Dr Piyush Tailor

USG GUIDED FINE NEEDLE ASPIRATION CYTOLOGY

1.PURPOSE: To prepare the Smears as per standard text literature & manufacture’s guidelines.
2. STAFF RESPONSIBLE: resident doctor.
3. PRINCIPLE: NA
4. PERFORMANCE SPECIFICATION: NA
5. SAMPLE: NA
6. TYPE OF CONTAINER:
7. EQUIPMENT AND REAGENT USED:
EQUIPMENTS:

• Standard 18/22 Gauze, 90 mm disposable lumbar puncture needle with trochar.
• 10 cc Disposable Syringes.
• Disposable slides.
• 0.2mm cover slip.
• Diamond pencil for labeling the slides.

REAGENTS:

• Fixative-Acetone free methanol – Extra pure
• Stains-H & E. Stain, Giemsa Stain, PAP Stain
  

9. CALIBRATION PROCEDURE: When new residents come, they observe the procedure of FNAC for 3 days and then they perform FNAC under the observation of a senior resident for 4 days. After 1 wk of training, they are allowed to perform FNAC independently.
10. PROCEDURE (STEPS):
PATIENT PREPARATION:

• A Clear explanation of procedure to patient to get his/her written consent and cooperation.
• Procedure is usually carried out as per position given by radiologist to the patient.
• Disinfect the skin using the spirit swab.
• Pre aspiration sedation is sometime necessary and the only in deep aspiration in anxious or agitated patients.

PROCEDURE:

• Experienced radiologist find out lesion where FNAC has to be done.
• With the help of USG probe, operator position the needle within the target tissue.
• Pull the trochar to apply the negative pressure.
• Move the needle back and forth inside the target, so good part of aspirate is often drawn into the needle.
• Release the negative pressure while needle remains in target tissue and withdraw the needle.
• Needle is detached and air is drawn into syringe.
• Blow sample on microscopy slide and with the help of other slides, spread the material.

11. TAT FOR TEST: ½ hour
12. LABORATORY INTERPRETATION: NA
13. SAFETY PRECAUTIONS: Universal safety precaution (Biosafety manual).
14. VALIDATION OF RESULTS TO BE DONE BY: By authorized signatories & Assi. Technical manager.
15. REVIEW, RECORDS & RECOMMENDATION: As per ISO 15189 Guidelines Clause 4.13 & NABL 112
16. REFERENCE: Fine Needle Aspiration Cytology, 4th edition, Svante R. Orell