Cytopathology

Cytopathology Laboratory, Level 4, Sarawak Daycare Centre of Sarawak General Hospital

Contact number

Receiving counter: 082-276606 or Ext no. 41201/ 3115

Monday to Thursday: 8.00 am to 12.45 pm, 2.00 pm to 4.45 pm

Friday: 8.00 am to 11.30 am, 2.15 pm to 4.45 pm

Saturday/ Sunday/ Public holiday: Closed

Laboratory Turnaround Time (LTAT)

1. Reports for urgent gynaecological Pap samples: 14 working days

2. Reports for routine gynaecological Pap samples: 30 calendar days

3. Reports for urgent non-gynaecological/FNAC samples: 3 working days

4. Reports for routine non-gynaecological/FNAC samples: 14 calendar days

5. Reports for seminal fluid analysis: 3 working days

Note:

LTAT depends on the number of pathologists on duty and workload, and may not be achieved due to the following circumstances:

1. Cases requiring additional processing such as cell block, special stain, and immunocytochemistry

2. Electricity or water supply disruption

3. Natural disasters

4. Disruption of Internet access

5. Technical issues with equipment/ reagents

6. Other issues that may affect optimum operating conditions in the laboratory

A. Pap Smears / Gynaecological Cytology

I. Conventional Pap Smears

1. 1. 1. Smear the sample on a clean glass slide and immediately immerse the slide in a container filled with 95% alcohol. 

      2. Fix the smear for 15-30 minutes. (Volume of alcohol should cover the entire surface of the unfrosted edge of slide.)

      3. ‘Spray fix’ method may also be used.

      4. Send the slide to the cytopathology laboratory with request form HPV Test/ Cytology (Pap Smear/ LBC) Request Form PS1/98 (Pindaan 2023).

II. Liquid-Based Preparations

1. 1. 1. Ensure that the collection device is immersed in the special collection vial containing liquid-based preservative.

      2. Send the sample to the cytopathology laboratory with request form HPV Test/ Cytology (Pap Smear/ LBC) Request Form PS1/98 (Pindaan 2023).

Note: Please refer to the latest version of Guidelines for Cervical Cancer Screening in Malaysia (2023) if necessary. The previous version of request form PS1/98 (Pindaan 2007) will still be accepted until 31 December 2024. From 1 January 2025, please use at least Pindaan 2020.

B. Non-Gynaecological Cytology

I. Body Fluids

1. 1. 1. Send samples in sterile urine containers with request form Kementerian Kesihatan Malaysia Perkhidmatan Patologi (PER-PAT-301) (in one copy).

      2. Ideally the maximum volume should not exceed 100 mL.

      3. Urgent samples should be sent immediately to the cytopathology laboratory.

II. Bronchial Washing

1. 1. 1.  Smear the sample on a clean glass slide and immediately immerse the slide in a container filled with 95% alcohol.

      2. Allow to fix for at least 15 minutes.

      3. Send the slide to the cytopathology laboratory with request form Kementerian Kesihatan Malaysia Perkhidmatan Patologi (PER-PAT-301) (in one copy).

C. Fine Needle Aspiration Cytology (FNAC)

Rapid On-Site Examination (ROSE) service is available for the FNAC clinics operated by the following disciplines based on appointment, except on public holiday:

• Every Monday 9.00 am to 12.00 pm: Day Care OT (ENT Team)

• Every Tuesday 2.30 pm to 4.00 pm: Radiology Department

• Every Wednesday (except second Wednesday of the month) 9.30 am to 12.00 pm: Breast Clinic

• Every second Friday of the month 9.00 am to 12.00 pm: Day Care OT (Respiratory Team)

If the procedure was performed without attendance of staff from the cytopathology laboratory, preparation of FNA smears may be done as follows:

1. 1. Prepare four (4) slides

   2. Smear the samples on clean slides

   3. Fix two (2) wet smears immediately in 95% alcohol (for 15 to 30 minutes)

   4. Leave two (2) dry smears to be air-dried

   5. Send samples to the laboratory immediately with request form Kementerian Kesihatan Malaysia Perkhidmatan Patologi (PER-PAT-301) (in one copy).

Note: The reagents needed may be acquired from the cytopathology laboratory.

D. Seminal Fluid Analysis (SFA)

Specimens should be collected fresh and must reach the laboratory counter within one hour of specimen collection.

1. Specimens should be sent to the laboratory as soon as possible after collection.

2. Specimens for routine cytopathological examination should be sent directly to Cytopathology Laboratory during working hours if possible, or in the morning of the next working day.

3. Urgent specimens may be sent to the Microbiology Laboratory (at level 4) after office hours.

4. If immediate transportation of specimens to the laboratory is not feasible, specimens should be refrigerated at 4°C to help preserve the cells and prevent degeneration.

5. Wards/ Clinics from Sarawak General Hospital must bring the specimen dispatch book when sending the sample to the lab counter. Specimens sent from the other clinics/ hospitals must be accompanied by a specimen dispatch list. The laboratory staff will acknowledge receipt of specimens by signing the dispatch book/ list. 

1. Specimen unsuitable for examination e.g. slide broken

2. Specimen delayed in transportation >3 days without preservative

3. Test not offered or test request cancelled by requesting team

All reports will be available on the web-based laboratory information system (LIS).

Please contact the laboratory administration for access if required.