Spectrum biology

FNAB is a technique used to investigate superficial lumps or masses. It is a safe, minor surgical procedure. Often, a

major surgical biopsy can be avoided by performing a needle aspirative biopsy. In 1981, the first fine-needle

aspiration biopsy in the United States was done at Maimonides Medical Center, eliminating the need for surgery and

hospitalisation. Today, this method is widely used in the diagnosis of cancer and inflammatory conditions.

A fine needle aspiration biopsy (FNAB) can be done in several different ways.

FINE NEEDLE ASPIRATION BIOPSY FOR PALPABLE

GROWTHS A palpable growth is one that can be felt.The

patient usually sits up while the doctor inserts a small hollow

needle with a syringe to withdraw (aspirate) fluid and cells from

the growth for testing. When the needle reaches the mass, the

doctor suctions out a sample with the syringe. The doctor

repeats this procedure several times. If the mass is a cyst, the

withdrawn samples will consist mainly of fluid and the cyst may

collapse, relieving pain. If the mass is solid, the samples will

consist primarily of tissue cells. By analysing the sample

immediately after their withdrawal, if it is found to be a cyst then

doctor diagnoses a benign. In all other cases, fluid and tissue

samples are placed on slides and then analysed by a pathologist

in a lab. This biopsy may signal that cancer is present.

GUIDED FNAB FOR NON-PALPABLE GROWTHS When a

growth is small or deep to palpate (feel), the doctor must locate

it with one of several imaging techniques. The images are taken

from different angles to form a virtual three- dimensional

(stereotactic) image that precisely pin points the location of the

suspicious area. The computer then uses a motor to guide a

small hollow needle to the site to remove the samples. The

withdrawn samples are then analysed for the presence of cancer.

ADVANTAGES OF FNAB OVER SURGICAL OPERATIONS

(a)Together with clinical-biochemical evalution, echo-guided FNAB

remains the first-line diagnostic test in the management of

thyroid nodules.

(b)It is safe and simple.

(c)It can be performed as an outpatient procedure and it is well tolerated by patients.

(d)In the present managed care environment, it also proves cost-effective.

(e)It is recommended as a first line of investigation in palpable head and neck masses.

1. The skin above the area to
   be biopsied is swabbed with an
   antiseptic solution and draped
   with sterile surgical towels.
   The skin, may be numbed
   with a local anaesthetic


2. The needle may be
   inserted and withdrawn
   several times
   Reason one needle may
   be used as a guide, with
   the other needles placed
   along it to achieve a
   more precise position

Using the X-rays,

the location of

mass was identified

Sometimes, several

passes may be needed

to obtain enough cells

for the intricate tests

which the

cytopathologists

perform

3. Cells are withdrawn by aspiration
   with a syringe and spread on a glass
   slide. This slide is viewed by a
   microscope equipped with a camera
   4. This technique
   diagnoses a carcinoma
   on the left and normalee
   cells on the right side

Locate the lesion,

insert the needle tip

Apply vacuum

Maintain vacuum and

sample different areas

of the lesion by inserting

back and forth

Release the vacuum

completely by releasing

the syringes piston

Carcinoma Normals