Specimen Information

Fine Needle Aspiration Cytology: Thyroid

The Afirma Gene Expression Classifier and Xpression Atlas will be performed if the following criteria are met:

• 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
• Thyroid nodule is greater than or equal to 1 cm
• Patient is 21 years or older

For Additional Information refer to Afirma Genomic Sequencing Classifier 

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 performed in the Medical Center Campus Radiology Department using various localizing techniques.  Gynecological abdominal masses, thyroid lesions, breast masses and head/neck lesions are performed using ultrsound guidance by physicians in the Departments of Gynecology, Oncology, Endocrinology, Surgery, and ENT.  Aspiration of palpable masses are also performed by Cytopathologists. 

Arrangement for Fine Needle Aspirations should be made through the above departments or by calling Cytopathology at (802)847-5136.

Special Collection Considerations for Head and Neck Lesions

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

Slide Preparation (For clinicians who perform frequent FNA procedures and are comfortable preparing fixed slides):

1. 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. 
2. 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.
3. Slides can either be fixed immediately with alcohol fixative or air-dried.
4. Please indicate whether the slide is fixed or air-dried on the laboratory requisition. 
5. Label the frosted end of slide with two patient identifiers: legal first and last name, and MRN or DOB. 
6. Needle rinses should be submitted in CytoLyt as described below.
7. The accompanying laboratory requisition must contain all pertinent clinical information.

Aspirate Collection (For clinicians who perform aspirate procedures less frequently):

1. Express all of the aspirate material into a container of CytoLyt, transport media supplied by the Cytopathology Department.
2. Aspirating a small amount of the fixative into the barrel of the syringe and “rinsing the needle” into the specimen container is also recommended. 
3. Slide preparation from the transport media will be performed in the Cytopathology Laboratory. 
4. The accompanying laboratory requisition must contain all pertinent clinical information.

Fluids and Effusions for Cytology: See CYTOLOGY BODY FLUID