BODY FLUID COLLECTION PROCEDURES


Test Information: 


DCCC uses the ThinPrep Processor, an automated instrument, to prepare body fluid specimens.  This method of body fluid preparation consistently produces high quality slides for microscopic evaluation. In order to maximize the capabilities of the ThinPrep Processor, all body fluid specimens should be collected in CytoLyt Solution.  CytoLyt is a fixative designed specifically for this instrument.  CytoLyt lyses red blood cells, dissolves mucus, prevents precipitation of protein and preserves and enhances cellular morphology.

DCCC will provide 90ml non-sterile specimen containers, each with 30ml of CytoLyt.  All specimens less than or equal to 50ml in volume should be collected in CytoLyt.  A 50ml aliquot of specimens should be transferred to the specimen container of CytoLyt.  Specimens must be fixed IMMEDIATELY in order to avoid degeneration of the cells.  Indicate on the Non-Gyn requisition the total volume of specimen collected.  Write the collection date on the excess specimen and store in a refrigerator until an adequate report is received.  A 30ml aliquot of specimen should be adequate for evaluation.  The refrigerated excess is for back up only.  Please dispose of excess specimen according to biohazard procedure. 

Please read the following procedures for body fluid collection carefully and completely.  You may want to copy and post the procedures that you perform most often.  There are many similarities between the procedures, but be sure to notice the differences as well.  The most important elements of body fluid collection are adequate fixation and precise identification of the patient's specimen.


Notes:

  1. All specimen containers (not lid) must be labeled with the following information:
    • Patient's name
    • Physician's name
    • Source of specimen
    • Date of Collection  
  2. A Non-Gyn requisition form must be used.  It must filled out completely and accurately with the following information:
    • Patient's name, birth date and sex
    • Physician's name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments)
  3. A separate requisition must be filled out for each specimen
  4. Biohazard bags must be used for all body fluid specimens. 
    • Place the specimen in the ziplock portion of the bag and seal it. 
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.
  5. All applicable State and Federal Regulations must be followed.  This includes, but is not limited to, the Clinical Laboratory Improvement Act of 1988 and OSHA Bloodborne Pathogens Standard.  Failure to comply with all regulations will result in rejection of specimen.
  6. If you have any questions, please call DCCC technical staff at: (608) 255-5135.


 

ANAL PAP

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Test Code:  9012 / CPT Code: 88112


Supplies:

  1. ThinPrep Pap Collection Vial or Non-sterile specimen containers with 30ml of CytoLyt
  2. Dacron swab or Cytobrush (endocervical brush)
  3. Non-Gyn requisitions
  4. Biohazard Bags

Collection:

  1. USE UNIVERSAL PRECAUTIONS.
  2. Insert a water-moistened Dacron swab (or Cytobrush) 5-6 cm into the anus to insure sampling of the anorectal transformation zone.
  3. Slowly rotate the swab or brush in a cone-shaped arc while maintaining firm pressure against the mucosa until the device is withdrawn.
  4. Rinse the swab or brush as quickly as possible in the collection container. 
    • Rotate the brush 10 times while pushing against the container wall.
    • Swirl the brush vigorously to further release material.
    • Discard the brush.
  5. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  6. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition card must be filled out for each specimen.
  7. Send specimen container and requisition card in a Biohazard bag to DCCC.
    • Tighten lid of collection container, place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Storage Instructions:

  1. No special storage instructions are necessary because the specimen is immediately fixed in a fluid preservative


 

EFFUSIONS

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Synonyms:

  • Pleural fluid
  • Peritoneal fluid
  • Pericardial fluid
  • Paracentesis
  • Abdominal fluid
  • Ascites
  • Lung fluid

Test Code:  C9012 / CPT Code: 88112 (fluid) and 88305 (cell block)


Supplies:

  1. Non-sterile specimen container with 30ml of CytoLyt
  2. Non-Gyn requisition
  3. Biohazard Bag

Collection:

  1. USE UNIVERSAL PRECAUTIONS.
  2. All effusions less than or equal to 30ml in volume should be IMMEDIATELY collected in CytoLyt.
  3. For larger volumes, up to a 50ml aliquot of specimen should be IMMEDIATELY transferred to the container of CytoLyt. 
    • Try to include any visible clots in specimen to be submitted.
    • Only submit one CytoLyt container for each specimen.
    • Write the collection date on the remaining specimen and store in refrigerator until an adequate report is received.
    • Dispose of the remaining specimen according to Biohazard procedure.
  4. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  5. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments)
    • A separate requisition must be filled out for each specimen.
  6. Send specimen container and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container, place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.     

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.


 

LAVAGE OR WASH SPECIMENS

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Synonyms

  • Bronchial Wash
  • Bronchial Alveolar Lavage
  • Bladder Wash
  • Kidney Pelvis Wash
  • Ureteral Wash
  • Peritoneal Wash
  • Pelvic Wash
  • Paracolic Gutter Wash
  • Cul-de-sac Wash

Test Code: C9012 / CPT Code: 88112


Supplies:

  1. Non-sterile specimen container with 30ml of CytoLyt
  2. Non-Gyn requisition
  3. Biohazard Bag

Collection:

  1. USE UNIVERSAL PRECAUTIONS.
  2. All specimens less than or equal to 30ml in volume should be IMMEDIATELY collected in CytoLyt.
  3. For larger volumes, up to a 50ml aliquot of specimens should be IMMEDIATELY transferred to the container of CytoLyt. 
    • Try to include any visible clots in specimen to be submitted.
    • Write the collection date on the remaining specimen and store in refrigerator until an adequate report is received.
    • Dispose of the remaining specimen according to Biohazard procedure.
  4. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  5. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition must be filled out for each specimen.
  6. Send specimen container and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container, place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.


 

BRUSH SPECIMENS

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Synonyms

  • Bronchial Brush
  • Esophageal Brush
  • Gastric Brush
  • Duodenal Brush
  • Pancreatic Duct Brush
  • Bile Duct Brush
  • Ureteral Brush

Test Code: C9012 / CPT Code: 88112


Supplies:

  1. Non-sterile specimen container with 30ml of CytoLyt
  2. Non-Gyn requisition
  3. Biohazard Bag

Collection:

  1. USE UNIVERSAL PRECAUTIONS.
  2. Rinse brush as quickly as possible in the CytoLyt filled container. 
    • Rotate the brush 10 times while pushing against the container wall.
    • Swirl the brush vigorously to further release material.
    • Discard the brush.
  3. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  4. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition must be filled out for each specimen.
  5. Send specimen container and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container, place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.


 

SPUTUM

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Synonyms

  • Consecutive Early Morning Sputum
  • Post Bronchoscopy Sputum

Test Code: C9012 / CPT Code: 88112


Supplies:

  1. Non-sterile specimen containers with 30ml of CytoLyt
  2. Non-Gyn requisitions
  3. Biohazard Bags

Collection:

  1. USE UNIVERSAL PRECAUTIONS
  2. For consecutive early morning sputum samples:
    • Collect early morning, “deep cough” specimen (not saliva) and place into CytoLyt container.
    • Specimen should be obtained before the patient has eaten.
  3. For post bronchoscopy sputum samples:
    • Collect separate sputum specimens at 24 and 48 hours after bronchoscopy is performed.
    • Collect “deep cough” specimen (not saliva) and place into CytoLyt container.
  4. Secure the lid and gently shake specimen.
  5. It is important to keep each specimen separate and state the collection date on both the specimen and the requisition.
  6. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  7. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition must be filled out for each specimen.
  8. Send specimen container and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container, place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.


 

URINE

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Synonyms

  • Voided Urine
  • Catheterized Urine

Test Code: C9012 / CPT Code: 88112


Supplies:

  1. Non-sterile specimen container with 30ml of CytoLyt
  2. Non-Gyn requisition
  3. Biohazard Bag

Collection:

  1. USE UNIVERSAL PRECAUTIONS.
  2. Collect a midday urine specimen, not the first urine of the morning.
  3. Catheterized urine in female patients is preferred, clean catch urine is acceptable.
  4. Try to avoid the use of excessive lubricant as this obscures cellular detail.
  5. After collecting specimen, IMMEDIATELY place it into specimen container of CytoLyt up to a total volume of 80ml.
  6. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  7. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen–PLEASE INDICATE WHETHER IT IS A VOIDED OR CATHETERIZED SPECIMEN.
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments)
    • A separate requisition must be filled out for each specimen
  8. Send specimen container and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container, place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.


 

MISCELLANEOUS CYTOLOGY SPECIMENS

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Synonyms

  • Cerebral spinal fluids
  • Joint/Synovial fluids
  • Ovarian fluid
  • Diaphragm scraping

Test code: C9012 / CPT Code: 88112


Supplies:

  1. Non-sterile specimen container with 30ml of CytoLyt
  2. Non-Gyn requisition
  3. Biohazard Bag

Collection:

  1. USE UNIVERSAL PRECAUTIONS.
  2. All effusions less than or equal to 30ml in volume should be IMMEDIATELY collected in CytoLyt.
  3. For larger volumes, up to a 50ml aliquot of specimens should be IMMEDIATELY transferred to the container of CytoLyt. 
    • Try to include any visible clots in specimen to be submitted.
    • Write the collection date on the remaining specimen and store in refrigerator until an adequate report is received.
    • Dispose of the remaining specimen according to Biohazard procedure.
  4. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  5. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition must be filled out for each specimen.
  6. Send specimen container and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container, place the specimen in the ziplock portion of the bag and seal it.
    • The Non-Gyn requisition goes into the back pocket with the overlapping flaps.

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.


 

TZANCK TESTING

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Synonyms

  • Herpes cytology
  • Tzanck smear

Notes:

  1. There are two techniques for specimen collection:
    • Preferred method using liquid-based collection (monolayer).
    • Alternate method using glass slides (smear).

Preferred Method – Test Code: C9012 / CPT Code: 88112

Alternate Method – Test Code: C9003 / CPT Code: 88161


Supplies:
Liquid-Based Collection (Preferred Method):

  1. Spatula or wooden scraper
  2. Non-sterile specimen container with 30ml of CytoLyt
  3. Non-Gyn requisition
  4. Biohazard Bag

Glass Slide Preparation (Alternate Method):

  1. Glass slide(s) with frosted ends
  2. Plastic or wooden spatula
  3. Cytology spray fixative or coplin jar filled with 95% alcohol
  4. Slide transport container
  5. Non-Gyn requisition
  6. Biohazard Bag

Collection:

Liquid-Based Collection (Preferred Method):

  1. USE UNIVERSAL PRECAUTIONS.
  2. Remove necrotic material to reach fresh specimen area and scrape underlying lesion.
  3. Rinse scraper as quickly as possible into the CytoLyt container.
    • Swirl the spatula vigorously in the vial 10 times.
    • Discard the spatula.
  4. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  5. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition must be filled out for each specimen.
  6. Send specimen container and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container, place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Glass Slide Preparation (Alternate Method):

  1. USE UNIVERSAL PRECAUTIONS.
  2. Using a No.2 pencil, label slide(s) with patient’s name.
  3. Remove necrotic material to reach fresh specimen area and scrape underlying lesion.
  4. Prepare a uniform thin smear on slides(s).
  5. Immediately fix slides by immersing the slide in the alcohol for 30 seconds or by using the cytology spray fixative.
    • It is important not to allow the material on the slide to dry in any way prior to fixation.
    • After fixation, allow slide to dry, face up on paper toweling.
  6. Place slide(s) into slide transport containers.
  7. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information.
    • A separate requisition must be filled out for each specimen.
  8. Send slide container and requisition in a Biohazard bag to DCCC.
    • Place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.


BREAST DISCHARGE

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Synonyms

  • Breast Discharge
  • Nipple Discharge

Notes:

  1. There are two techniques for specimen collection:
    • Preferred method using liquid-based collection (monolayer).
    • Alternate method using glass slides (smear).

Preferred Method – Test Code: C9012 / CPT Code: 88112

Alternate Method – Test Code: C9003 / CPT Code: 88161


Supplies:
Liquid-Based Collection (Preferred Method):

  1. Non-sterile specimen container with 30ml of CytoLyt
  2. Non-Gyn requisition
  3. Biohazard Bag

Glass Slide Preparation (Alternate Method):

  1. Glass slide(s) with frosted ends
  2. Cytology spray fixative or coplin jar filled with 95% alcohol
  3. Slide transport container
  4. Non-Gyn requisition
  5. Biohazard Bag

Collection:

Liquid-Based Collection (Preferred Method):

  1. USE UNIVERSAL PRECAUTIONS.
  2. Immobilize breast.
  3. Nurse, assistant or patient can hold specimen container under breast.
  4. Gently express breast until discharge appears.
  5. Allow drop to fall into specimen container.
  6. Continue to express breast in full clock-like manner.
  7. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  8. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition must be filled out for each specimen.
  9. Send specimen container and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container, place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Glass Slide Preparation (Alternate Method):

  1. USE UNIVERSAL PRECAUTIONS.
  2. Using a No.2 pencil, label slides with patient’s name.
  3. Express breast until a single drop forms at the nipple.
  4. Gently press slide against droplet and smear by moving slide lengthwise across the nipple to make an even, thin smear.
  5. If more than one droplet is expressed:
    • Place material on one of the slides.
    • Place the second slide on top of the first slide and very gently pull the slides across each other in opposite directions.
  6. Immediately fix slide(s) by immersing the slide in the alcohol for 30 seconds or by using the cytology spray fixative.
    •  It is important not to allow the material on the slide to dry in any way prior to fixation.
    • After fixation, allow slide to dry, face up on paper toweling.
  7. Place slide(s) into slide transport containers.
  8. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition must be filled out for each specimen.
  9. Send slide container and requisition in a Biohazard bag to DCCC.
    • Place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.


FINE NEEDLE ASPIRATIONS–CYSTS

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Synonyms

  • Breast cysts
  • Thyroid cyst
  • Miscellaneous cysts

Test Code: C9012 / CPT Code: 88112


Supplies:

  1. Syringes, optional syringe holder and small gauge needles (not provided by  DCCC)
  2. Non-sterile specimen container with 30ml of CytoLyt
  3. Non-Gyn requisition
  4. Biohazard bag

Collection:

  1. USE UNIVERSAL PRECAUTIONS.  USE CAUTION TO AVOID NEEDLE STICKS.
  2. Attach needle to syringe.  Use syringe holder if desired.
  3. Isolate cyst with fingers.
  4. Insert needle into cyst.
  5. Pull back on syringe plunger to create negative pressure.
  6. Allow cyst fluid to be collected into syringe.
  7. Don’t push, but release syringe plunger to equalize pressure.
  8. Withdraw needle.
  9. Leaving the needle on the syringe, flush all of the material into a collection container of CytoLyt.
  10. Palpate area to note if the cyst has been entirely aspirated. 
  11. Repeat procedure until cyst is fully collapsed using a clean needle with each pass.
  12. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  13. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition must be filled out for each specimen.
  14. Send specimen container and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container, place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.


FINE NEEDLE ASPIRATIONS–SOLID MASS (Excluding head and neck masses)

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Synonyms

  • Breast mass  
  • Transbronchial needles  
  • Liver mass  
  • Kidney mass
  • Abdominal mass

Test Code: C9006 / CPT Code: 88173


Supplies:

  1. Syringes, optional syringe holder and small gauge needles (not provided by DCCC)
  2. Non-sterile specimen container with 30ml of CytoLyt
  3. Non-Gyn requisition

Collection:

  1. USE UNIVERSAL PRECAUTIONS.  USE CAUTION TO AVOID NEEDLE STICKS.
  2. Attach needle to syringe.  Use syringe holder if desired.
  3. Isolate mass with fingers, if possible.
  4. Insert needle into mass.
  5. Pull back on syringe plunger to create negative pressure.
  6. Gently move needle back and forth within the mass in an up and down motion while changing angles.  Do not break skin barrier.
  7. Material should go no farther than the needle hub.  Once material is visualized in the hub (either blood or cellular material) the aspiration is stopped.
  8. Release the syringe plunger to equalize the pressure and withdraw the needle.  Do not push the plunger.
  9. Place the tip of the needle into CytoLyt and inject the specimen into the solution.
  10. Rinse needle and syringe and express back out into the container.
  11. If additional passes are required, use a new, sterile needle with each pass.
  12. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  13. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition must be filled out for each specimen.
  14. Send specimen container and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container, place the specimen in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.


 

 FINE NEEDLE ASPIRATION—SOLID MASS (Head or neck)

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Synonyms

  • Thyroid mass aspiration
  • Salivary gland aspiration
  • Parotid mass aspiration
  • Submandibular gland aspiration
  • Sublingular gland aspiration
  • Lymph node aspiration

Test Code: C9006 / CPT Code: 88173


Notes:

  1. For multiple nodules on the same patient:
    • Each specimen should have a separate Cytolyt container and requisition.
    • Clearly label each slide and Cytolyt container with specific specimen source (i.e. right/left, upper/lower).

Supplies:

  1. Syringes, optional syringe holder and small gauge needles (not provided by DCCC).
  2. Non-sterile specimen container with 30ml of CytoLyt.
  3. Non-Gyn requisition .
  4. Biohazard bag.
  5. Plastic transport container with glass slides with frosted ends.
  6. Coplin jar with 95% methanol or cytology spray fixative.

Collection:

  1. USE UNIVERSAL PRECAUTIONS AND BE CAREFUL TO AVOID NEEDLE STICKS.
  2. Label all slides with patient’s name in pencil on the frosted end of the slides. 
  3. Write “Air dry” on the top of two of the slides and “Fix” on the other two.
  4. Attach needle to syringe.
  5. Isolate mass with fingers.
  6. Insert needle into mass.
  7. Pull back on syringe plunger to create negative pressure.
  8. Gently move needle back and forth within the mass in an up and down motion while changing angles.  Do not break skin barrier.
  9. Material should go no farther than the needle hub.  Once material is visualized in the hub (either blood or cellular material) the aspiration is stopped.
  10. Release the syringe plunger to equalize the pressure and withdraw the needle.  Do not push the plunger.
  11. Prepare slides:
    • Place two slides on the work surface.   (One should be marked “Air dry” and the other as “Fix”.)
    • Place 2-3 drops of FNA material near the center of one slide.
    • Cover droplets with the face of a second plain glass slide.
    • As the droplets spread between the face to face slides, very gently pull the slides across each other in opposite directions.
    • The “Fix” slide should be IMMEDIATELY fixed for 30 seconds in a Coplin jar of 95% alcohol or spray slides with cytology fixative.
    • Place the “Air dry” slide face up on a paper towel to dry. 
    • After fixation, “Fix” slides should also be allowed to dry, face up, on a paper towel.
    • Place slides in transport container.
  12. The remainder of the FNA specimen should be rinsed into a container of CytoLyt.
  13. Rinse needle and syringe in CytoLyt by placing needle in pre-filled specimen container.
  14. Pull back on syringe until CytoLyt is drawn into the syringe and express it back out into the container.
  15. Repeat steps 4-14 for second pass.
  16. Use a clean needle for each pass.
  17. Multiple passes from the same site should be rinsed in one specimen container.
  18. Passes from different sites must be rinsed in separate specimen containers and require separate requisitions.
  19. Any subsequent passes should be rinsed directly into the CytoLyt container.
  20. Secure the lid and label specimen container with the following:
    • Patient’s name
    • Physician’s name
    • Source of specimen
    • Date of collection
  21. Complete the Non-Gyn requisition with the following information:
    • Patient’s name, birth date and sex
    • Physician’s name and clinic account number
    • Source of specimen
    • Date of collection
    • All pertinent clinical information (especially history of cancer, chemotherapy and radiation treatments).
    • A separate requisition must be filled out for each specimen.
  22. Send specimen container, slides and requisition in a Biohazard bag to DCCC.
    • Tighten lid of CytoLyt container.
    • Place CytoLyt and slide container in the ziplock portion of the bag and seal it.
    • Place the Non-Gyn requisition into the back pocket with the overlapping flaps.

Storage Instructions:

  1. If more than a 24-hr delay is anticipated between collection and receipt in the laboratory, please refrigerate specimen.

 



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