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Fine Needle Aspiration, Deep - Royal Oak

FNA, Needle aspirate, Fine needle biopsy, FNB, CYTOLOGY, MEDICAL (NON-GYN/FNA)

Test Codes

EPIC: LAB6797, SOFT: CYT

Instructions

• Contact the Cytology Laboratory at 248-989-9035 for assistance in preparation of the FNA specimen. Cytology staff is available for specimen preparation on routine FNAs which begin Monday – Friday, 8:00 am – 4:00 pm. Pathologists are available for rush assessments of adequacy in the Endoscopy department and the OR suites on procedures that begin from 8:00 am – 3:30 pm.
• It is strongly recommended that all deep FNAs be attended/assisted and prepared by Cytology staff during working hours Monday – Friday, 8:00 am – 4:30 pm. 
• Slides, spray fixative, Tissue Culture Media (TCM), and ThinPrep® Cytolyt containers are available by contacting the Cytology Laboratory:
• In-House: 248-898-9035
• Outreach: 800-511-0488

Collection Fluids for FNAs:

• ThinPrep® Cytolyt: Outreach specimens without suspicion of Lymphoma, specimens collected after hours without refrigeration, thyroid and breast FNAs.
• Tissue Culture Media – Used when there is suspicion of Lymphoma, specimen is collected within the hospital and delivered immediately upon collection to Cytology or refrigerated before delivery. 

Specimen Collection Criteria

Collect: Fill the hub of a 10 cc luer lock syringe with cellular material from the target area, using a 23 gauge or smaller needle.

• Localize lesion. 
• Draw approximately 1/2 cc of air into a 10 cc luer lock syringe. Place needle into lesion and apply negative pressure in order to aspirate specimen. Continue to apply negative pressure until the hub of the syringe is full. 
• Release negative pressure, withdraw the needle from the patient, and expel onto a slide provided by Cytology staff. The slide will be smeared with a second slide, one slide will be immediately spray fixed, and the other will be air dried. 
• Rinse the needle in tissue culture media (RPMI) or ThinPrep® Cytolyt. 
• The Cytology staff will label the slides and specimen container with the patient name, hospital number, birthdate, and Cytology case number. 
• A separate pass is recommended for each additional test requested (i.e. flow cytometry, microbiology, mucin stain). 
• In house cytology specimens should be ordered in EPIC order entry. In the “additional orders” field input “CYTOLOGY, MEDICAL (NON-GYN/FNA)” and fill in all appropriate fields. IMPORTANT: ORDER AND SIGN EACH CYTOLOGY TEST INDIVIDUALLY. THE LABORATORY INFORMATION SYSTEM CANNOT FILE MULTIPLE TESTS ORDERED IN THE SAME SESSION AND SOME ORDERS MAY BE LOST. Label specimen container and requisition with SOFT ID labels. 
• All Cytology specimens must be accompanied by a requisition and must include the patient name, hospital and visit number, date of birth, date of specimen collection, pertinent patient history, physician name and source of specimen.    

Physician Office/Draw Specimen Preparation

Maintain the fixed and air-dried slides or ThinPrep® Cytolyt needle rinse at room temperature (20-26°C or 68-78.8°F), and the tissue culture media (RPMI) needle rinse refrigerated (2-8°C or 36-46°F), prior to transport. 

Preparation for Courier Transport

Transport: Fixed and air-dried slides and ThinPrep® Cytolyt room temperature (20-26°C or 68-78.8°F), and tissue culture media (RPMI) needle rinse, refrigerated (2-8°C or 36-46°F). 

Rejection Criteria

• Improper labeling of specimen container or requisition. 
• Specimen not accompanied by requisition. 
• Requisitions not accompanied by a specimen. 
• Improper collection of specimen (such as improper fixation). 
• Any specimen received without all of the required information will result in a delay of processing until all information can be verified.  

Inpatient Specimen Preparation

• Cytology staff delivers the specimen directly to the Cytology Laboratory (Lower Level, Northwest tower, Monday – Friday, 8:00 am – 4:30 pm. 
• If a deep aspirate is procured when the laboratory is closed, properly prepared specimens can be delivered to the Surgical Pathology Laboratory (located on the lower level near the east tower elevators Clinical Pathology Specimen Receiving (located in the Beaumont Laboratory Research Building), or STAT lab. Specimens may be picked up from the surgical floors, Endoscopy and Clinical Pathology Monday – Friday, 8:00 am – 7:00 pm, Saturday, 7:00 am – 11:00 am, NT and Endoscopy ONLY.    

Storage

Specimen Stability for Testing:

Fixed FNA Slides
Room Temperature (20-26°C or 68-78.8°F): 30 years
Refrigerated (2-8°C or 36-46°F): Acceptable, but not recommended
Frozen (-20°C/-4°F or below): Unacceptable

Specimens in Tissue Culture Media
Specimen must be refrigerated immediately upon procurement.
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Specimens in ThinPrep® Cytolyt Vial
Room Temperature (20-26°C or 68-78.8°F): 14 days
Refrigerated (2-8°C or 36-46°F): 14 days
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Slides – Room Temperature (20-26°C or 68-78.8°F): 30 years
Needle Rinse in Tissue Culture Media (RPMI) – Refrigerated (2-8°C or 36-46°F): 7 days     
Needle Rinse in ThinPrep® Preservcyt Vial – Room Temperature (20-26°C or 68-78.8°F): 14 days 

Laboratory

Royal Oak Cytology Laboratory

Performed

Monday – Friday, 8:00 am – 4:30 pm.
Results available within 24-36 hours of receipt in the Cytology Laboratory, if received Monday – Friday. The Cytology Laboratory is closed on weekends and holidays. Specimens received after 3:00 pm on Friday will be processed the following Monday and resulted on Tuesday. 

Test Methodology

Smear preparation, ThinPrep® Monolayer Preparation, Cell Block Preparation (if possible), Cytospin Preparation, (if applicable). 

Contacts

Last Updated

4/8/2024