CALCITONIN, FINE NEEDLE ASP (FNAB)-NEEDLE WASH, LYMPH NODE

Message

OBTAIN WILD CODE FROM MARGIE OR JOEY
Collection Instructions:
1. Needle wash specimens for analysis should be collected in conjunction with cytology specimens.



2. Have saline available prior to start of procedure. Saline is the only acceptable solution for needle washings.



3. After each fine-needle aspiration biopsy (FNAB) has been collected and the material in the needle has been expelled onto a slide for cytologic analysis, attach the used FNAB needle to an empty syringe.



4. Withdraw between 0.10 mL and 0.25 mL of saline up through the needle until the saline starts to fill the hub of the needle or end of the syringe.



5. Expel this fluid back through the needle into a separate tube. This is the needle washing used for analysis.



6. Repeat steps 2 through 4 for each needle pass of the same biopsied site and empty into the same tube, accumulating a total of 0.5 mL to 1.5 mL of fluid to send to the laboratory. (If more than 1 site is biopsied, see Additional Information)



7. Inspect specimen for visible blood or tissue contamination:



 -a. If bloody, centrifuge specimen and transfer supernatant to a new plastic aliquot tube (5-mL standard tube) to send to laboratory. The supernatant, not the cellular material, is used for analysis.



 -b. If specimen is clear, centrifugation is not necessary.



8. Refrigerate within 1 to 2 hours of collection and freeze within 2 to 4 hours of collection.




Test Code
CAL-ASP (CATLN) QUEST TO MAYO

CPT Codes
82308

Preferred Specimen
Fine Needle Wash

Patient Preparation
Patient Preparation: For 12 hours before this test do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.

Minimum Volume
 1 to 1.5mL
 A minimum of 0.5 mL is required for testing; however, the total collection volume should not exceed 1.5 mL. Sample volumes outside these parameters may be rejected.


Instructions
1. The biopsied site of each specimen must be clearly identified in LIS and/or batch sheet.
2. Send specimen frozen to Mayo Clinic Laboratories for analysis.

Transport Container
Plain, plastic, screw-top tube

Transport Temperature
FROZEN

Specimen Stability
7 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis

Methodology
Electrochemiluminescence Immunoassay

Setup Schedule
M-F

Limitations

Blood contamination during the biopsy might lead to false elevations of calcitonin in the fine-needle aspiration biopsy washout if serum calcitonin is significantly elevated. If blood was present in the washout, only calcitonin values significantly higher than the serum should be considered as true positives.



Immunometric assays can, in rare occasions, be subject to interferences such as "hooking" at very high analyte concentrations (false-low results) and heterophilic antibody interference (false-high results). If the clinical picture does not fit the laboratory result, these possibilities should be considered.



Samples should not be taken from patients receiving therapy with high biotin or vitamin B7 doses (ie, >5 mg/day) until at least 12 hours following the last biotin administration.



Results are dependent on accurate sampling and a maximum needle wash volume of 1.5 mL or less.



While the needle washes from several distinct needle passes or aspirations from a single area should be pooled, biopsies from different areas should be submitted as separate specimens.




Reference Range
An interpretive report will be provided.

Clinical Significance
As an adjunct to cytologic examination of fine-needle aspiration specimens in athyrotic individuals treated for medullary thyroid carcinoma to confirm or exclude metastases in enlarged or ultrasonographically suspicious lymph nodes.

Calcitonin in needle washes is particularly useful in cases where the cytology result is nondiagnostic or indeterminate.


Performing Laboratory
MAYO



The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.