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Test Code TFNAB Thyroglobulin, Tumor Marker, Fine-Needle Aspiration Biopsy Needle Wash


Necessary Information


The biopsied site of each specimen must be identified as from a lymph node or non-lymph node source, and the specific biopsy site must be clearly identified in LIS or on batch sheet.



Specimen Required


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

Collection Container/Tube: Plain, plastic, screw-top tube

Specimen Volume: 1 to 1.5 mL

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 plastic screw-top 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. Send specimen frozen (preferred) or refrigerate.

Additional Information

1. If more than 1 site is biopsied, each washing material should be submitted on a separate tube and under a different order number.

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

3. Do not send a saline control. This test has been validated to rule-out saline matrix effect.


Forms

If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.

Useful For

Confirming or excluding metastases in enlarged or ultrasonographically suspicious lymph nodes from athyrotic individuals treated for differentiated thyroid cancer in conjunction with cytologic analysis

 

Confirming or excluding the presence of thyroid tissue in the biopsied area from athyrotic individuals treated for differentiated thyroid cancer in conjunction with cytologic analysis

 

This test is not useful for screening asymptomatic individuals for neoplastic disease.

Method Name

Immunoenzymatic Assay

Reporting Name

Thyroglobulin, FNAB Needle Wash

Specimen Type

Fine Needle Wash

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Fine Needle Wash Frozen (preferred) 90 days
  Refrigerated  14 days
  Ambient  7 days

Reference Values

Lymph node: ≤1.0 ng/mL

This cutoff has been validated for total needle wash volumes of ≤1.5 mL of normal saline. If wash volumes are substantially larger, a lower cutoff might apply.

Non Lymph node: an interpretation will be provided

Day(s) and Time(s) Performed

Monday through Friday; 6 a.m.-9 p.m.

Saturday; 6:30 a.m.-1 p.m.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

84432

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TFNAB Thyroglobulin, FNAB Needle Wash 53922-1

 

Result ID Test Result Name Result LOINC Value
TFNA3 Thyroglobulin, FNAB, Lymph Node 53920-5
TFNA4 Thyroglobulin, FNAB, Non Lymph Node 53922-1
TFNA5 Thyroglobulin, FNAB, Interpretation 69053-7
TFNA6 Lymph Node (LN) or Non-LN Source 31208-2
TFNA7 Site Location 39111-0