How to do various smears or cytology

Tzanck preparation

1. imprint the lesion

2. clean lesion with saline sponge

3. take another imprint

4. debride and take another imprint

5. If scab is present, imprint the bottom of that scab

6. Imprint the exposed tissue

syringe and needle for needle biopsy

• 21-25g needle

• 3-20 ml syringe

softer tissue needs smaller syringe and needle, as large needles will collect tissue cores leading to blood contamination and poor yield of free cells

Wedge Film

• use sample collected by fine needle biopsy

1. Transfer the sample to a clean slide, near the frosted edge

2. use a second slide at an angle, back the slide edge into the sample

3. allow sample the spread along the edge

4. use the slide to push the sample the full length of the slide

Is basically done like a blood smear

Fine needle - aspiration technique

1. stabilize the mass

2. insert needle into the mass and draw back to create negative pressure

3. Redirect the needle several times, do not exit the mass and maintain negative pressure

4. remove the needle from the mass

5. remove the syringe from the needle

6. fill syringe with air and reattach needle

7. gently force the sample from the needle onto clean slide

8. air dry, fix ans stain

Fine needle - non-aspiration technique

Done the same as aspiration technique but done with just a needle or a needle and syrine wirth the plunger removed from the syringe

1. stabilize the mass

2. insert needle into the mass

3. Redirect the needle several times, do not exit the mass and maintain negative pressure

4. remove the needle from the mass

5. remove the syringe from the needle

6. fill syringe with air and reattach needle

7. gently force the sample from the needle onto clean slide

8. air dry, fix ans stain

compression smear

1. Transfer the sample to a clean slide, near the frosted edge

2. add another slide perpendicular (the should be criss crossed)

3. in a smooth single motion pull the top slide evenly across the bottom

4. air dry, fix, and stain the top slide

5. viewed under 40x

Modified compression smear

use sample collected by fine needle biopsy

1. transfer sample to clean slide near frosted edge and toward middle of the slide

2. add another slide perpendicular (the should be criss crossed)

3. in a smooth single motion twist the two slides in opposite directions (create an X shape)

4. life the top slide straight up

5. air dry, fix, and stain the top slide

6. viewed under 40x

Line smear

use sample collected by fine needle biopsy

1. Transfer sample to a clean slide near the frosted edge

2. use a second slide at an angle and back the edge of the slide into the drop of the sample

3. allow sample to spread along the edge of the slide

4. Use the second slide to push the sample across the slide and stop abuptly before getting to slide end abruptly

5. pick second slide straight up

6. air dry, stain, and fix