discard the swab. Tighten the cap on the ThinPrep� PreservCyt� solution container so that the torque line on the cap passes the torque line on the vial. Be sure to specify source of specimen on the test request form. |
| Unacceptable Conditions: | Unlabeled and/or leaking specimens will not be tested. |
| Requisition Form: |
WSLH Cytology Form 141
|
| Required Information: | Laboratory regulations require the following minimum information to be provided on the requisition form for a specimen to be accepted for testing: Patient name or unique identifier; date and time of collection, patient date of birth and sex, specimen type/site of collection, test request(s), clinician name and UPIN, and address for reporting results. Please be certain that name/identifier on the form matches that on the specimen label. |
| Results Include: | Negative for Intraepithelial Lesions or Malignancy, Unsatisfactory, Atypical Squamous Cells of Undetermined Significance, Atypical Squamous Cells cannot rule out High Grade Lesion, Atypical Glandular Cells of Undetermined Significance, Low Grade Squamous Intraepithelial Lesion, High Grade Squamous Intraepithelial Lesion, Endocervical Adenocarcinoma in situ, Positive for Squamous Carcinoma, Positive for Adenocarcinoma. Results may also include inflammatory, bacterial, and viral findings. |
| Limitations: | Specimens that do not meet basic requirements of cell volumes, or that are not well-preserved/or visualized, may be non-diagnostic and rendered unsatisfactory for evaluation. Abnormal findings must be correlated with history and other test results. As with any laboratory test, both false negative and false positive results may occur. Positive results should be confirmed with additional studies as clinically indicated. |
| Additional Tests Recommended: | At this time molecular based reflex testing is not validated at the WSLH. |
| Additional Comments: | Directly swabbing external perianal lesions may not yield enough cellular material for an adequate sample. Please follow all collection instructions. For at-risk patients, testing at regular intervals should be performed based on screening guidelines combined with clinical judgement. Abnormal results (ASCUS or higher) may be referred for additional testing such as high-risk HPV testing (not currently available for anal specimens in our laboratory) or high resolution anoscopy. References: Hirsch B, Fine SM, Vail R, et al. Screening for Anal Dysplasia and Cancer in Adults With HIV. Johns Hopkins University; 2022. Accessed April 19, 2024. http://www.ncbi.nlm.nih.gov/books/NBK556472/ Stier EA, Clarke MA, Deshmukh AA, et al. International Anal Neoplasia Society's consensus guidelines for anal cancer screening. Intl Journal of Cancer. 2024;154(10):1694-1702. doi:10.1002/ijc.34850 |
| Methodology: | Cytologic evaluation of cells from the rectum using liquid-based technology |
| Includes: | Anal Rectal specimens (ARC) |
| CPT Code: | 88112 |
| Price: | $134.00 |