Neck Fine Needle Aspirate

Test Name:   Neck Fine Needle Aspirate
Alternate Name (s):    
Laboratory Module:   Cytology
Ordering Mnemonic:   All specimens must be accompanied by a completed manual or Meditech generated cyto-pathology non-gynecological requisition. All mandatory fields must be satisfied in order to complete the request. In the case of computer downtime use the standard cytopathology non-gynecological requisition.
Specimen Type:   

An excised FNA of the neck

Collection Container:   Collect in cytology fixative  
Container Information
Specimen submitted in cytology fixativeSpecimen submitted in cytology fixative
Collection Information:  


 

I.1.All specimens must be accompanied by a completed manual or Meditech generated cyto-pathology non-gynecological requisition. All mandatory fields must be satisfied in order to complete the request. In the case of computer downtime use the standard cytopathology non-gynecological requisition.

The following information is required on the requisition
(a) Patient identifiers (addressographs may be used)

      (i) patient's first and last name
      (ii) hospital unique number
      (iii) date of birth
      (iv) Ontario Health Insurance Number with version code.
(b) Submitting area identifiers: Hospital site (BGH or The Willett) and the submitting department (Emergency, Ambulatory Care etc.).
(c) Submitting physician's name.
(d) Date of specimen collection
(e) Pre- and post-operative presumptive diagnosis.
(f) A brief clinical history, relevant pathological and radiological findings.
(g) Specimen information
     (i) specimen type/source
     (ii) specimen site
    
I.2. If received, the specimen container must be labeled. Addressograph labels are preferred, otherwise the following information must be provided, clearly written in ink:
(a) Patient identifiers -
     (i) patient's full name
     (ii) hospital unique number
     (iii) and at least one other unique additional identifier (ie. date of birth, OHIN).
(b) Date of specimen collection.
(c) Specimen type and site, as it is written on the Cytology Requisition form.
This information must be recorded on the side of the specimen container and not the lid.
If a specimen is known or suspected to contain unique or extreme biohazard (e.g. CJD) the container shall be so marked.

I.3.Place labeled slides with the patients name and specimen type, in a cardboard slide holder and drying and attach an addressograph label on the outside of the holder.

I.4. Place specimen containers in a biohazard bag (if applicable). The requisition should be placed in the outer pouch of the biohazard bag.

I.5. Transport specimen to the Triage area of the laboratory as soon as possible

I.6. Inform the triage staff that you have delivered a specimen.

Taking the FNA and preparing smears

1. Fine needle aspirate is taken from the patient and physician expels part of the needle contents onto the labeled slide (with pencil, NO pen).

2. The second slide is placed upside down over the first slide and specimen is allowed to spread. Gently separate the slides by pulling labeled ends in opposite directions. If still not spread, repeat smearing technique just once more.

3. Once slides are separated, set them back in the mailer and quickly spray the cytospray fixative. Spray liberally (~8 sprays) from 30 cm away from the slide ( ~ the length of a piece of paper). If sprayed too closely, it will damage the cells or even blow them off of the slide. If sprayed too far away, cells may not get fixed and may degenerate.

4. While someone is making the smears, the physician immediately rinses the needle in the cytology fixative to prevent air drying. First dispel the needle content in the container of fixative, gently aspirate the fixative and then expel it back into the container. This process should be repeated a few times to wash lingering cells out of the needle bore.

Any further attempts at aspiration can be washed in the same original container of cytology fixative as long as the site has not changed. If any subsequent needle aspirations are taken from a different site on the same patient, a new FNA Kit must be prepared and used.

 

Test Schedule:  

Monday to Friday prior to 1:00 pm

Turnaround Time:   Routine

1 week

Stat / Urgent

2 days

Reference Interval:  

 

Critical Values:    
Lab Process Notes :    
Storage & Transport:   Specimens should be stored at room temperature in the cytology box
Test Referred to :    BGH, On site
 
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