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Fine Needle Aspiration, Cytology

FNA, Needle aspirate, Fine needle biopsy, FNB, FNAB, CYTOLOGY, MEDICAL FNA, Fine Needle Aspiration (FNA) Cytology

Test Codes

EPIC: LAB2111263

Department

Cytology

Instructions

• Contact the Cytology Laboratory for assistance in preparation of the FNA specimen. Cytology staff is available for specimen preparation on routine FNAs Monday – Friday. It is strongly recommended that all deep FNAs be attended/assisted and prepared by Cytology staff between:
• 8:00 am – 2:00 pm, Monday – Friday (Dearborn)
• 7:00 am – 3:00 pm, Monday – Friday (Farmington Hills)
• 8:00 am – 3:30 pm, Monday – Friday (Grosse Pointe)
• 8:00 am – 4:00 pm, Monday – Friday (Royal Oak, ROSEs 8:00am- 3:30pm)
• 7:30 am – 3:00 pm, Monday – Friday (Troy)
• 8:00 am – 12:00 pm, Wednesdays (Taylor)
• 8:30 am – 12:00 pm, Tuesdays and Thursdays (Trenton)
• 7:30 am – 3:00 pm, Monday – Friday (Troy)
• 10:00 am, 11:00 am appointments, Tuesdays and Thursdays (Wayne)
• If it is decided to perform a fine needle aspiration during off-hours the Cytology Laboratory can supply individual containers of ThinPrep^® Cytolyt for collection of separate fine needle aspiration biopsy attempts.
• Pathologist approval must be obtained for ROSE (Rapid Onsite Evaluation for Adequacy) at least 24 hours prior to procedure
• If Hematologic malignancy is suspected dedicate two additional passes into a container of Tissue Culture Medium (RPMI) for flow cytometry testing and transport immediately or refrigerate.
• Slides, spray fixative, ThinPrep^® Cytolyt and Tissue Culture Media (RPMI) containers are available by contacting the Cytology Laboratory:

• Dearborn: 313-436-2369
• Farmington Hills: 947-521-8247
• Grosse Pointe: 313-473-1801
• Royal Oak: 248-898-9035
• Taylor: 313-295-5365
• Trenton: 734-671-3868
• Troy: 248-964-9050
• Wayne: 734-467-4275
• Outreach: 800-511-0488

Specimen Collection Criteria

Collect: Fill the hub of a 10.0 cc luer lock syringe with cellular material from the target area, using a 23 gauge or smaller needle.

• Localize lesion. 
• Draw approximately 1/2 cc of air into a 10.0 cc luer lock syringe. Place needle into lesion and apply negative pressure in order to aspirate specimen. Continue to apply negative pressure until the hub of the syringe is full. 
• Release negative pressure, withdraw the needle from the patient, and expel onto a slide provided by Cytology staff. The slide will be smeared with a second slide, one slide will be immediately spray fixed, and the other will be air dried. 
• Rinse the needle in ThinPrep^® Cytolyt. 
• The Cytology staff will label the slides with patient name, birthdate and Cytology case number.  The needle rinse specimen container will be labeled with the EPIC specimen label which contains the patient name, birthdate, medical record number, and specimen source.
• A separate pass is recommended for each additional test requested (i.e. flow cytometry, microbiology, mucin stain). Follow collection guidelines for specific testing (collection tube/solutions, handling and storage).
• In house cytology specimens should be ordered in EPIC order entry. In the “additional orders” field input “CYTOLOGY, MEDICAL FNA” and fill in all appropriate fields. Label specimen container and requisition with EPIC specimen labels. 
• All Cytology specimens must be accompanied by a requisition and must include the patient name, medical record and visit/CSN number, date of birth, date of specimen collection, pertinent patient history, ordering physician name and source of specimen. Place an EPIC specimen label on the requisition.

It is imperative when submitting multiple specimens on the same patient that the labels on the requisition and vial match the correct EPIC order to ensure proper source/collection type to be assigned to the specimens.

Physician Office/Draw Specimen Preparation

Maintain the fixed and air-dried slides or ThinPrep^® Cytolyt needle rinse at room temperature (20-26°C or 68-78.8°F), and the tissue culture media (RPMI) needle rinse refrigerated (2-8°C or 36-46°F), prior to transport.  

Preparation for Courier Transport

Transport: Fixed and air-dried slides and ThinPrep^® Cytolyt room temperature (20-26°C or 68-78.8°F), and tissue culture media (RPMI) needle rinse, refrigerated (2-8°C or 36-46°F).

Rejection Criteria

• Improper labeling of specimen container, slides or requisition. 
• Requisitions not accompanied by a specimen. 
• Improper collection of specimen (such as improper fixation). 
• Specimens contaminated with a foreign material.
• Specimens dried up in a cup or frozen.
• Slide stuck to cardboard slide carrier due to being placed in carrier while wet.
• Any specimen received without all the required information will result in a delay of processing until all information can be verified. 
• It is imperative when submitting multiple specimens on the same patient that the labels on the requisition and vial match the correct EPIC order to ensure proper source/collection type to be assigned to the specimens.

Inpatient Specimen Preparation

Dearborn:

• Deliver specimens from FNA procedures not attended by Cytology staff directly to Cytology, Monday – Friday, 7:00 am – 5:00 pm.
• Specimens are also picked up throughout the day from the surgical area and endoscopy, Monday – Friday, 7:00 am – 3:00 pm, Saturday, 8:00 am – 12:00 pm.
• When the Cytology and Histology labs are closed specimens must be delivered to the main lab and signed in.
  

Farmington Hills

• Deliver the specimen directly to the Cytology Laboratory (2nd floor, East) Monday – Friday, 7:00 am – 4:30 pm.
• Specimens are also picked up throughout the day from the surgical floors and Endoscopy, Monday – Friday at 9:00 am, 11:00 am, 1:00 pm, and 3:00 pm. 
• After 4:30p.m. and on weekends/holidays, deliver to Lab Central Processing.
  

Grosse Pointe

• Deliver specimens from non-Cytology staff attended FNAs directly to the AP lab (first level) Monday-Friday, 8:00 am-4:30 pm. After hours, the specimens are taken to the Clinical Pathology main lab (lower level), entered in the specimen log, handed to lab staff and placed in the refrigerator.
• Specimens are picked up by the AP lab staff throughout the day from the Surgical Department and Clinical Pathology main lab Monday-Friday, 8:30 am-4:00 pm.  Endoscopy and radiology specimens are delivered to the AP Lab throughout the day.
• When the AP Laboratory is closed, specimens are delivered to the Clinical Pathology main lab specimen processing area.  Specimens are to be entered into the specimen log, handed to lab staff and placed in the refrigerator
  

Royal Oak

• Specimens can be delivered to the Cytology Laboratory directly, Lower Level, Northwest tower, Monday – Friday, 6:00 am – 6:00 pm. 
• If a deep aspirate is procured when the laboratory is closed, properly prepared specimens can be delivered to the Surgical Pathology Laboratory (located on the lower level near the east tower elevators), Clinical Pathology Specimen Receiving (located in the Beaumont Laboratory Research Building), or STAT lab. Specimens are picked up from the surgical floors, Endoscopy and Clinical Pathology Monday – Friday, 8:00 am – 7:00 pm, Saturday, 7:00 am – 11:00 am, NT and Endoscopy ONLY.    

Taylor:

• Deliver the specimen to the Main Lab. Open 24/7.

Trenton:

• Specimens are picked up from Emergency Department, Interventional Radiology, and operating rooms from 8:00 am – 2:00 pm.
• After hours deliver specimens to the Main Lab. Open 24/7.

Troy

• The Cytotechnologists deliver the specimen directly to the Cytology Laboratory (Lower Level, Area D of the Troy Hospital), Monday – Friday, 7:30 am – 3:00 pm.
• If a deep aspirate is procured when the laboratory is closed, properly prepared specimens may be hand-delivered to the Specimen Reception Department, Phone: 248-964-8615.

Wayne:

• Specimens are picked up from from FNA procedures not attended by Cytology staff from Emergency Dept. and Interventional Radiology Monday through Friday 8:00 am – 2:00 pm.
• After hours deliver specimen to the Main Lab. Open 24/7.

Storage

Specimen Stability for Testing:

Fixed FNA Slides
Room Temperature (20-26°C or 68-78.8°F): 11 years
Refrigerated (2-8°C or 36-46°F): Acceptable, but not recommended
Frozen (-20°C/-4°F or below): Unacceptable

Specimens in Tissue Culture Media
Specimen must be refrigerated immediately upon procurement.
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Specimens in ThinPrep^® Cytolyt Vial
Room Temperature (20-26°C or 68-78.8°F): 14 days
Refrigerated (2-8°C or 36-46°F): 14 days
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Slides – Room Temperature (20-26°C or 68-78.8°F): 11 years
Needle Rinse in Tissue Culture Media (RPMI) – Refrigerated (2-8°C or 36-46°F): 7 days
Needle Rinse in ThinPrep^® Preservcyt Vial – Room Temperature (20-26°C or 68-78.8°F): 14 days  

Laboratory

Dearborn, Grosse Pointe, Farmington Hills, Taylor, Trenton, Troy, and Wayne Cytology Laboratories

Original specimen registration is performed prior to sending to Royal Oak Cytology Laboratory

Final results on specimens from Taylor, Trenton, Wayne, and Dearborn are issued by the Dearborn hospital. 

Final results on Farmington Hills and Troy specimens are issued by the  originating hospitals

Royal Oak Cytology Laboratory

Dearborn, Taylor, Trenton, Wayne, Grosse Pointe, Troy, and Farmington Hills specimens are sent to Royal Oak Cytology Laboratory for preparation and screening. 

Final results on Grosse Pointe and Royal Oak specimens are issued by the Royal Oak hospital.

Performed

Monday – Friday, 7:00 am – 5:00 pm (Dearborn) Attend FNAs 7:30 am – 2:00 pm
Monday – Friday, 7:00 am – 3:30 pm (Farmington Hills). Attend FNAs 7:00 am – 3:00 pm
Monday – Friday, 8:00 am – 4:30 pm (Grosse Pointe). Attend FNAs 8:00 am – 4:00 pm
Monday – Friday, 6:00 am – 6:00 pm (Royal Oak). Attend routine FNAs 8:00 am – 4:00 pm
Monday – Friday, 7:00 am – 2:00 pm (Taylor) Attend FNAs Wednesdays, 8:00 am – 12:00 pm
Monday – Friday, 7:00 am – 2:00 pm (Trenton) Attend FNAs Tuesdays, Thursdays, 8:00 am – 12:00 pm
Monday – Friday, 7:30 am – 4:00 pm (Troy). Attend FNAs 8:30 am – 3:00 pm
Monday – Friday, 7:00 am – 3:00 pm (Wayne) Attend FNAs Tuesdays, Thursdays, 10:00 am, 11:00 am

Most results are available within 24-48 hours of receipt in the Cytology Laboratory if received Monday – Friday. The Cytology Laboratory is closed on weekends and holidays. Specimens received after 3:00 pm on Friday will be processed the following Monday and resulted on Tuesday. Specimens received after 3:00 pm the day before a holiday will be processed the next working day and resulted out the following day.

Test Methodology

Smear preparation, ThinPrep^® Monolayer Preparation, Cell Block Preparation (if possible), Cytospin Preparation, (if applicable).  

CPT Codes

CPT (All Sites): 88173, 88182, 88305 (Cell block preparation, if possible).
LOINC: 33716-2. 

Contacts

Last Updated

9/26/2025