Fine-needle aspiration

Fine Needle Aspiration Biopsy (FNA): An In-depth Study

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Micrograph of a papillary neoplasm of the breast

Fine Needle Aspiration Biopsy (FNA) is a diagnostic procedure utilized in cytology to investigate lumps or masses. In this minimally invasive procedure, a thin, hollow needle is inserted into the mass for sampling of cells that, after being stained, will be examined under a microscope. FNA is typically used to investigate swellings or lumps located in areas like the thyroid, breast, and other organs, and can assist in the diagnosis of cancer, inflammatory conditions, and other pathologies.

Overview

FNA is a medical process that involves using a fine needle to collect cell samples from a tumor or mass. The primary aim of this procedure is to allow for microscopic evaluation and thus establish a diagnosis.

Procedure

The main steps of FNA involve:

• Positioning of the patient: The patient must be positioned in a way that the lump or mass is easily accessible.
• Disinfection and local anesthesia: The site of the aspiration is cleaned with an antiseptic, and local anesthetic may be applied.
• Aspiration: A fine needle is inserted into the mass, and a syringe is used to draw out tissue or fluid.
• Sample collection: The contents are then expelled onto a glass slide and sent to the laboratory for analysis.

FNA is an abbreviation for the self explanatory word, fine needle aspiration biopsy.

A physician's hands are seen performing a needle biopsy to determine the nature of a lump, either a fluid-filled cyst or solid tumor.

How is FNA performed?

FNA refers to a procedure where samples of part of the body are obtained by inserting a needle into that part of the body and sucking out cells which can be stained in the laboratory and viewed under a microscope to help make a diagnosis.

Anesthesia

Local anesthesia may be used to reduce pain papillary neoplasm of the breast. FNA specimen. Pap stain.]]

Use

• FNA is commonly used as a test to diagnose thyroid disease or thyroid cancer.
• It is also used in the evaluation of a breast lump.
• Other uses include any lump in an organ or tissue of the body.
• It is used to differentiate if if the lump or mass is noncancerous or cancerous by examining the cells under micro-scope.

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FNA of pancreatic tissue. An adenocarcinoma is seen on the left, normal ductal epithelium on the right.

Normal results

A normal result shows the thyroid tissue looks normal and the cells do not appear to be cancer under a microscope.

Before the test

Some drugs that increase the chance of bleeding may need to stopped although a licensed physician will need to evaluate the risks and benefits. Some drugs to consider include:

• Aspirin
• Clopidogrel (Plavix)
• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve, Naprosyn)
• Warfarin (Coumadin)

Advantages and Disadvantages

Advantages

• Minimally invasive: Compared to an open surgical biopsy, FNA involves less pain, fewer complications, and minimal recovery time.
• Cost-effective: It is relatively inexpensive compared to other forms of biopsy.
• Quick: The procedure itself typically takes only a few minutes, and results can be ready relatively quickly.

Disadvantages

• Sample adequacy: Sometimes, the sample obtained may not be sufficient for a definitive diagnosis, necessitating a repeat procedure or a different type of biopsy.
• Less detailed: FNA might not provide as much detailed information on the tumor as other types of biopsies.

Applications of FNA

• Cancer diagnosis: FNA is commonly used for the initial evaluation of masses suspected to be cancer.
• Thyroid nodules: It's a primary tool in the evaluation of thyroid nodules.
• Breast lumps: Used to distinguish between benign (non-cancerous) and malignant (cancerous) lumps.
• Lymph node swelling: Helps determine whether swollen lymph nodes are due to infection, inflammation, or malignancy.

Conclusion

Fine Needle Aspiration Biopsy (FNA) is an important tool in modern medicine that provides a swift, less invasive means for diagnosing various diseases, notably cancer. While it has limitations, its benefits make it a valuable first-line procedure for investigating masses and lumps in various parts of the body.

Risk The main risk is bleeding into or around the area.

• Risk of tumor cell seeding through biopsy and aspiration cytology 2014

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