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Test Code FNAPA FINE NEEDLE ASPIRATE CYTOLOGY

Important Note

Cytopathologists are available to perform Fine Needle Aspirations on patients with palpable lesions (soft tissue and subcutaneous masses) . Same day service is the norm. Bedside or clinic referrals accepted. Rapid on-site evaluations are performed, allowing for immediate triage.

To schedule call 847-5136: Monday-Friday 7:30 to 4:00. Service available at the Main Campus, 111 Colchester Avenue, Burlington, Vermont. It is essential to include history of cancer, radiation and chemotherapy on the laboratory order.

Additional Codes

Primary ID

Epic Code

Mayo Access ID

FNAPA

LAB2671 N/A

 

Specimen Information

Fine Needle Aspiration Cytology: Thyroid

Afirma Gene Expression Classifier

If the cytopathology diagnosis is indeterminate (Bethesda Category III-IV) which includes Follicular Lesion of Undetermined Significance, Atypia of Undetermined Significance, Suspicious for Follicular Neoplasm/Follicular Neoplasm and Suspicious for Hurthle Cell Neoplasm/Hurthle Cell Neoplasm, the thyroid nodule is greater than or equal to 1 cm and the patient is 21 years or older, the Afirma Gene Expression Classifier may be performed.

Fine Needle Aspiration Cytology:  All Body Sites:

On site assessment is also available to assist providers performing procedures on non-palpable masses.Fine needle aspiration cytology is a relatively non-invasive procedure for the percutaneous collection of cells from a suspected tumor mass using an 18 to 25 gauge needle.  Lesions of the lung, mediastinum, pancreas, liver, kidney, retroperitoneum, lymph nodes and bone are done in the Medical Center Campus Radiology Department using various localizing techniques.  GYN abdominal masses, thyroid lesions, breast masses and head/neck lesions are done using ultrsound guidance by physicians in the Departments of GYN, Oncology, Endocrinology, Surgery  and ENT.  Aspiration of palpable masses are also performed by the Cytopathologists.  Arrangement for Fine Needle Aspirations should be made through the above departments or by calling Cytopathology at (802)847-5121.


Fine needle aspirate samples should be collected and processed by one of the following two techniques:

 

Slide Preparation: For physicians who perform frequent FNA procedures and are comfortable preparing fixed slides:
Hold stationary slide firmly in one hand, rest edge of spreader slide that is closer to you on stationary slide and tilt spreader slide until the aspirated material begins to spread.  Move the spreader slide toward you, applying slight pressure to thec aspirated material.  Do not lift either end of spreader slide until smear is complete. Slides can either be fixed immediately with alcohol fixative or air-Dried. Please indicate whether the slide is fixed or air-dried on the laboratory requisition.  Please label the frosted end of slide with two patient identifiers, name, and MRN or DOB.  Needle rinses can be submitted in CytoLyt as described below. The accompanying laboratory requisition should contain all pertinent clinical information.

Aspirate Collection: For physicians who perform aspirate procedures less frequently the recommended procedure is to express all of the aspirate material into a container of liquid cytology fixative (Cyto Lyt) supplied by the Cytopathology Department or into a tube of 50% ethanol.  Aspirating a small amount of the fixative into the barrel of the syringe and “rinsing the needle” into the specimen container is also recommended. Actual slide preparation will be performed in the Cytopathology Laboratory. The accompanying laboratory requisition should  contain all pertinent clinical information.

 

Fluids and Effusions for Cytology: Deliver fresh specimens to the laboratory immediately after collection.  Specimen containers (not the lid) need to be labeled with the patient’s name.  Samples collected between 4:00 pm and 7:30 am should be refrigerated upon receipt in the laboratory.  If evacuated glass plasma bottles are used for collection, 3 units of heparin per mL of anticipated fluid should be added to the bottle prior to collection, submit specimen in its entirety up to 1-liter.  No specimen should be submitted with a needle attached to the collection container or syringe.

Test Schedule / Analytical Time / Test Priority

Monday – Friday / Varies / Not available STAT

Method

Direct Smears, Thin Prep Modified Pap, Cell Block

CPT(s)

Description CPT
   

 

Section

Cytology

Performing Location

University of Vermont Medical Center

Is the UVMMC lab NY State Certified to perform this testing?  Yes/No

Yes

LOINC Code Information

N/A