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Trephination: Get More Cells and Less Blood
By Phil Zeltzman, DVM, Dipl. ACVS
 Sure it’s an old article1, but it explains a very practical and simple way to increase the yield of fine needle aspirates.
Once supplies are gathered (see box), the needle is connected to the IV extension set, which is connected to the air-filled syringe. Cool people place the IV extension set around their neck rather than letting it dangle or be in the way.
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Supplies Needed:
- Glass slides.
- 22 G needles, short for superficial masses, long for deeper masses.
- IV extension set (14 inches are enough).
- 12 ml syringe containing at least 5 ml of air.
Note: The IV extension set and the syringe can be reused multiple times since they should not become contaminated. | The patient is sedated if needed, and the biopsy site is scrubbed aseptically. The needle is held like a pen in one hand, and the mass is held in the other hand.
The needle is placed inside the mass and moved quickly back and forth about eight to 10 times.
The needle is then removed from the mass and its contents are placed on the glass slides by pushing the plunger of the air-filled syringe. A classic smear is then made and air-dried using a blow dryer.
The process can be repeated as needed, typically three to five times, in other areas of the mass.
It is important to perform all steps quickly to avoid hemodilution of the sample or coagulation, which is trauma-induced.
Advantages of this system is a higher cellular yield, less hemodilution and the possibility of reusing the IV extension set and syringe multiple times. They can be kept with your glass slides for the next patient. <HOME>
FOOTNOTE
1. M. Menard and M. Papageorges. “Fine needle biopsies: how to increase diagnostic yield.” Comp. Cont. Ed. 1997, Vol. 19, N. 6, p. 738-740.
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