Thyroid Fine Needle Aspirate

Category: Cyto

Mneumonic - AB - Cyto Aspiration Biopsy

Thyroid

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. The specimen container must be labeled. Addressograph labels are preferred, otherwise the following information must be provided, clearly written in ink:
(a)  Minimum of 2 Patient identifiers 
(i) patient's full name ... and
(ii) hospital unique number
(iii) Date of birth,

(iiii)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 the container shall be so marked. Cytology technical processing is not performed on positve CJD cases. For suspect CJD cases, the specimen may be held and processed  once a negative CJD result is confirmed.

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

I.4. Place specimen containers in a biohazard bag. 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.

Collecting the FNA sample and preparing the smears

1. The fine needle aspirate is taken from the patient and physician expels part of the needle contents from the first pass onto the labeled slide (with pencil, or inedible pen). It is important to note that the majority of the material be fixed in Cytolyt rather than on the smear. Place one drop of aspirate material in the centre of the slide close to the labelled end.
 
2. With the long edge of a second slide held at 90 degrees, smear the content along the slide length. 
 
3. Fix both slides immediately with cytospray, holding the bottle no closer than 6 inches from the slide. 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. Allow wth smeared slides to dry completely before placing them into the slide holders for transport.

4. While someone is making the smears, the physician immediately expels the remaining specimen into the container with cytolyt preservative and rinses the needle to prevent air drying. First dispel the needle content in the container of preservative, gently aspirate the preservative 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 specimen container and order must be entered.

Usually the first pass yields the most diagnostic material. Diagnostic yield can be improved by using up to 3 passes. The use of more than 3 passes does not generally incrase the yield.

Monday to Friday