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Fine Needle Aspiration, Superficial - Royal Oak

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

Test Codes

EPIC: LAB6797, SOFT: CYT

Instructions

Slides, spray fixative, and ThinPrep CytoLyt Solution® or Tissue Culture Medium (RPMI) are available by contacting the Royal Oak Cytology Laboratory at 248-898-9035 (extension 89035).

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, 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 organ, using a 23 gauge or smaller needle.

• Using a lead pencil only, label the end of the frosted slide and clear glass slide with the patient's name and birthdate.  Please indicate specimen laterality (“R” or “L”) if appropriate.
• Each pass into the lesion must be identified separately (i.e. 1, 2, 3, ...) on the glass slide.
• Draw approximately 1/2 cc of air into a 10 cc luer lock syringe.
• Place needle into palpable lump or bump 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 fully frosted slide.
• Using a clear glass slide, smear the specimen on the fully frosted slide lengthwise.
• Immediately spray fix the fully frosted slide. Spray should be about 3 inches from the slide. Allow the fully frosted slide to air dry after you spray the fixative.
• Allow the clear glass slide to air dry (do not spray fix the clear glass slide).
• Place all slides in slide carrier labeled with patient’s full name, date of birth, hospital number, source of specimen and date of test.
• Rinse the needle in ThinPrep CytoLyt Solution®. If lymphoma is suspected collect specimen in Tissue Culture Medium (RPMI) and transport immediately or refrigerate.
• Cystic fluid should be placed in the ThinPrep CytoLyt Solution®. Note on the specimen container the amount, the color, and the consistency of the cystic fluid retrieved. 
• 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 requisitions 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 fixed FNA slides and ThinPrep CytoLyt Solution® at room temperature (20-26°C or 68-78.8°F) prior to transport. Refrigerate needle rinsing collected in Tissue Culture Medium (RPMI) prior to transport.

Preparation for Courier Transport

Transport: Maintain fixed FNA slides and ThinPrep CytoLyt Solution® at room temperature (20-26°C or 68-78.8°F) prior to transport.  

Rejection Criteria

• Improper labeling of specimen container or requisition.
• Specimens placed in cardboard carrier with wet fixative resulting in the slide sticking to the cardboard.
• 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

• Deliver specimen directly to the Cytology Laboratory (north tower, lower level, west wing) Monday – Friday, 8:00 am – 4:30 pm.
• Specimens are also picked up from the surgical floors, endoscopy and clinical pathology Monday – Friday, 8:00 am – 7:00 pm, and Saturday 7:00 am – 11:00 am, NT and Endoscopy ONLY.
• When the laboratory is closed specimens may be delivered to the Surgical Pathology Laboratory (located on the lower level near the east tower elevators) or clinical pathology specimen receiving (located in the Beaumont Laboratory research building), or STAT Lab.

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, not recommended
Frozen (-20°C/-4°F or below): Unacceptable

ThinPrep® CytoLyt Solution®
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 

Needle rinsing in Tissue Culture Medium (RPMI) 

Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable
Fixed Archived FNA Slides Room Temperature (20-26°C or 68-78.8°F): 30 years

Specimen Storage in Department Prior to Disposal:

Needle rinse in Tissue Culture Medium (RPMI): Refrigerated (2-8°C or 36-46°F): 7 days
Needle rinse in ThinPrep® PreservCyt: Room Temperature (20-26°C or 68-78.8°F): 1-4 days 

Laboratory

Royal Oak Cytology Laboratory

Performed

Test Methodology

Smear preparation, Monolayer Preparation, Cell Block Preparation when possible (orderable only by pathologist).

CPT Codes

CPT: 88104, 88112, 88305, 88108.
LOINC: 33716-2

Contacts

Last Updated

4/8/2024