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Fine Needle Aspiration
Collection

Test indication: Fine needle aspiration of mass lesions is commonly utilized in the detection and characterization of a variety of malignant diseases. Obtaining an adequate specimen requires attention to good aspiration technique as well as processing of material obtained. It is highly desirable that several direct smears be prepared (preferably air-dried) for all fine needle aspiration specimens submitted to Cytopathology Laboratory.

Methodology: Routine cytopathologic evaluation.
Performed: Monday-Friday.
Reported: 1 day.

Collection of FNA Specimens

Patient Preparation
a) Examine the patient with review of clinical history.
b) Determine the gross characteristics of the mass to be aspirated including location relative to other structures, estimated depth, consistency and any evidence of pulsation or bruit.
c) If the lesion is not palpable, then fine aspiration procedure can also be done using ultrasound fluoroscopy or CT scan guidance by radiology.

Specimen required: Adequate cellular material for cytologic evaluation obtained from an appropriately performed fine needle aspiration. This will depend on the specimen site and character of the lesion being aspirated. In general, this requires that there be enough material for the examiner to at least determine that the aspiration needle sampled the targeted mass lesion.

Supplies: 10 mL syringe. Syringe pistol (optional). 22 to 25 gauge needle of appropriate length. Single-end frosted glass slides labeled with the patient’s first and last name and specimen source (for preparation of direct smears). Alcohol skin preparation pad. Fixative (either CytoRich Red™ cytology preservative or 95% ethanol).

Collection procedures: Please note that the following collection procedure is a suggested guideline. Aspiration techniques vary widely based on personal preferences and specific clinical circumstances must be taken into account when deciding on the method of aspiration utilized.

Identification and Localization of a Mass Lesion

Mass lesions usually come to attention either by simple identification of the development of a palpable mass (usually superficially) or by the development of symptoms directly or indirectly caused by the lesion. In order to be able to sample the identified lesion, some means of accurate localization must be available. If the mass is superficial, simple isolation of the mass by palpation using the thumb and index fingers of the non-aspirating hand is usually sufficient. For deeper masses, ultrasound or radiographic techniques are usually required for accurate guidance and localization of the aspirating needle.

See Links Below for more specific information

FNA Obtaining Specimen
Aspiration of Superficial Masses-Procedural Notes
Aspiration of Deep Lesions-Procedural Notes
FNA-Preparation of Direct Smears
FNA Clinic


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