American Society for Veterinary Clinical Pathology
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Madison, WI 53704

Telephone: +1-608-443-2479
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2. Analytical factors important in veterinary clinical pathology

2.6. Cytology

2.6.1. Monitoring.
Equipment and reagents used for preparation and analysis of cytologic specimens should be maintained in a manner consistent with good laboratory practices as detailed in the clinical chemistry and hematology sections of these Guidelines.  

2.6.2. Method Validation - see General recommendations.
Not all of the method validation experiments listed in section 2.1.2. may be applicable to evaluation of cytologic methods.  Method validation experiments should be selected or modified as necessary to ensure that new methods/analyzers are functioning satisfactorily to meet the laboratory's requirements and the manufacturer's specifications.

2.6.3. Instrumentation - see General recommendations

2.6.4. Laboratory Personnel Knowledge

a. Laboratory technical personnel should be proficient at examining samples grossly (e.g., fluid color and clarity) and performing all relevant tests (routine and special, i.e., mucin clot test). 
b. Laboratory personnel should have knowledge of common problems encountered in sample preparation and have the ability to troubleshoot procedures for problem resolution.
c. The individual interpreting veterinary specimens, preferably a veterinary pathologist, should have documented cytopathology training and have knowledge of the cytologic findings from all species and cytologic specimen types expected to be assessed by the laboratory.  .
d. Appropriate avenues should exist for a second opinion and additional review or consultation with a cytopathologist, if needed or requested.
e. Attempts to ascertain diagnostic accuracy of cytologic interpretations should be pursued.  These may include but are not limited to:

i. Correlation of findings with histologic or additional cytologic specimens.
ii. Follow-up information regarding the animal's conditions and/or responses to therapy.
iii. Peer review of selected cytologic specimens by another cytologist/cytopathologist to determine if there are features that have been overlooked, over-interpreted or under-interpreted.
iv. Correlation with other diagnostic modalities, e.g., radiography, ultrasound, microbiologic culture, etc.

1. The cytopathologist should be knowledgeable regarding ancillary procedures.
2. The cytopathologist should review technical aspects of sample handling and processing with laboratory personnel and provide guidance as needed.
3. The cytopathologist should be able to communicate with clients concerning important pre-analytical, analytical and post-analytical factors.  These may include:

i. Information about specimen adequacy
ii. Suggested modifications of techniques
iii. Additional testing options
iv. Diagnoses or differential diagnoses
vi. Prognosis or monitoring
vii. Treatment recommendations at a level based on experience or knowledge.  If the cytologist/cytopathologist is not experienced in treatment options, they should instruct the client to consult with a specialist.

2.6.5. Quality Control. See also General recommendations.
Cytopathologists are critical to quality control, as they see most or all of the laboratory's cytologic samples and preparations and depend upon the products reliability for their interpretations and recommendations.  Therefore, the working relationship between laboratory staff and cytopathologists is critical.Quality control should be appropriate for the types of specimens, stains and procedures included as part of cytology preparation and analysis.  These may vary with each laboratory, type of cytologic preparations and preferences of the cytopathologist. Total nucleated cell counts from automated analyzer or manual method (hemacytometer) should be correlated with the cellular density on the slide if straight smears are made.  Equipment utilized for determining total nucleated cell counts should be monitored as for hematologic analysis (see Hematology section).

2.6.6. Procedures Manual - see General recommendations
2.6.7. Comparison of Tests - see General recommendations
2.6.8. Identification of out-sourced tests - see General recommendations