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Ultrasound-guided fine-needle aspiration and biopsy from the pelvis


Ultrasound-guided biopsy from the pelvis is taken usually under general anesthesia, but fine-needle aspiration for cytology examination can be taken without anesthesia.

Cytology sample (fine-needle aspiration)

  • Wash the vagina with chlorhexidine 1 mg/ml
  • Localize the lesion with the ultrasound probe
  • Determine the best point of puncture and direction. Use a puncture line.
  • Puncture the spinal needle quickly through mucous membrane.
  • Insert the needle into the lesion using ultrasound.
  • Pull out the mandrin.
  • Insert the needle into the lesion.
  • Aspirate while the needle moves back and forth 2-3 times per second until the material is visible in the upper part of the needle.
  • Retract the suction and pull the needle out.
  • Deposite the specimen onto the slide

Spread for cytology

  • Spread the specimen onto the slide.
  • Dry the specimen under a fan or hairdryer.
  • Alternative 1: send the specimen unfixed to the cytologist.
  • Alternative 2: Immediate staining and assessment.
    • Fixation solution with methanol + haemacolor + rinse in water
    • 5 dips in fixer. Allow the solution to drip off onto paper.
    • 3 dips in stain solution 1.
    • 6 dips in stain solution 2. Allow the solution to drip onto paper.
    • Rinse in 2 baths of clean water.
  • Examine the specimen under the microscope with 10x or 20x objective.
  • Microscopic assessment of the cell material should be done by a cytologist to determine if supplementary samples are needed. 

Histological biopsy (pistol biopsy)

  • For pistol biopsy, general anesthesia is used.
  • Insert the biopsy needle up to the lesion and insert slightly, depending on the size and type of the tissue in front and behind the lesion.
  • The needle moves 2.5 cm forward when released.
  • Retract the pistol such that the sample is taken.
  • Retrieve the needle out and open it.
  • Place the piece of tissue on a slide with transfer medium, for example formalin.  

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