WO1992000039A1

WO1992000039A1 - Method and instrument for cytological examination of body fluids and fine-needle aspirates

Info

Publication number: WO1992000039A1
Application number: PCT/SE1991/000468
Authority: WO
Inventors: Nils Stormby
Original assignee: Nils Stormby
Priority date: 1990-06-29
Filing date: 1991-06-28
Publication date: 1992-01-09
Also published as: SE466785B; AU8209291A; SE9002293D0; SE9002293L

Abstract

The invention refers to a method for collecting and concentrating cells in a fluid such as body fluid, liquid for irrigation or aspiration cytological material, wherein the fluid is brought to pass through a brush or a wad of cotton in the flow passage of the liquid for collecting existing cells on the filter body. The cells are deposited on a glass slide (20). The invention also refers to an instrument for working the method, comprising an element forming a passage for the fluid and having a brush (15) or a wad of cotton provided therein as a filter body, said passage being connected to a collecting device (10) for the fluid for filtering the fluid when passing through the passage to the collecting device.

Description

or a transformation in an organ by means of a syringe and after the aspirate having been deposited on a glass slide, spreading it as evenly as possible over said slide by means of another glass slide or a coverslip. The procedure has two drawbacks: firstly, some of the cell material sucked out by aspiration will often enter the syringe proper and can only with difficulty be removed therefrom, which means loss of cells and risk of reduced diagnostic accuracy, and secondly, the smearing of the aspirate presently must be performed immediately by the physician who has performed the operation, thin and even smearing of the cell material without crushing being important. In inexperienced hands, however, the material often becomes defect due to incorrect treatment. A defect cell material will, of course, influence the diagnostic precision to a great extent.

US-A-4366822 discloses a device where bone marrow is aspirated by means of a syringe comprising a filter chamber wherein the bone marrow is filtered through a filter on which particles from the bone marrow are deposited. The particles can then be scraped off by means of a scalpel or a knife to be transfered to a glass slide.

The invention eliminates the disadvantage and the risk of post-treating biological fluids and considerably reduces the cost of transport. The purpose of the invention is also to overcome the disadvantages mentioned above.

In order to achieve this purpose a method of the above-mentioned kind is proposed wherein the fluid is brought to pass through a filter body for collecting existing cells on the filter body and the cells from the filter body are deposited on a glass slide or the like. According to the invention, the method of the invention has obtained the characterizing features of claim 1, and for working the method there is proposed an instrument according to claim 4. ^f METHOD AND INSTRUMENT FOR CYTOLOGICAL EXAMINATION

OF BODY FLUIDS AND FINE-NEEDLE ASPIRATES .

5 The invention refers to a method and an instrument for collecting and concentrating cells in a fluid.

The term fluid refers to fluids normally occuring in the body (urine, saliva, bronchus secretion, spinal fluid etc), effusions of fluids resulting from disease (effusions

10 in the pleura, abdominal cavity etc) as well as liquids for irrigation recovered for diagnostic purposes (from for example the urinary bladder, abdominal cavity, bronchi) and also cells in a small volume, which are sucked up - aspirated - with a thin needle (fine-needle aspiration)

15 from an organ or a pathological transformation in an organ (aspiration cytology) .

The presently applied method of handling fluids containing cells as mentioned above is either to deliver the fluid in its entirety to a laboratory where it is

20 treated in different ways (centrifugation, sedimetation, filtration) in order to concentrate the cells in the fluid and deposit (smear) them on a glass slide for staining and microscopical examination. In order to prevent the disintegration of the cells during a prolonged transport

25 the fluid is - if it is not tapped at the hospital where the laboratory is situated - furnished with an additive, for example alcohol which indeed preserves the cells but on the other hand results in a considerable reduction of the ability of the cells to adhere to the glass slide. The use * 30 of so called cell filtration, which implies collecting cells on a filter which can be made transparent for microscopical examination, eliminates the disadvantage mentioned but is an expensive and technically susceptible method.

35 The aspiration of cells via a thin needle involves sucking out a small volume of fluid of cells from an organ It is a specie advantage that the filter body - brush or wad - also constitutes a smearing body by means of which the gathered cells can be smeared on a glass slide or the like. The invention will be described described below with reference to embodiments shown in the accompanying drawing, wherein

FIG. 1 is a side view of an instrument according to the invention for sampling a tissue region in aspiration cytology,

FIG. 2 is an enlarged side view of a container forming part of the instrument, having a filter body consisting of a brush inside the container which is parted for removal of the brush therefrom, FIG. 3 is a side view of the opened container, the brush being withdrawn therefrom by means of a special tool,

FIG. 4 is a side view which shows how the material collected in the brush is smeared on a glass slide, and FIG. 5 is a fragmentary side view, partly an axial cross section of a modified embodiment of the instrument for aspiration of fluid.

FIG. 1 shows a syringe 10 which can be quite conventional and has an outlet socket 11 forming a Luer type coupling piece. A cylindrical container 12 is at one end thereof connected to said coupling piece, the container at the other end thereof having a Luer type coupling piece 13 for attachment of a thin cannula 14. The container 12 comprises two parts, a larger one 12A and a smaller one 12B, which can be detachably interconnected or can be permanently joined in such a way that part 12B can be broken or twisted off from part 12B, as illustrated in FIG. 2. Inside the container 12 there is a filter body 15 which in this case comprises a brush, suitably a brush of the type used for cervical sampling and including a stem 16 of twisted wires with bristles 17 mounted therein. Such a brush is disclosed and described in US-A-4 759 376. However, the brush can also be manufactured in another way and can for example consist of a body with velour finished surface according to WO 89/10724, and the brush can also be replaced by a wad of cotton or similar material. It is essential that the filter body substantially fills the container 12 completely.

When the cannula 14 has been inserted into the organism from which a sample shall be taken, for example a tissue region 18 in an organ or a pathological trans¬ formation in an organ from which a fluid, i.e. liquid and accompanying cells (inclusive cell fragments), shall be aspirated, the syringe 10 is operated to suck up the fluid into the syringe. The fluid passes through the cannula 14 and the container 12 and from there into the syringe 10, the fluid when passing through the container 12 being forced to follow the labyrinth-like paths between the bristles of the brush 15, which implies that cells and cell fragments will be collected in the brush which functions as a filter.

When enough fluid has passed through the container 12 this is disconnected from the syringe 10 and opened by separating part 12B from part 12A such that the brush 15 will be available. On the stem 16 a suitable handle 19 can now be attached either by connecting the stem 16 with light forced fit to the handle, or by the handle being provided with a chuck or the like for fastening the stem 16 to the handle. The brush is then withdrawn from the container part 12A, as illustrated in FIG. 3, and the cells and cell fragments collected in the brush can now, according to FIG. 4, be smeared on a glass slide 20 in the manner commonly used for cervical sampling by means of a brush of the kind described above.

The fluid can also consist of body fluid or liquid for irrigation as described above, which is sucked directly from the organism or from a vessel in which the liquid has been collected into a syringe or another collecting device through the container 12 receiving the brush 15. Alternatively, during tapping from the organism the liquid may be passed through said container.

FIG. 5 discloses an instrument for aspiration of body fluids, liquids for irrigation and the like, wherein a rigid or flexible, preferably transparent tube (hose) 21 at one end thereof is connected to a syringe 10 or a Luer type coupling piece 11, a brush 15 being introduced into the tube from the other end thereof, the stem 16 of the brush suitably projecting from latter end of the tube so as to be gripped when withdrawn from the tube.

The brush can in all embodiments of the invention comprise a brush with bristles which are mounted to a stem, or with bristles which are applied on the stem by flocculation, but the brush can also be replaced by a wad of cotton or similar material with or without a stem.

The advantage of proceeding in the manner described herein is above all that collecting and concentration of cells occuring in the aspirated fluid can be performed in an effective way and that the cells then in an easy and effective way can be transferred from the brush (wad) 15 to the glass slide 20 without destroying the cells. However, another and maybe equally important advantage is that smearing of the sample on the glass slide 20 does not have to take place while sampling and above all does not have to be performed by the person taking the sample but can be performed by personnel accustomed to the procedure at the receiving laboratory. In fact, the container 12 can serve as a storage and transport package for the brush (wad) enclosed therein with cells collected on the brush and separated from the liquid for delivery to the laboratory where the sample obtained is to be examined and diagnosed. In order to improve the adherence of cells in for example urine and liquids for irrigation, respectively, the addition of a liquid protein may be appropriate. Likewise, when longer transport times are expected addition of an antibiotic may be recommended. The addition may take place in the container or in the tube. Another alternative consists in the brush or wad being treated with protein medium or antibiotic.

Claims

1. Method for collecting and concentrating cells in a fluid such as body fluid, liquid for irrigation or aspiration cytological material, wherein the fluid is brought to pass through a filter body (15) for collecting existing cells on the filter body and the cells from the filter body are deposited on a glass slide (20) or the like c h a r a c t e r i z e d in that a brush (15) or a wad of cotton or similar material is used as the filter body, which is received in the flow passage of the liquid.

2. Method as claimed in claim 1 wherein the collection of fluid takes place while adding protein medium and/or antibiotic.

3. Method as claimed in claim 1 wherein the brush (15) or cotton wad after the passage of the fluid is allowed to remain in the container (12) which serves as a storage and/or transport package for the same.

4. Instrument for collecting and concentrating cells in a fluid such as body fluid, liquid for irrigation or aspiration cytological material, c h a r a c t e r i z e d by an element (12, 21) connected to a collecting device (10) for the fluid, said element forming a passage for the fluid and having a brush (15) or a wad of cotton or similar material provided therein as a filter body substantially filling the cross section of the passage, for filtering the fluid when passing through the passage to the collecting device.

5. Instrument as claimed in claim 4 wherein the element comprises a container (12) arranged for connection at the ends thereof a cannula (14) and a syringe (10), respectively, said syringe forming the collecting device.

6. Instrument as claimed in claim 5 wherein the container (12) is disconnectable at a cross section for removal of the filter body (15) .

7. Instrument as claimed in claim 4 wherein said element comprises a rigid or flexible tube (21) .

8. Instrument as claimed in any of claims 4-7 wherein the filter body comprises a brush (15) with bristles (17) projecting radially from a stem (16), and with the stem extending axially in the passage.

9. Instrument as claimed in any of claims 4-8 wherein the brush (15) is conical.