Patients may be referred to the University of Michigan Health System for fine needle aspiration of superficial masses to be performed by Cytopathology faculty. Please call 734-936-6799 to schedule an appointment. ASPIRATION PROCEDURE FOR SUPERFICIAL MASSES:
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Cleanse the skin over the lesion with an alcohol swab. If local anesthesia is needed, use ethyl chloride spray or 1% lidocaine.
Fix the mass between your fingers to immobilize the mass during the needle passes.
Carefully poise the 23 or 25-guage needle at right angles to the surface of the skin, just touching the point of insertion. Quickly introduce the needle through the skin and advance it into the mass. When the needle has entered the mass, apply strong suction.
Apply negative pressure to the syringe and move the needle back and forth within the mass and in different directions to effect the cutting action of the needle point and retain cells in the needle hollow.
It is not necessary to see visible aspirated material in the hub, but the moment blood or any material appears in the hub, stop aspirating but do not remove the needle from the mass until pressure on the plunger is released; this will allow cells to be contained in the needle and not the syringe. If you do not release the suction, the aspirated material will enter the barrel of the syringe and may result in loss of cellular material as it is difficult to recover material from the syringe.
Place the entire sample directly in CytoLyt® solution by aspirating CytoLyt® solution through the needle into the syringe and then expelling back into the CytoLyt® container several times (see below). Samples from different anatomic sites should be placed in separate containers or slides, labeled appropriately, and submitted with separate requisitions.
Occasionally the aspirated lesion is cystic. In this case, aspirate as much fluid as possible and place the fluid into the CytoLyt® vial. Resample any residual mass following the procedure described above.
[/list] Submit the CytoLyt® sample along with a completed MLabs Surgical / Cytopathology Requisition form (https://mlabs.umich.edu/media/171), including pertinent patient history. The container should be clearly labeled with the patient’s first and last names as well as a second identifier such as the patient’s birthdate or medical record number. Refrigerate specimens that cannot be delivered immediately and deliver as soon as possible. Do not allow specimens to freeze. See https://mlabs.umich.edu/media/173 for FNA Collection Guidelines.