Fine needle aspiration Cytology (FNAC), Fine needle aspiration biopsy (FNAB)
Fine needle aspiration cytology (FNAC)
Sample sites for Fine needle aspiration Cytology
- FNA sample may be obtained from:
- All parts of the body.
- Lymph nodes.
- Breast.
- Liver.
- Respiratory tract.
- Oral cavity.
- Thyroid.
- Genital Tract.
- The most common sites are the breast, thyroid, and palpable lymph nodes.
- All parts of the body.
- FNAC is an inexpensive and less traumatic procedure.
- FNA has good results with the help of ultrasound in the Liver and other abdominal masses.
- FNA may be done with the help of a CT scan, mammogram, or ultrasound-guided.
Indications of Fine needle aspiration Cytology (FNAC)
- FNA material gives a cytological diagnosis of benign or malignant lesions.
- FNA has excellent results in palpable lumps like breast or superficial masses.
- FNA material may be subjected to bacterial examination.
- FNA is recommended in areas suspected of cystic fluid, nodules, lumps, and enlarged lymph nodes.
Procedure for Fine needle aspiration cytology (FNAC)
- This procedure is performed with local analgesia or without it, and 25 g needles are used to get a sample from the suspected mass, (Our experience is with 25 G needles, and we get adequate material). But most people use a 22/23 G needle.
- We made the smear and air dry it before staining.
- In the routine, we use Field stain.
- Also, we do not give negative pressure unless we see poor yield. Most of the time, enough material comes without any aspiration.
- After the procedure, separate the needle.
- Create negative pressure in the syringe and connect the needle.
- Push the material on the slide.
- Spread the material with another slide.
Important facts of Fine needle aspiration Cytology (FNAB)
- This is one of the best tools for diagnosing tumors in expert hands.
- FNA is a procedure to obtain diagnostic material for cytologic (Cells) study.
- FNA causes minimal trauma to the patient.
Advantages of Fine needle aspiration Cytology (FNAB)
- It is economical.
- No anesthesia is required.
- No need for hospitalization.
- It is less painful.
- It is less invasive.
- It takes less time compared to tissue biopsy.
- Results are satisfactory in the expert hands.
Reporting of Fine needle aspiration Cytology (FNAB)
- The results can be reported as follows:
- Atypical.
- Suspicious of malignancy.
- Positive for malignancy.
- There are the following possibilities.:
- Infectious condition. There will be characteristic cellular components like poly, lymphocytes, and histiocytes.
- Benign conditions. There are characteristic benign cellular changes like uniform nuclei and normal N/C ratio.
- Malignant conditions. The cellular changes are typical of malignancy, like bizarre cellular appearance, changed N/C ratio, etc.
Reporting of Thyroid FNA
- FNA of thyroid differentiates between thyroid cysts or tumors.
- It can be done with the help of an ultrasound.
- There is a Bethesda reporting system that classified the result into 6 categories.
- Nondiagnostic or unsatisfactory.
- Benign lesion.
- Atypical or undetermined significance or follicular lesion of undetermined significance.
- Follicular lesion or suspicious for follicular neoplasm.
- Suspicious of malignancy.
- Malignant.
Reporting of Breast FNA
- It is the aspiration of the breast mass for cytologic examination of the aspirated material.
- FNA breast result:
- It is about 1% false-positive results.
- There are 5% to 10% false-negative results.
- It gives good results in experienced hands.
- It will give good results to the experienced pathologist.
- If there is a fluid, that will indicate a cystic lesion.
- FNA will differentiate between benign or malignant smears.
- The FNA is reported as follows:
- Insufficient yield.
- There is a benign lesion.
- Atypical, probably a benign lesion.
- Suspicious, probably in situ, or invasive carcinoma.
- Malignant lesion.