Norm of Cytologic Study of Respiratory Tract
Usage of Cytologic Study of Respiratory Tract
Diagnosis of respiratory neoplasms or premalignant cell changes related to chronic inflammation, inhaled toxins, tuberculosis, or asthma; diagnosis of respiratory bacterial, viral, or parasitic infections.
Description of Cytologic Study of Respiratory Tract
Respiratory tract cytology is the microscopic study of the number and type of cells of the respiratory tract or sputum to detect the presence of cells abnormal for that specimen, including tumor or pretumor cells or evidence of an infective process. Any anomalies of cells are correlated to clinical data for diagnosis.
Professional Considerations of Cytologic Study of Respiratory Tract
Consent form NOT required unless the sample for study is obtained by bronchoscopy.
- An aerosol treatment just before specimen collection may help to mobilize respiratory secretions.
- Three early-morning specimens are obtained.
- Have the client rinse the mouth with water.
- Instruct the client to inhale deeply and then exhale with a deep, expulsive cough and expectorate sputum directly into a sterile, wide-mouthed container.
- Alternatively, bronchial secretions may be removed directly during bronchoscopy or by nasotracheal suctioning using a specimen trap.
- Write the client's name, the date, the specimen source, the specimen number, the diagnosis, and the clinical symptoms on the laboratory requisition.
- Send the specimen to the laboratory immediately.
Client and Family Teaching
- Results are normally available within 72 hours.
- To produce a deep sputum specimen, rather than saliva, take several deep breaths, without fully exhaling between them. When you feel as though you cannot take any more breaths, cough out forcefully and catch the sputum in the sterile cup.
- The results may have to be confirmed by culture or biopsy.
Factors That Affect Results
- The results are most accurate when examined within 1 hour of collection.
- The results are invalid if the sample is saliva, rather than respiratory secretions.
- Smoking and pharmacotherapy affect the results of the analysis.
- About 15% of results are false negatives.
- Sputum cytologic findings are more likely to be negative in a client with small cell carcinoma than in one with non–small cell carcinoma of the lung.
- Culture with or without biopsy is usually more reliable than cytologic examination for diagnosis of respiratory tract neoplasm or infection.
- The detection of the codon-12 K-ras mutation in BALF cells aids the diagnosis of lung cancer in clients with negative cytologic findings.