COLLEGE OF MEDICAL LABORATORY SCIENCE

OUR LADY OF FATIMA UNIVERSITY-

VELENZUELA
 PRE-ANALYTICAL PHASE
• The site of the experiment should be sterilized. The
medical technologist should wear proper personal
protective equipment before the experiment
• Upon receiving the sputum in the laboratory, the
receptionist checks if the sample is properly
labeled and the amount of sample is adequate
then records the information indicated.
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE

PHYSICAL EXAMINATION
• Sputum
• Specimen container
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
Materials:
MICROSCOPIC EXAMINATION
• Sputum
• Applicator stick
• Inoculating loop
• Glass slide and cover slips
• Alcohol lamp
• Cedarwood oil
• Ziehl – Neelsen acid fast staining solution:
• Carbol fuschin
• 3% Acid alcohol
• Methylene blue
 SPUTUM COLLECTION

• First morning- Most ideal

• 24 hour- Volume measurement
• Throat swab- For pediatric patient
• Sputum induction- Non-cooperative patients
• Tracheal Aspiration- Debilitated patient

Collected in a dry wide mouthed with 25 ml

capacity and leak proof container

OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE

 SPUTUM CONTAINER

1. Volume capacity of 50 mL
2. Made of transparent or translucent material
3. Wide-mouthed (at least 35mm in diameter)
4. Screw-capped
5. Unbreakable and leak-proof
6. Clean and sterile (preferably)
7. Single-use, combustible material
8. With walls that can be easily labeled

OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE

OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
 SPUTUM COLLECTION

OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE

 STORAGE

• Store in a cool (2-10°C), dry place away from

sunlight until ready for transport to the laboratory
to avoid liquefaction
• Refrigeration also reduces the growth of
contaminants in the specimen
• Do not use any chemical preservative
for storage
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
 PHYSICAL EXAMINATION
• Examine the quantity, consistency,
color and odor directly from the
container or preferably in a petri
dish.
• Record for minute macroscopic
masses:
– Cheesy masses
– Bronchial casts
– Dittrich’s plugs
– Lung stones
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
 Macroscopic Examination
(Volume)

The necessary amount of sputum for most tests is 5 ml

Decreased in: Increased in:
• Early pneumonia • Bronchiectasis
• Bronchial asthma • Lung abscess
• Acute Bronchitis • Edema
• Gangrene
• TB
• Lung Cancer
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
 Macroscopic Examination
Color: Colorless and translucent or whitish to faint yellow
Odor: Odorless
– Foul/Putrid: Cavitary TB, Lung abscess, gangrene
– Fruity: P. Aeruginosa
Consistency: Watery
– Mucoid: asthma/bronchitis
– Serous/frothy: lung edema
pH: 6.5 to 7.0
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
 Sputum Color Significance
Transparent Normal

Yellow-green TB or Bronchiectasis
Green Pseudomonas aeruginosa

Red TB
Rusty Red Lobar Pneumonia
Brown Congestive Heart Failure
Black Heavy Smokers
Olive green/ Grass Green Carcinoma of the lungs
(chronic cancer)

OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE

 Macroscopic Examination
Specific Gravity Features
• Mucoid- 1.004 to 1.008 • Cheesy Masses
• Purulent- 1.015 to 1.060 • Dittrich Plug
• Serous- 1.037 or higher • Curshman’s spiral
• Pneumoliths / Broncholiths
• Casts/ Bronchial Casts
• Parasites
• Mycetomas- rounded
masses of fungal debris
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
Macroscopic Structures in Sputum Significance

Made of fibrin, branching tree-like cast, seen in

Bronchial Cast Lobar Pneumonia
Fragments of necrotic pulmonary tissues, seen in
Cheesy Masses Pulmonary TB and Pulmonary Gangrene
Dittrich Plug Grayish to yellowish, made up of cellular, fatty
(size of pinhead, foul odor when acids, fat globules and some bacteria
crushed) Seen in Bronchiectasis and Bronchitis

Lungstones, Pneumoliths/ Formed from calcified pulmonary tissues, seen in

Bronchioliths Histoplasmosis

Lungstones, Pneumoliths/ Mucoid threads that are twisted

Bronchioliths Seen inn bronchial asthma and acute bronchitis

OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE

 MICROSCOPIC EXAMINATION
• Select a portion of the
sputum using an applicator
stick
• Spread it on the glass slide
• Fix the specimen into the
slide by passing 2-3
times over the flame
• Stain the smear with Ziehl-
Neelsen stain
• Observe under OIO
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
 Microscopic Examination
• Crystals
– Charcot-Leyden Crystals- most significant,
seen in asthma as Creola Bodies (cluster of
columnar cells)
– Hematoidin
– Cholesterol
– Fatty Acids
– Pigmented Cells- endothelial leukocytes
taking up pigmented granules
• Carbon-Laden or Dust Cells- contains black
granules; Anthracosis
• Heart Failure Cells/ Siderocytes-
hemosiderin
Laden
OUR LADYMacrophage in the alveolar
OF FATIMA UNIVERSITY- spaces
COLLEGE OF MEDICAL LABORATORY SCIENCE
 Microscopic Examination

OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE

 Microscopic Examination

3. Myelin Globules
4.Yeast- budding forms
seen in antibiotic
treatment
5. Fungi and Molds
6. Parasites

OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE

 POST ANALYTICAL PHASE
Before leaving, the medical technologist must
do all of the following:
• Returning of materials, slides and
microscopes
• Disposal of wastes and disinfection with
liquid Lysol or 10% sodium hypochlorite of
the area.
OUR LADY OF FATIMA UNIVERSITY- COLLEGE OF MEDICAL LABORATORY SCIENCE
 “Strength does not come from physical capacity. It
comes from an indomitable will” – Mahatma Gandhi

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