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Fine Needle Aspiration (FNA) Cytology

Cellular Pathology


Principle of Examination

Fine needle aspiration (FNA) entails using a narrow gauge (25-22G) needle to collect a sample of a lesion for microscopic examination. It allows a minimally invasive, rapid diagnosis of tissue but does not preserve histological architecture. The rapid diagnosis possible with fine needle aspiration can shorten or avoid hospital admissions, and speed a patient’s route to an appropriate specialist. Used appropriately aspiration cytology offers a relatively cheap, quick and accurate tool for the diagnosis and follow up of cancer. Under endoscopic ultrasound cytology provides a useful tool in assessing accurate FNA sampling and cytological material for both diagnosis and staging.

A number of clinics are offered and attended by a member of the cytology team:

1. Thyroid clinic

The one-stop Thyroid clinic runs on a Friday morning with Biomedical Scientist support.

2. Head & Neck clinic

The one-stop Head and Neck clinic runs on a Thursday morning with Biomedical Scientist support.

2. Endoscopy day clinic attendance (EUS/EBUS)

EUS FNA pancreas is routinely performed on Tuesday and Thursday mornings.

EBUS FNA is routinely performed on Thursday and Friday afternoons in the endoscopy suite (Level 2, Area N).

The cytopathology department is contacted by the endoscopy department when attendance is required.

3. Other FNA attendance on site (e.g. imaging)

With advanced notice and staff permitting, we are able to offer ‘hands-on’ technical support for this procedure. Please contact the laboratory office on 01392 402991 or the BMS team on 01392 402909 (8.30am-5pm Mon-Fri) to request attendance to request attendance.

 

Specimen Requirements, Delivery and Labelling

For full instructions on the FNA procedure and preparation of slides, see FNA Instructions For Clinicians Sheet information sheet,

Or TORBAY Clinicians please see FNA Instructions for TORBAY Clinicians Sheet information sheet.

all internal Trust samples must be requested via Epic and labelled with an Epic label. All GPOCS samples must be labelled with a GPOCS label. All other sample must have a request form.

The request should state:

  • Three patient identifiers
  • Specimen type as ‘FNA cytology’
  • Enter specimen source i.e. ‘left neck’, ‘right breast’, ‘left cervical node’
  • Date and time of sample collection
  • Requesting clinician
  • Patient location – inpatient/outpatient and ward
  • All relevant clinical information – including if there is a history of relevant foreign travel
  • All slides should be labelled with three patient identifiers and an indication of if the slide is wet fixed or air dried.

URGENT SPECIMENS: Please label urgent specimens clearly; an explanation as to why the specimen is urgent is helpful. On receipt, laboratory staff will notify the pathologist who will report the specimen as soon as possible.

HIGH RISK SPECIMENS: Requests must indicate if a specimen is high risk. Please indicate details of the risk, eg: TB, blood-borne virus, etc.

Turnaround Time

The Laboratory aims to comply with The Royal College of Pathologists Key Performance Indicator (KPI 6.4) for Cellular Pathology reporting turnaround times with 90% of all cases reported within 10 calendar days.

Specimen Labelling Procedure
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