Despite seeing beautiful images during splenic sampling with a visible needle, lovely “woodpecker” technique and nice feathery slides my splenic aspirates still having me holding my breath until I see definitive cells in my microscope field. I feel like I’m at the roulette wheel hoping for my my lucky number to be the winner.
I either get this: 
WINNER!!!
Or I get this: 
HELLO?? …
My FNA of liver is 85-95% odds of obtaining a great, highly cellular sample.
My FNA of Spleen 50% chance. 🙁
Comments
Unless there is infiltrative disease or inflammatory reaction, splenic aspirates tend to be as you say a “roulette wheel”. It is very dependend where the needle ends up in the splenic parenchyma. Also, primary splenic tumors tend to be even more elusive on FNA.
Start wiht trying to reach this type of light pink slide after you fna and before you go to the scope… not red enough means poor exfiliation and too red means hemodil;atuon so in the former case either corkscrew technique with same 25 gauge needle or go to a 22… in the latter case lighten the jab or go to smaller needle. This shoudl save you some time and frustration.
Thank you for the explanation and direction Dr. Lobetti!
Yeah, I think mine are usually hemodiluted. I’ll try a lighter approach. Thx!