PART 10: CYTOLOGY

The cytology module allows the laboratory team to determine diagnosis of diseases through the examination of tissue samples.

How to create a cytology test order.

1. To access and create a cytology test, follow steps 1 to 9 under How to create a laboratory analysis order for an existing patient. 

Note: In this illustration, a patient by the name Test Casey is used to capture a cytology test request

2. Upon executing step 1, click on the Program  drop-down menu.

3. Click on cytology under the drop-down menu. 

4. Click on the Next button.

5. Fill in the fields under the program which include; nature of specimen, site of specimen, procedure performed, provisional clinical diagnosis and previous surgery/treatment then click on the Next button and click next

6.  The Add Sample page allows for the addition of samples by selecting a sample type. To Add a sample, click on the select sample type drop-down menu item and select the sample In this instance, cytology was selected as a program we have selected Tissue Antemortem as the sample.

7. The date and time are picked from the system. Fill in the Collector field, the Order Tests will be populated upon choosing the available immunohistochemistry test. In this illustration, the AMACR(p 504 s) and anti-CD 3 are the selected tests.

8. To remove an ordered immunohistochemistry test, click the cancel (x) icon on the test

9. Click on the Next button.

10. Fill in the order section by Scanning  or manually entering the lab number or by clicking on the Lab Number text link to generate the lab number. Select the Priority from the drop-down menu. Fill in the Site name  and the requester's details, select the payment status from the drop-down menu,select the Sampling performed for analysis from the drop-down menu and click on the Submit button. 

11. Upon submitting the histopathology lab request, a Save successful message will be displayed. You can print the barcode for the test.  To print the barcode, click on the print barcode button.

How to access the cytology module and process a test.

1. Hover the mouse over the hamburger icon and click to open the menu.

2. Hover the mouse and click on the drop-down menu under the cytology module.

3. Click on Dashboard sub-menu item.

 The dashboard provides  summaries for Cases in progress, Awaiting Pathology Review, Additional Pathology Request and Complete test in a week

All the cytology test requests entered under  Add Order (Test Request) are displayed under a table that displays the Request Date, Stage, Last Name, Assigned Technician, Assigned Pathologist and Lab Number.

4. The cytology  module allows you to filter the test request . Click on the My cases checkbox to filter the cases. 

5. The Status dropdown menu is used to filter the immunohistochemistry cases by their status. The status can be displayed All, In Progress, Ready for Pathology and Completed.

6. You can filter the requests in an ascending or descending order for each menu item For instance, click on the Lab Number menu item.

7. To search for a pathology test, enter the patient name or the lab number  under the Search by LabNo or Family Name text field. The search results will retort a list of matching patients.The cancel icon (x) is used to cancel the search. 

8. Click on the desired patient from the search result. In this illustration, the start button is clicked.

Note: The top section of the cytology page displays information about the immunohistochemistry case. 

Note: There is a sequence of stages in a cytology  examination. The Status drop-down menu provides a list of the different stages. The default stage is preparing slides  for the test. The select technician drop down menu allows for the selection of the technician conducting the test. This is role based. Anyone with the cytology permission will be displayed under this drop-down menu. Similarly, the select pathologist allows for the selection of a cytopathologist  with cytology permission.

9. Click on these select status drop-down menu and select the status. In this illustration, Preparing slides is the default status.

10. Click on the Select Technician drop-down menu and select the technician.

11. The Slides section allows you to add the number of slides that will be used for specimen processing. Click on the upward facing arrow to add the number of slides then click on the Add Block button. In this illustration,  two slides will be added.

12. Upon clicking on the Add Slides button, Fill in the locations for the slides. These could be racks where the specimens are stored. 

13. You can upload a scanned slide by clicking on  the Upload file button. A file upload dialogue will be opened on your workstation. Navigate to the location where you have saved the scanned slide. In this illustration, the scanned slide  for patient Casey was saved under downloads. Click on the filet to select it then click on the Open button.

Note: upon clicking on the Open button, the report will be uploaded successfully.

14. You can print labels for the slide by clicking on the Print Label button. A new tab will be opened on your browser you can download and or print the label to attach on the sample.

Note: To remove the uploaded scanned slide file, click on the cancel icon x. 

15. Click on the Save button upon uploading the prepared slide(s).

Note: Upon saving the prepared slide(s) a save successful message will be displayed

16. The slide(s) can now be screened by changing the status to screening. Click on the request under the cytology dashboard page.

17. Click on the Status drop-down menu, select screening. 

18. Click on the Technician Assigned drop-down menu and select the technician then click on the Save button. The status will be saved successfully.

Note: The status for the cytology request will be changed to screening under the list of tests in the dashboard page.

19. The technician can conduct screening for the slides by clicking on the request under the  list of tests in the dashboard page.

Upon clicking on the patient, the cytology test page will be displayed. The laboratory technician can conduct screening on the slides and change the status to Ready for  CytoPathologist. The view button will display the uploaded scanned slide in the event the laboratory technician is not physically available in the laboratory.

20. To change the status to Ready for  CytoPathologist click on the status drop down menu and select Cytopathologist.

21. Click on the CytoPathologist Assigned drop-down menu and select a CytoPathologist.

22. Click on the Save button. The status will be saved successfully.

Note: The status for the cytology request will be changed to CytoPathologist under the list of tests in the dashboard page.

23. The slide(s) can now be reviewed by the assigned CytoPathologist. The Cytopathologist will click on the test request under the cytology dashboard page.

24. Upon clicking the test request and accessing the request page, the CytoPathologist will review the test request by scrolling to the bottom of the page and clicking on the Specimen Adequacy drop-down menu.

25. Upon clicking on the Specimen Adequacy, select the appropriate option. In this illustration, the satisfactory for evaluation is selected. The selection of Un Satisfactory for evaluation under the Specimen Adequacy drop-down menu will display  a drop-down menu from which two checkbox options can be selected.

26. Upon selection satisfactory for evaluation, two radio buttons will be displayed to select either of the two. In this illustration, the first radio button is selected.

Note: The Negative For Intraepithelial Lesion or Malignancy checkbox is checked by default. If this is the case with the cytology test request, the reviewer would proceed and validate the results by checking the Ready For Release checkbox and clicking on the Save button.

27. In this illustration, the Negative For Intraepithelial Lesion or Malignancy checkbox is checked, click on the Ready for Release checkbox then click on the Save button.

Note: The following workflow is presented when there is Intraepithelial Lesion or Malignancy.

28. In the event the Intraepithelial Lesion or Malignancy  is not negative, uncheck the check-box. This will expand drop-down sections for Epithelial Cell Abnormality, Non-neoplastic cellular variations,Reactive cellular changes,Organisms and Other Diagnosis Result.

29. Click on the Epithelial Cell Abnormality drop-down menu and select the applicable checkbox(s).

30. Fill in the Neo Malignancy text field.

31. Fill in the  Non-neoplastic cellular variations fields by selecting the options from the checkboxes.

32. Fill in the Reactive cellular changes  fields by selecting the options from the checkboxes. 

33. Fill in the Organisms fields by selecting the options from the checkboxes.

34. Fill in the Other Diagnosis Result fields by selecting the options from the checkboxes.

35. Click  on the Ready for Release checkbox then click on the Save button.

36.  Upon Saving, the laboratory technician can mark the cytology test as complete. Click on the test request under the Cytology dashboard.

37.  To change the status to Completed, click on the status drop down menu and select Completed.

38. Click on the Save button. The status will be saved successfully.

The test request will be marked as Completed under the Cytology dashboard

How to upload or generate a cytology report.

1. Follow steps 1 -3 under How to access the cytology module and process a test.

2. Click on the desired patient under the dashboard. In this illustration, a patient by the name Test Casey  is clicked.

3. Scroll to the report section and click  on the drop-down menu under report.

4. Click on the item to generate report

5. Upon selecting the item to report on, you can either upload or generate a report. To upload a report, click on the Upload file button.

6. Upon clicking on the Upload file button, a file upload dialogue will be opened on your workstation. Navigate to the location where you have saved the report for Cytology. In this illustration, the report file for patient Casey Test  was saved under downloads. Click on the report to select it then click on the Open button.

Note: upon clicking on the Open button, the report will be uploaded successfully.

7.  To remove the report, click on the cancel icon x. Otherwise, Click on the Save button at the bottom of the page.

8. As a user, you can generate a report from the system as opposed to uploading one. To do so, Click on the item to generate report under the Add Report drop-down menu

9. Click on the Generate Report button. The report will be generated successfully. 

Note: a pdf containing the patient report will be generated successfully.

10. Click on the Save button at the bottom of the page