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Fine Needle Aspiration
FINE NEEDLE ASPIRATION

 

Your Pathology Team

 

Gyn (Pap Smear) Results:
 
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858.939.3600
Supplies and Requisitions:
 

619.295.0506
619.295.0964
619.295.0853(fax)

Other Inquires:
Pathology 619.295.0965
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FINE NEEDLE ASPIRATIONS OF PALPABLE LESIONS - Protocol

Equipment

1.
Use 22-25 gauge disposable needles with lengths from 1 to 3 inches

2.
Disposable 20 mL plastic syringe

3.
Aspiration syringe holder (aspiration gun) if possible

4.
Coplin jar or plastic container with 95% ethanol or reagent alcohol

5.
Vial with Saccomanno type solution (Green Fluid)

6.
Microscopic glass slides (Frosted-end for labeling)

 

Aspiration Procedure

1.
The syringe gun, syringe, and needle are assembled.
All slides and specimen containers are labeled with patient name and a requisition form is completed.

2.
The lesion is palpated and its distance from the skin estimated.

3.
Skin surface is sterilized with alcohol or other iodine-like solution.

4.
The target is fixed with one hand, usually between index finger and thumb.

5.
The needle is placed into the mass. Usually a distinct change in consistency of tissue is felt when a subcutaneous lesion is entered.

6.
The plunger on the syringe is withdrawn to create a vacuum. The needle tip is moved within the mass with short movements, withdrawing approximately 2 to 5 mm and reinserting with redirection of the needle tip. At least three needle passes should be performed within the target lesion.

7.

Negative pressure within the syringe is released when aspiration is complete or when any hemorrhagic material or fluid is noted within the needle hub or syringe.

NOTE: If a cystic lesion is aspirated, the cyst fluid should be placed directly into a separate vial of Saccomanno-type solution. It is recommended that the cyst wall of the lesion then be reaspirated to insure that the cyst wall has been properly sampled.

 

Specimen / Slide Preparation

1.

A small drop of the aspirated material is carefully expressed onto the glass slide (Labeled side up). Several slides are usually prepared at one time in this fashion.

NOTE: If a drop cannot be expressed, the syringe needle may be detached and the plunger withdrawn to fill the syringe with a small amount of air and the needle reattached to the syringe.
(Careful! Use single-hand technique only.) The specimen should then be more easily expressed.

2.
Smears are prepared by placing one glass slide perpendicular to the other, over the expressed material. The expressed material is GENTLY smeared over the original glass slide surface by sliding the second perpendicular slide over its surface.
(No resistance should be felt. It is not necessary to cover the entire slide with material.)

3.

Once the smear is achieved, the original glass slide should be IMMEDIATELY placed in the alcohol fixative (have Coplin jar containing 95% alcohol ready). The remaining slides are smeared one at a time and placed in the alcohol fixative.

NOTE: If air-dried smears are desired, no fixative is required. These are sometimes helpful in lesions involving the thyroid gland, salivary glands, and lymph nodes.
The slides should also be labeled "air-dried."

4.

The needle should then be rinsed with Saccomanno fixative for later cytospin or cell block preparations. This is done by drawing some fluid into the syringe and then expressing the entire contents into the vial.

NOTE: All slides and specimen containers must be labeled with the patient name and sent with a completed requisition form.

If enough material is available, a few air dried smears may also be prepared. These are sometimes helpful in lesions involving the thyroid gland, salivary gland and lymph nodes. The slides should be labeled "Air Dried".


For additional information or questions, contact Dr. Wayne Muller 858.939.3660

FOR ALCOHOL AND SACCOMANNO FIXATIVE
CALL CYTOLOGY DEPT AT (619) 295-0964

 

 

 


 
 
 

 

 


 
 

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