Sputum Cytology

	Test Overview
	Why It Is Done
	How To Prepare
	How It Is Done
	How It Feels
	Risks
	Results
	What Affects the Test
	What To Think About
	References
	Credits
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Sputum cytology examines a sample of sputum (mucus) under a microscope to determine whether abnormal cells are present. Sputum is not the same as saliva. Sputum is produced in the lungs and in the airways leading to the lungs. Sputum has some normal lung cells in it. See a picture of the lungs' airways.

Sputum cytology may be done to help detect certain noncancerous lung conditions. It may also be done when lung cancer is suspected.

A sputum sample may be collected:

• By a person coughing up mucus.
• By breathing in a saltwater (saline) mist and then coughing.
• During bronchoscopy, which uses a bronchoscope to look at the throat and airway.

Sputum cytology is done to detect:

• Lung cancer. But this is not used as a screening test for people at risk for developing lung cancer, such as smokers.
• Noncancerous lung conditions, such as pneumonia or inflammatory diseases, tuberculosis, or the buildup of asbestos fibers in the lungs (asbestosis).

Home or office sample

No special preparation is required if the sputum sample is to be collected at home or in your doctor's office.

Bronchoscopy sample

Before you have a bronchoscopy to collect a sputum sample, tell your doctor if you:

• Are taking any medicines.
• Have allergies to any medicines, including anesthetics.
• Have any bleeding problems or take blood thinners, such as aspirin or warfarin (Coumadin).
• Are or might be pregnant.

For a bronchoscopy, you will also be asked to sign a consent form. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).

Your doctor will tell you how soon before the procedure to stop eating and drinking. In most cases, you will need to stop eating at least 6 hours before your procedure. You may be able to drink clear liquids, such as water, coffee, or tea, up to 2 hours before the procedure. But be sure to follow the exact instructions your doctor gives you.

Arrange to have someone drive you home after the procedure.

Home or office sample

Three sputum samples are usually collected over 3 days. Your doctor will give you a container to collect the sputum. This container may have a small amount of liquid (called fixative) in it. The fixative helps preserve the sample. Do not drink this liquid.

For best results, collect the sample in the morning right after waking up. Follow these steps:

• If you wear dentures, remove them before collecting the sample.
• Rinse your mouth with water.
• Take about four deep breaths followed by a few short coughs, then inhale deeply and cough forcefully into the container. Sputum is not the same as saliva, so make sure to get a sample of mucus from deep in your airway.

Carefully follow your doctor's instructions about where to deliver the sample. You may be instructed to take the sample to the doctor's office or to a laboratory. Deliver the sample soon after you obtain it. You may be instructed to refrigerate the sample if you are unable to deliver it immediately.

Bronchoscopy sample

See the medical test Bronchoscopy for detailed information on how this procedure is done.

If you have discomfort when taking a deep breath or coughing, getting a sputum sample may be uncomfortable.

For information on how a bronchoscopy procedure feels, see the medical test Bronchoscopy.

Home or office sample

There is no risk associated with collecting a sputum sample at home or at your doctor's office.

Bronchoscopy sample

Bronchoscopy is generally a safe procedure. Although complications are rare, you should discuss the risks in your particular case with your doctor. Complications that may occur include:

• Spasms of the bronchial tubes. These can impair breathing.
• Irregular heart rhythms (arrhythmias).
• Infection, such as pneumonia. These usually can be treated with antibiotics.

Sputum cytology examines a sample of sputum (mucus) under a microscope to determine whether abnormal cells are present. It may take several days to receive results from a sputum cytology.

Abnormal cells may indicate lung conditions such as pneumonia, inflammation, the buildup of asbestos fibers in the lungs (asbestosis), or lung cancer.

Reasons you may not be able to have the test or why the results may not be helpful include a sample that is too small, dried out, contains only saliva, or is from nasal secretions, not your airway.

• There is a chance of false-negative test results with sputum cytology. This means that the test indicates a lung condition is not present when it actually is present. Follow-up testing may need to be done if your symptoms continue.
• Sputum is not the same as saliva. It is important to obtain a sputum sample from deep in your airway. Collecting the sample in the morning, when you first wake up, is generally best.
• If you have trouble obtaining a good sample, try taking a hot shower first to help loosen the mucus in your airway.
• A sputum culture is a test to detect and identify bacteria or fungi that are infecting the lungs or breathing passages. It is also done to identify the best antibiotic to treat a lung infection. For more information, see the medical test Sputum Culture.
• Bronchoscopy or a needle lung biopsy are more commonly used than sputum cytology because the results provide more information about airway problems. For more information, see the medical tests Bronchoscopy and Lung Biopsy.

Other Works Consulted

• Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.

• Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

• Pagana KD, Pagana TJ (2006). Mosby’s Manual of Diagnostic and Laboratory Tests, 3rd ed. St. Louis: Mosby.