Gynecologic Pap Smear, One Slide and Maturation Index w/ Reflex*

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Category:

Turnaround Time: 2-5 days
CPT Code:

88155; 88164

Test Type: Slide

Overview:

Diagnose primary or metastatic neoplasma; diagnose genital infections with herpesvirus, Candida, Trichomonas vaginalis, cytomegalovirus, and Actinomyces; aid in the diagnosis of vaginal adenosis, cervicovaginal endometriosis, human papillomavirus (HPV), lymphogranuloma venereum; aid in evaluating hormonal function (maturation index); evaluate cellular composition of the surface layers of vaginal squamous epithelium, which reflects balance of estrogen and progesterone effects upon this target tissue; diagnose conditions producing abnormal cytohormonal balance (ie, pituitary dysfunction, ovarian dysfunction, feminizing tumor, and virilizing tumor).

Failure to obtain adequate ectocervical, endocervical, or vaginal cell population renders the specimen suboptimal for evaluation. Excessive use of lubricating jelly on the vaginal speculum will interfere with cytologic examination and may lead to unsatisfactory Pap results. All powder should be wiped off gloves before spatulas are handled since presence of starch granules will make interpretation of slides difficult. Inflammatory reaction may preclude hormonal evaluation. A very significant proportion of adenocarcinomas of endometrium are not detected by this means. Occasionally, highly differentiated adenocarcinomas of endocervix can be missed. Occasional aggressive lesions of squamous epithelium of cervix can be missed, especially if patient has only a single examination.

Collection Details:

Patient Preparation:

Patient should avoid douches 48 to 72 hours prior to examination. Specimen should not be collected during or shortly after menstrual period. Excessive use of lubricating jelly will interfere with cytologic examination.

Collection Instructions:

Include patient's name, date of birth, Social Security number (or other identification number), previous malignancy, drug therapy, radiation therapy, last menstrual period (LMP), postmenopausal patient (PMP), surgery (including surgical biopsies), exogenous hormones, abnormal vaginal bleeding, abnormal Pap results, IUD, and all other pertinent clinical information on the request form.

Note: In accordance with criteria established by CLIA, Pap tests will be referred for pathologist review if laboratory personnel suspect:

• Reactive or reparative cellular changes

• Atypical squamous or glandular cells of undetermined significance

• Cells in the premalignant or malignant category

Cardboard or plastic slide holder(s), Coplin jar(s).

Maintain specimen at room temperature. Slides may be stored indefinitely when spray fixed.