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How to Make a Bad Ass Cytology Slide – SAMPLE – SEPARATE – SMEAR [VIDEO]

clinical pathology oncology procedures

Be prepared – get all your supplies together on a tray or clip board.

  • 22g needles (20 g if it’s not exfoliating, 25 g if it’s bloody). Blood contamination makes it harder for the pathologists to find things. Think Where’s Waldo... 🩸
  • Frosted edge slides. If they are dirty or dusty clean them with alcohol and dry them off before using otherwise it will be hard to make nice smears. Make sure to label your slides on the frosted edge. ✏️
  • 6 cc syringe. 3 cc syringes are too wimpy.  You need more umph to get those cells out of the hub of the needle!  💪

Get a secure hold on what you are sampling. You won’t get a good SAMPLE if you don’t isolate the lesion. The only time I use suction is when I’m not getting any material out of the lesion. 

Use the woodpecker or aspiration technique.  Woodpecker is easier and the samples are usually just as good! Keep an eye on the hub of the needle and look for a bleb of stuff. Once you see something stop and make your smears. 

Squirt your sample on several slides – a little goes a long way so if all of it sprays onto the first slide, use another slide to dab it then smear on another. Watch the video for my technique! The goal is to SEPARATE the sample onto several slides so that when you smear it there is a nice monolayer.  You can sometimes get 4-5 slides out of a nice sample.

SMEAR very gently! Some cells, like lymphoblasts like to pop under pressure, so be gentle. Handle them with kid gloves. Your friendly pathologist will appreciate it. 

Take a look at one slide in-house before you send off your slides.  Make sure that you got a diagnostic sample.  Clients don’t like having to come in for a re-do if it can be avoided.

The better you get at making nice, thin smears, the more often you will get a diagnosis via cytology!

 #practicepearls #videotutorials


 About the Guide: Stacy Santoro Binstock, DVM, DACVIM (Oncology)

Dr. Stacy Binstock is a NJ native who was transplanted to the midwest for 7 years for vet school and residency training. She has been working as a medical oncologist in private practice for over 15 years. Her passion is to provide personalized, practical options for treating cancer in pets, and to give her clients and patients an excellent experience despite the difficult journey. Stacy created an oncology telemedicine service called Lotus Pet Oncology to provide access to cancer care for dogs and cats nationwide.

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