Fine Needle Aspiration
You can use needle sizes from 25 gauge up to 20 gauge for performing
a fine needle aspiration. A 12 - 20 mL syringe will generate adequate
suction for aspiration of lymph nodes and most mass lesions
Most masses are heterogeneous with regard to cell types. To obtain a
sample for cytologic evaluation that is representative of the mass as a
whole, several areas within the mass should be aspirated. The needle is
inserted into the mass, (a) negative pressure is created within the
syringe by pulling back the plunger to 5-10 ml (b) . Maintaining this
negative pressure, redirect the needle in several directions ( 3-5)
within the mass lesion, without removing the tip of the needle from the
mass. Release the syringe plunger (c) and remove the needle from the
mass (d) .
Aspiration of lymph nodes is no more invasive than venipuncture. Skin
preparation is similar to that for venipuncture; simply wet the hair coat with
alcohol to better define the structure being aspirated. The degree of skin
preparation prior to aspiration of other masses depends upon the suspected
contents of the mass and your plans for use of the aspirated sample. If you plan
to culture the sample, then the skin surface should be clipped of hair and
cleaned with an antiseptic solution such as Betadine. If the mass is fluctuant,
suggesting it is fluid filled, aseptic skin preparation is indicated to prevent
contamination of the fluid in the mass, if not already septic.
If you are right handed, immobilize the mass with your left hand and
hold the syringe in your right hand. Sample serveral areas of the mass
as described on the previous screen. You only need to aspirate a few
drops of fluid from the mass. This small amount of fluid will remain in
the needle during aspiration; you will not see any sample enter the
syringe. If blood is aspirated, release the syringe plunger and stop
Large amounts of blood will dilute the cells obtained from the mass and
may render the cytolology, nondiagnostic. If the mass is fluctuant,
suggesting it is fluid filled, aspirate several ml of the fluid and put
this sample in a tube containing an anticoagulant such as EDTA. This
sample can be centrifuged to concentrate the cells in the sample.
||After the needle is removed from the mass, the syringe is disconnected
from the needle and is filled with air. Make sure the needle is removed
from the syringe before aspirating air into the syringe to avoid
aspirating the sample out of the needle.
The air in the syringe is used to blow the sample out of the needle onto
one or more glass slides. Many glass slides have a frosted edge (a).
This edge is rough textured and identifies the top of the slide. Place
the drop of sample close to the frosted edge of the slide, making sure
the rough side is up. You can expect to obtain enough sample from one
aspiration to make 1-3 slides. The aspiration procedure can be repeated
several times from the same mass.