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Fine Needle Aspiration for Cytology


TEST DIRECTORY
Test Name
Fine Needle Aspiration for Cytology
Description
Cytopathologic evaluation for the detection and characterization of malignancy of mass lesions.
Test Code
425
SPECIMEN REQUIREMENTS
Supplies for Submission
  • Glass slides, preferably non-adhesive
  • No. 2 pencil
  • Syringe/needle
  • Spray fixative
  • CytoLyt® or 95% ethanol
  • Specimen container
Specimen Collection

If there are any questions about the collection technique, we strongly recommend that you obtain a copy of our "FNA Biopsy Technique" video through our Client Response Center at 800.258.1253, or that you review it online at www.propath.com (Go to Healthcare Providers > Specimen Collection > FNA Biopsy Technique).

  1. Aspirate the nodule, cyst or mass according to preferred technique and submit any combination of the fluid, fixed slides, and air-dried slides to the laboratory. If submitting slides, please submit paired slides of both fixed and air-dried slides for optimal cytologic evaluation.
  2. Fluid submission
    1. Label all specimen containers with two identifiers. Acceptable identifiers include patient’s name, date of birth, social security number, requisition number, and medical record number.
    2. Express the obtained cellular material into the labeled specimen container with at least an equal volume of CytoLyt®. A "flushing or rinse" technique should be used to ensure that the residual cellular material is obtained from the needle.
    3. Tighten the cap.
    4. Write the type of fixative used on the requisition and indicate the specimen source.
  3. Paired slides submission (2-4 slides)
    1. Label slides with patient’s full first and last name, using a pencil. One of each pair of slides should be labeled as "fixed" and the other as "air dried."
    2. Transfer 1-2 drops of the aspirated material onto a glass slide which is lying on a flat surface.
    3. Invert the second slide of the pair on top of the first slide containing the specimen.
    4. Gently pull the two slides in opposite directions, spreading the cellular material evenly.
    5. Place the "fixed" slide into 95% ethanol or spray-fix immediately.
    6. Allow the "air dried" slide to dry completely as quickly as possible and maintain at room temperature. (The slide may be waved vigorously back and forth or a hair dryer can be used. Do not hold the hair dryer too close to the slide in order to avoid pushing material off the edges.)
    7. If several passes are made, or if aspirate is obtained at slightly different locations but from the same source, label accordingly with ‘A’, ‘B’, etc.
    8. Prepare additional paired slides as above.
    9. Rinse residual material in needle in CytoLyt® (preferred) or 95% ethanol; submit the vial.
DO NOT submit the needle to the laboratory. If the syringe contains residual material to be submitted to the laboratory, aspirate fixative equal to 2x volume of specimen into the syringe. Safely detach the needle with a needle-removing device and discard in a Sharp’s container. Cap the labeled syringe and submit only the syringe to the laboratory.
Storage Requirements
  • Store slides at room temperature (15 to 30°C).
  • Store fluid specimens at room temperature if fixative is used. If saline is used, refrigerate until transported.
Causes for Rejections
Click here for Specimen Rejection Criteria.
GENERAL AND TECHNICAL INFORMATION
Turn Around Time
2-3 days
Limitations
  • Allowing smears to dry before fixation will render them unsatisfactory for cytologic evaluation. If a fixative is unavailable, or the specimens will be processed within 24 hours, sterile saline may be used with a note on the requisition, "saline used - no fixative."
  • Specimens in incorrect fixative (such as formalin) can only be processed as cell blocks.
CPT Code
88172, 88173, 88177