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HelpTest Code LAB5002 Fine Needle Aspiration Biopsy: Neck, Lymph Node, Parotid, Salivary, and Miscellaneous
Specimen Requirements
Non-Thyroid solid lesion FNA’s require air dried and alcohol fixed pull smear preparation during collection in addition to needle rinses in CytoLyt.
Cystic non solid lesions such as ovarian cysts and others that are mostly fluid can be rinsed in CytoLyt or sent fresh to the lab without smear preparation on site. See collection instructions for detail on solid versus cystic lesion collection.
See Fine Needle Aspiration Biopsy Thyroid for its collection information.
See collection instructions to obtain supplies in advance of the procedure.
Materials:
1. PPE including eye protection for blood and body fluid splashes
2. Light blue top CytoLyt cup(s), 30 ml volume
3. Charged glass frosted end slides
4. 2-3 95% alcohol jars
5. RPMI for lymph nodes and suspected lymphoma/leukemia lesions
6. Sterile container for fluid filled cystic non-solid lesions
7. FNA order authorized by the physician/radiologist
8. Patient clinical history - Non-EPIC locations
9. Patient demographics and insurance information - Non-EPIC locations
10. 10 cc syringes or as appropriate
11. 25 gauge needles or as appropriate
12. Specimen collection supplies (2-5 above) are provided by BAH Cytology, 541-269-8454
Specimen Transport.
Place labeled specimen containers and slides inside a biohazard bag with the request form in the outside pocket of the bag. Transport specimen to laboratory within 4 hours of collection
Unacceptable Criteria
Specimens submitted in formalin.
Unlabeled specimens.
Stability:
| Temperature | Time |
| CytoLyt collected specimen at Room Temp 18-28°C | 72 hours |
| CytoLyt collected specimen Refrigerated 2–8°C | 72 hours |
| RPMI collected specimen at Room Temp 18-28°C | 4 hours |
| RPMI collected specimen Refrigerated 2–8°C | 48 hours |
| RPMI collected specimen Frozen <0°C | Not acceptable |
| CytoLyt Frozen <0°C | Not acceptable |
Collection Instructions
1. Follow standard aseptic collection procedures.
2. Separate containers must be used for multiple sites sampled.
3. Obtain syringe and needle of each pass from Radiologist/physician by contactless transfer.
4. Ideally, there should be 0.1 to 0.25 ml of solid/bloody material in the syringe for each pass. This equates to material visible past the hub of the needle, extending into the syringe housing.
5. Place a small drop the size of a BB in the middle of one labeled slide.
6. Place inverted second slide over the first slide, allow material to spread out or apply gentle pressure to spread material out, then pull apart allowing slides to slide without out or down pressure.
7. Place on slide immediately in alcohol, allow other slide to dry
8. If material on slide is scant, gently press slides together and pop apart upward. There will be a feathering pattern. This method on scant material prevents cell trauma and distortion. It allows good interpretation on scant specimens, especially lymph nodes.
9. Repeat slide prep for each pass, usually up to 3 passes
10. Rinse remainder of material from each pass into the CytoLyt.
11. To rinse the syringe housing, hub, and needle; unscrew needle from syringe, pull 1-2 ml CytoLyt into syringe.
12. Replace needle to syringe, rinse material into CytoLyt.
13. This may need to be done twice to remove most of blood and cell sample from hub.
14. Discard needle in Sharps.
15. Repeat this needle rinse process for each pass.
16. Clots should not develop, as CytoLyt has a hemolytic agent, but if a clot develops in the needle, try to pull some CytoLyt into the needle to rinse out clot. You can also try to gently push some CytoLyt through the needle after pulling some into the syringe and securely reattaching the needle to the syringe. Avoid too much pressure to prevent leakage or splash from screw hub of needle.
17. Once 3 passes are made, inspect CytoLyt cup for particulate matter and blood fragments. Additional passes may be needed in CytoLyt if there are not visible flecks, fragments, clots and blood in the cup.
18. Slides should be made on 2-3 of the most cellular passes, the remaining passes should be rinsed just in CytoLyt.
19. Cystic fluid may exceed bloody cellular aspirate amounts. Liquid, cystic material should also be aspirated directly in the CytoLyt vial. The fluid can also be sent in a sterile container or remain in the syringe with needle removed to the lab. Solid component aspirates can have smears made, while liquid aspirated can be placed in a CytoLyt or sterile container.
20. Clear fluid cystic aspirates (ovarian cyst, etc.) should be sent directly in a sterile container or in a capped syringe.
21. Complete FNA order, specifying laterality, location of lesion(s), and other pertinent history, imaging results.
22. Complete FNA order with providers to copy. Submit paperwork including history as appropriate, FNA order with labeled slides and containers
23. Place samples in biohazard bag with appropriate paperwork.
Additional Information
1. Report provides interpretation.
2. For non-EPIC providers, results are faxed to the locations/providers.
3. Cytology results TAT: 2-3 days, performed M-F 8:00-16:30
4. If Flow Cytometry is ordered, the lab will triage the RPMI tube to PC Lab for testing. The pending flow cytometry will be indicated on the original report.
5. Flow Cytometry results are scanned into the cytology interpretive report in EPIC as an addendum, and faxed directly to Non-EPIC providers.
6. Questions on results and reporting can be directed to the pathologists @ 541-269-8453, or the cytotechnologist @ 541-269-8458
Test Limitation
Abnormal results must be correlated with history and other test results.
Synonyms
FNA, Fine Needle Aspirate, Neck, Parotid, Salivary, Lymph Node, Cyst, Miscellaneous FNA, LAB5002, Cytology
Department
Cytology