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FINE NEEDLE ASPIRATION OF THE THYROID
FINE NEEDLE ASPIRATION OF THE THYROID
Published: 2015/02/23
Channel: VarisSon Girişimsel Radyoloji Merkezi
Fine Needle Aspiration Thyroid Nodule  (graphic)
Fine Needle Aspiration Thyroid Nodule (graphic)
Published: 2012/07/17
Channel: Cleveland Clinic
How a fine needle aspiration breast biopsy is taken
How a fine needle aspiration breast biopsy is taken
Published: 2013/08/14
Channel: Bupa Health UK
Fine Needle Aspiration Techniques
Fine Needle Aspiration Techniques
Published: 2017/02/27
Channel: UGA Veterinary Diagnostic Laboratories
Fine Needle Biopsy of Thyroid Nodule
Fine Needle Biopsy of Thyroid Nodule
Published: 2007/10/16
Channel: jcfo
Fine Needle Aspirate
Fine Needle Aspirate
Published: 2014/07/30
Channel: Kansas State Veterinary Diagnostic Laboratory
Fine needle breast aspiration  • Oncolex
Fine needle breast aspiration • Oncolex
Published: 2013/05/03
Channel: Institute for Cancer Genetics and Informatics
Ultrasound Guided Fine Needle Aspiration (UGFNA) - Anagh Vora, MD
Ultrasound Guided Fine Needle Aspiration (UGFNA) - Anagh Vora, MD
Published: 2016/12/09
Channel: Anagh Vora
Superficial Fine Needle Aspiration Biopsy Technique, Dr. Robert Oliai PART 1
Superficial Fine Needle Aspiration Biopsy Technique, Dr. Robert Oliai PART 1
Published: 2014/03/18
Channel: ProPath Pathology
Fine Needle Aspiration of Breast Cyst
Fine Needle Aspiration of Breast Cyst
Published: 2017/05/03
Channel: Med School 101
Lymph node biopsy
Lymph node biopsy
Published: 2014/12/18
Channel: Ben Muresan
FNA Basic Smearing Technique
FNA Basic Smearing Technique
Published: 2015/03/26
Channel: Vien Chunggia
ULTRASOUND GUIDED BREAST BIOPSY
ULTRASOUND GUIDED BREAST BIOPSY
Published: 2015/02/23
Channel: VarisSon Girişimsel Radyoloji Merkezi
Fine needle aspiration biopsy
Fine needle aspiration biopsy
Published: 2014/07/08
Channel: Erin LiveLifeActive
Fine needle aspiration of a dog lump
Fine needle aspiration of a dog lump
Published: 2017/05/08
Channel: Walkerville Vet
COMPASS Breast Cancer Edition: Fine Needle Aspiration (FNA)
COMPASS Breast Cancer Edition: Fine Needle Aspiration (FNA)
Published: 2016/10/03
Channel: CancerQuest
Fine Needle Aspiration Procedure
Fine Needle Aspiration Procedure
Published: 2014/10/20
Channel: Chih-Yao Hsu
Fine Needle Aspiration Breast   Full Details   Procedures Consult
Fine Needle Aspiration Breast Full Details Procedures Consult
Published: 2017/06/02
Channel: Pix Cel
Transthoracic percutaneous fine needle aspiration • Oncolex
Transthoracic percutaneous fine needle aspiration • Oncolex
Published: 2013/09/24
Channel: Institute for Cancer Genetics and Informatics
Fine Needle Aspiration Cytology by Dr Danish
Fine Needle Aspiration Cytology by Dr Danish
Published: 2016/08/07
Channel: Fine Needle Aspiration Cytology Danish
Fine Needle Aspiration Biopsy (FNA) Using a Needle with a Stylet or Trochar with the RPD®
Fine Needle Aspiration Biopsy (FNA) Using a Needle with a Stylet or Trochar with the RPD®
Published: 2009/02/01
Channel: avancamedical
FNAC Test Procedure in India
FNAC Test Procedure in India
Published: 2016/09/07
Channel: MediFee.com
Monty - fine needle aspirate
Monty - fine needle aspirate
Published: 2013/04/02
Channel: Wellpets Animal Hospital
Endoscopic Ultrasound with Fine Needle Aspiration Biopsy
Endoscopic Ultrasound with Fine Needle Aspiration Biopsy
Published: 2011/07/15
Channel: Johns Hopkins Pathology
Fine needle aspiration - two men technique
Fine needle aspiration - two men technique
Published: 2010/03/02
Channel: Antonios Liolios
Techniques Of Breast Biopsy - Manipal Hospital
Techniques Of Breast Biopsy - Manipal Hospital
Published: 2015/04/02
Channel: Manipal Hospitals
HR_EN_cyto1.wmv
HR_EN_cyto1.wmv
Published: 2011/10/21
Channel: Andrea Lane
Fine Needle Aspiration-Thyroid Biopsy
Fine Needle Aspiration-Thyroid Biopsy
Published: 2016/10/25
Channel: MsTweet37
Thyroid Nodule Biopsy Animation
Thyroid Nodule Biopsy Animation
Published: 2016/06/08
Channel: Wilmington Endocrinology Thyroid Media
Ultrasound Guided Needle Biopsy Techniques Video 4 - Sampling Techniques FNA
Ultrasound Guided Needle Biopsy Techniques Video 4 - Sampling Techniques FNA
Published: 2015/03/25
Channel: BCF Technology
Fine Needle Aspiration (FNA) Biopsy Thyroid
Fine Needle Aspiration (FNA) Biopsy Thyroid
Published: 2011/04/17
Channel: ThyCaFirework
Ultrasound-Guided Thyroid Biopsy
Ultrasound-Guided Thyroid Biopsy
Published: 2010/08/04
Channel: SouthSoundRadiology
EUS.  Fine-Needle Aspiration Biopsy of Lymph Nodes
EUS. Fine-Needle Aspiration Biopsy of Lymph Nodes
Published: 2016/01/27
Channel: Miguel Angel Ramirez-Ramirez
PDM Sx ปี5 fine needle aspiration
PDM Sx ปี5 fine needle aspiration
Published: 2014/06/28
Channel: nimbenchama2
Steps in performing EUS-FNA using 22G MTW EUS-FNA needle
Steps in performing EUS-FNA using 22G MTW EUS-FNA needle
Published: 2011/08/11
Channel: salemomar
Fine needle biopsy non-aspiration technique • Oncolex
Fine needle biopsy non-aspiration technique • Oncolex
Published: 2013/09/30
Channel: Institute for Cancer Genetics and Informatics
Ultrasound guided biopsies of the head and neck
Ultrasound guided biopsies of the head and neck
Published: 2015/04/28
Channel: Cardiff and Vale University Health Board
Thyroid Fine Needle Aspiration (TFNA)
Thyroid Fine Needle Aspiration (TFNA)
Published: 2014/08/07
Channel: RIAZ QAMAR
FNA at VCA   FINAL
FNA at VCA FINAL
Published: 2015/10/24
Channel: VCA Salem Animal Hospital
fine needle aspiration of thyroid part 2
fine needle aspiration of thyroid part 2
Published: 2015/08/07
Channel: sh alam
Fine-Needle Aspiration Biopsy Of The Thyroid, What Were The Results?
Fine-Needle Aspiration Biopsy Of The Thyroid, What Were The Results?
Published: 2010/02/17
Channel: EmpowHER
Pulse Scenes : Fine needle aspiration cytology (FNAC) 28th June 2014
Pulse Scenes : Fine needle aspiration cytology (FNAC) 28th June 2014
Published: 2014/06/29
Channel: asianetnews
thyroid Fine needle aspiration video
thyroid Fine needle aspiration video
Published: 2016/02/12
Channel: Sunina Baboolall
Medical Simulation Training: Fine Needle Aspiration Cytology using Phantoms - HPSN World 2017
Medical Simulation Training: Fine Needle Aspiration Cytology using Phantoms - HPSN World 2017
Published: 2017/03/13
Channel: Eduardo MD Pathologist / Patólogo
My Fine Needle Aspiration (FNA)  Biopsy of My Thyroid
My Fine Needle Aspiration (FNA) Biopsy of My Thyroid
Published: 2013/07/10
Channel: QueenWandaful
Fine Needle Aspiration Biopsy, What Is It?
Fine Needle Aspiration Biopsy, What Is It?
Published: 2010/08/31
Channel: EmpowHER
Endoscopic Ultrasonography-Guided Fine Needle Aspiration of Kidney Masses
Endoscopic Ultrasonography-Guided Fine Needle Aspiration of Kidney Masses
Published: 2016/01/15
Channel: AmerGastroAssn
Fine Needle Aspiration basics
Fine Needle Aspiration basics
Published: 2008/12/16
Channel: DigestiveDiseaseMUSC
Thyroid FNA.
Thyroid FNA.
Published: 2016/08/06
Channel: Atanu Basu
Endoscopic Ultrasound with Fine Needle Aspiration at Springfield Clinic
Endoscopic Ultrasound with Fine Needle Aspiration at Springfield Clinic
Published: 2011/03/08
Channel: Springfield Clinic
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WIKIPEDIA ARTICLE

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Fine-needle aspiration
Medical diagnostics
Adenoid cystic carcinoma cytology.jpg
Micrograph of a needle aspiration biopsy specimen of a salivary gland showing adenoid cystic carcinoma. Pap stain.
MeSH D044963

Fine-needle aspiration (FNA) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin (23-25 gauge), hollow needle is inserted into the mass for sampling of cells that, after being stained, will be examined under a microscope (biopsy). The sampling and biopsy considered together are called fine-needle aspiration biopsy (FNAB) or fine-needle aspiration cytology (FNAC) (the latter to emphasize that any aspiration biopsy involves cytopathology not histopathology). Fine-needle aspiration biopsies are very safe, minor surgical procedures. Often, a major surgical (excisional or open) biopsy can be avoided by performing a needle aspiration biopsy instead. In 1981, the first fine-needle aspiration biopsy in the United States was done at Maimonides Medical Center,[1] eliminating the need for surgery and hospitalization. Today, this procedure is widely used in the diagnosis of cancer and inflammatory conditions.

A needle aspiration biopsy is safer and less traumatic than an open surgical biopsy, and significant complications are usually rare, depending on the body site. Common complications include bruising and soreness. There is a risk, because the biopsy is very small (only a few cells), that the problematic cells will be missed, resulting in a false negative result. There is also a risk that the cells taken will not enable a definitive diagnosis.

Medication uses[edit]

This type of sampling is performed for one of two reasons:

  1. A biopsy is performed on a lump or a tissue mass when its nature is in question.
  2. For known tumors, this biopsy is performed to assess the effect of treatment or to obtain tissue for special studies.

When the lump can be felt, the biopsy is usually performed by a cytopathologist or a surgeon. In this case, the procedure is usually short and simple. Otherwise, it may be performed by an interventional radiologist, a doctor with training in performing such biopsies under x-ray or ultrasound guidance. In this case, the procedure may require more extensive preparation and take more time to perform.

Also, fine-needle aspiration is the main method used for chorionic villus sampling,[2] as well as for many types of body fluid sampling.

It is also used for ultrasound-guided aspiration of breast abscess,[3] of breast cysts, and of seromas.[4]

Preparation[edit]

Several preparations may be necessary before this procedure.

  • No use of aspirin or non-steroidal anti-inflammatory medications (e.g. ibuprofen, naproxen) for one week before the procedure;
  • No food intake a few hours before the procedure;
  • Routine blood tests (including clotting profile) must be completed two weeks before the biopsy;
  • Suspension of blood anticoagulant medications;
  • Antibiotic prophylaxis may be instituted.

Before the procedure is started, vital signs (pulse, blood pressure, temperature, etc.) may be taken. Then, depending on the nature of the biopsy, an intravenous line may be placed. Very anxious patients may want to be given sedation through this line. For patients with less anxiety, oral medication (Valium) can be prescribed to be taken before the procedure.

Procedure[edit]

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

The skin above the area to be biopsied is swabbed with an antiseptic solution and draped with sterile surgical towels. The skin, underlying fat, and muscle may be numbed with a local anesthetic, although this is often not necessary with superficial masses. After locating the mass for biopsy, using x-rays or palpation, a special needle of very fine diameter is passed into the mass. The needle may be inserted and withdrawn several times. There are many reasons for this:

  • One needle may be used as a guide, with the other needles placed along it to achieve a more precise position.
  • Sometimes, several passes may be needed to obtain enough cells for the intricate tests which the cytopathologists perform.

After the needles are placed into the mass, cells are withdrawn by aspiration with a syringe and spread on a glass slide. The patient's vital signs are taken again, and the patient is removed to an observation area for about 3 to 5 hours.

  • For biopsies in the breast, ultrasound-guided fine needle biopsy is the most common.The biopsy is advised.

Post-operative care and complications[edit]

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

As with any surgical procedure, complications are possible, but major complications due to thin needle aspiration biopsies are fairly uncommon, and when complications do occur, they are generally mild. The kind and severity of complications depend on the organs from which a biopsy is taken or the organs gone through to obtain cells.

After the procedure, mild analgesics are used to control post-operative pain. Aspirin or aspirin substitutes should not be taken for 48 hours after the procedure (unless aspirin is prescribed for a cardiac or neurological condition). Since sterility is maintained throughout the procedure, infection is rare. But should an infection occur, it will be treated with antibiotics. Bleeding is the most common complication of this procedure. A slight bruise may also appear. If a lung or kidney biopsy has been performed, it is very common to see a small amount of blood in sputum or urine after the procedure. Only a small amount of bleeding should occur. During the observation period after the procedure, bleeding should decrease over time. If more bleeding occurs, this will be monitored until it subsides. Rarely, major surgery will be necessary to stop the bleeding.

Other complications depend upon the body part on which the biopsy takes place:

  • Lung biopsies are frequently complicated by pneumothorax (collapsed lung). This complication can also accompany biopsies in the upper abdomen near the base of the lung. About one-quarter to one-half of patients having lung biopsies will develop pneumothorax. Usually, the degree of collapse is small and resolves on its own without treatment. A small percentage of patients will develop a pneumothorax serious enough to require hospitalization and placement of a chest tube for treatment. Although it is impossible to predict in whom this will occur, collapsed lungs are more frequent and more serious in patients with severe emphysema and in patients in whom the biopsy is difficult to perform.
  • For biopsies of the liver, bile leakages may occur, but these are quite rare.
  • Pancreatitis (inflammation of the pancreas) may occur after biopsies in the area around the pancreas.
  • In biopsies in the area of the breast, bleeding and bruising may occur, less frequently also infection (rarely) or (very rarely, and only if performed near the chest wall) pneumothorax.
  • Deaths have been reported from needle aspiration biopsies, but such outcomes are extremely rare.

Criticism[edit]

A recent study showed that in one case a needle biopsy of a liver tumor resulted in spread of the cancer along the path of the needle, and concluded that needle aspiration was dangerous and unnecessary. The conclusions drawn from this paper were strongly criticized subsequently.[5]

See also[edit]

  • Antibody barcoding, a technique for identifying proteins in small tissue samples such as aspirates

References[edit]

  1. ^ http://www.maimonidesmed.org/Main/CultureofInnovation.aspx, First US Procedure
  2. ^ Chorionic villus sampling and amniocentesis: information for you from Royal College of Obstetricians and Gynaecologists. Date published: 01/06/2006
  3. ^ Trop I, Dugas A, David J, El Khoury M, Boileau JF, Larouche N, Lalonde L (October 2011). "Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up". Radiographics : a Review Publication of the Radiological Society of North America, Inc (review). 31 (6): 1683–99. PMID 21997989. doi:10.1148/rg.316115521. 
  4. ^ Department of Pathology University of Massachusetts Medical School (Emeritus) Guido Majno Professor; Department of Pathology University of Massachusetts Medical School (Emerita) Isabelle Joris Associate Professor (12 August 2004). Cells, Tissues, and Disease : Principles of General Pathology: Principles of General Pathology. Oxford University Press. p. 435. ISBN 978-0-19-974892-1. 
  5. ^ "bmj.com". Retrieved 2010-03-14. 

External links[edit]

Lung

Neck

Bone

Risk

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