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Fine Needle Aspiration, Cytology

FNA, Needle aspirate, Fine needle biopsy, FNB, FNAB, CYTOLOGY, MEDICAL FNA

Test Codes

EPIC: LAB2111263

Department

Cytology

Instructions

• Contact the Cytology Laboratory for assistance in preparation of the FNA specimen. Cytology staff is available for specimen preparation on routine FNAs Monday – Friday.
• It is strongly recommended that all deep FNAs be attended/assisted and prepared by Cytology staff between:
• 8:00 am – 4:00 pm, Monday – Friday (Royal Oak, ROSEs 8:00am- 3:30pm)
• 7:00 am – 3:00 pm, Monday – Friday (Farmington Hills)
• 8:00 am – 3:30 pm, Monday – Friday (Grosse Pointe)
• 7:30 am – 3:00 pm, Monday – Friday (Troy)
• 8:00 am – 2:00 pm, Monday – Friday (Dearborn)
• 8:00 am – 12:00 pm, Wednesdays (Taylor)
• 8:30 am – 12:00 pm, Tuesdays and Thursdays (Trenton)
• 7:30 am – 3:00 pm, Monday – Friday (Troy)
• 10:00 am, 11:00 am appointments, Tuesdays and Thursdays (Wayne)
• If it is decided to perform a fine needle aspiration during off-hours the Cytology Laboratory can supply individual containers of ThinPrep^® Cytolyt for collection of separate fine needle aspiration biopsy attempts.
• If Hematologic malignancy is suspected dedicate two additional passes into a container of Tissue Culture Medium (RPMI) for flow cytometry testing and transport immediately or refrigerate.
• Slides, spray fixative, ThinPrep^® Cytolyt and Tissue Culture Media (RPMI) containers are available by contacting the Cytology Laboratory:

• Dearborn: 313-436-2369
• Farmington Hills: 947-521-8247
• Grosse Pointe: 313-473-1801
• Royal Oak: 248-898-9035
• Taylor: 313-295-5365
• Trenton: 734-671-3868
• Troy: 248-964-9050
• Wayne: 734-467-4275
• Outreach: 800-511-0488

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 ThinPrep^® Cytolyt. 
• The Cytology staff will label the slides with patient name, birthdate and Cytology case number.  The needle rinse specimen container will be labeled with the EPIC specimen label which contains the patient name, birthdate, medical record number, and specimen source.
• A separate pass is recommended for each additional test requested (i.e. flow cytometry, microbiology, mucin stain). Follow collection guidelines for specific testing (collection tube/solutions, handling and storage).
• In house cytology specimens should be ordered in EPIC order entry. In the “additional orders” field input “CYTOLOGY, MEDICAL FNA” and fill in all appropriate fields. Label specimen container and requisition with EPIC specimen labels. 
• All Cytology specimens must be accompanied by a requisition and must include the patient name, medical record and visit/CSN number, date of birth, date of specimen collection, pertinent patient history, ordering physician name and source of specimen. Place an EPIC specimen label on the requisition.

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, slides or requisition. 
• Specimen not accompanied by requisition. 
• Requisitions not accompanied by a specimen. 
• Improper collection of specimen (such as improper fixation). 
• Specimens contaminated with a foreign material.
• Specimens dried up in a cup or frozen.
• Slide stuck to cardboard slide carrier due to being placed in carrier while wet.
• Any specimen received without all the required information will result in a delay of processing until all information can be verified. 

Inpatient Specimen Preparation

Royal Oak

• Specimens can be delivered to the Cytology Laboratory directly, Lower Level, Northwest tower, Monday – Friday, 6:30 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 are 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.    

Farmington Hills

• Deliver the specimen directly to the Cytology Laboratory (2nd floor, East) Monday – Friday, 7:00 am – 4:00 pm.
• Specimens are also picked up throughout the day from the surgical floors and Endoscopy, Monday – Friday, 8:00 am – 3:00 pm.
• When the Cytology Laboratory is closed, specimens must be delivered to Laboratory Central Processing.

Troy

• The Cytotechnologists deliver the specimen directly to the Cytology Laboratory (Lower Level, Area D of the Troy Hospital), Monday – Friday, 7:30 am – 3:00 pm.
• If a deep aspirate is procured when the laboratory is closed, properly prepared specimens may be hand-delivered to the Specimen Reception Department, Phone: 248-964-8615.

Grosse Pointe

• Cytology staff delivers the specimen directly to the Cytology Laboratory (first floor) Monday – Friday, 8:30 am – 4:00 pm.
• If a deep aspirate is procured when the laboratory is closed, properly prepared specimens must be delivered to the Clinical Pathology Specimen Processing area. 

Dearborn:

• Deliver the specimen to the main lab drop off window and sign in. Open 24/7.
• Deliver directly to Cytology, Monday – Friday, 7:00 am – 5:00 pm.
• Specimens are also picked up throughout the day from the surgical area and endoscopy, Monday – Friday, 6:00 am – 4:30 pm, Saturday, 8:00 am – 12:00 pm.
• When the Cytology lab is closed specimens must be delivered to the main lab window and signed in.

Taylor:

• Deliver the specimen to the main lab. Open 24/7.

Trenton:

• Specimens are picked up from Emergency Dept., Interventional Radiology, and operating rooms from 8:00 am – 2:00 pm.
• After hours deliver specimens to the main lab. Open 24/7.

Wayne:

• Specimens are picked up from Emergency Dept. and Interventional Radiology from 8:00 am – 2:00 pm.
• After hours deliver specimen to the main lab. Open 24/7.

Storage

Specimen Stability for Testing:

Fixed FNA Slides
Room Temperature (20-26°C or 68-78.8°F): 11 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, 7 days at Dearborn
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): 11 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

Dearborn Cytology Laboratory
Taylor, Trenton and Wayne specimens are sent to Dearborn Cytology Laboratory for preparation, screening and issuing final results.

Royal Oak Cytology Laboratory
Grosse Pointe and Farmington Hills specimens are sent to Royal Oak Cytology Laboratory for preparation and screening.Final results are issued by originating hospital.

Troy Cytology laboratory (some prepared and screened at Royal Oak Cytology).

Performed

Monday – Friday, 7:00 am – 5:00 pm (Dearborn) Attend FNAs 8:00 am – 2:00 pm
Monday – Friday, 7:00 am – 4:00 pm (Farmington Hills). Attend FNAs 7:00 am – 3:00 pm
Monday – Friday, 8:30 am – 4:00 pm (Grosse Pointe). Attend FNAs 8:00 am – 3:30 pm
Monday – Friday, 6:30 am – 4:30 pm (Royal Oak). Attend routine FNAs 8:00 am – 4:30 pm
Monday – Friday, 7:00 am – 3:00 pm (Taylor) Attend FNAs Wednesdays, 8:00 am – 12:00 pm
Monday – Friday, 7:00 am – 3:00 pm (Trenton) Attend FNAs Tuesdays, Thursdays, 8:00 am – 12:00 pm
Monday – Friday, 7:30 am – 4:00 pm (Troy). Attend FNAs 7:30 am – 3:00 pm
Monday – Friday, 7:00 am – 3:00 pm (Wayne) Attend FNAs Tuesdays, Thursdays, 10:00 am, 11:00 am

Most results are available within 24-48 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. Specimens received after 3:00 pm the day before a holiday will be processed the next working day and resulted out the following day.

Test Methodology

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

CPT Codes

CPT (All Sites): 88173, 88182, 88305 (Cell block preparation, if possible).
LOINC: 33716-2. 

Contacts

Last Updated

10/22/2024