Transcript

FINE NEEDLE ASPIRATION

CYTOLOGY(FNAC)-AN
OVERVIEW
Prof. Tamal Kanti Ghosh MD
Medical superintendent –Cum- Vice Principal.
School of Tropical Medicine, Kolkata

FNAC
Sample of cells aspirated from suspicious mass
for diagnostic purpose-material converted to
cytological sample for microscopic examination

HISTORY
FNAC dates back to 19th Century St.
Barthalomew’s Hospital-Surgeon Stanley &
Earle - Aspiration from Liver
St.Paget advocated aspiration
in lumps
Menetier- 1st Lung ASPIRATION
Greigg& Gray - 20th Century beginning –
L. Nodes in trypanosomiasis

 Gutherei -1921-first to use 21 g needle Martin . Ellis & Stewart First large scale study of 2500cases using 18 g needle .

Zajicek of Karolinska Hospital Stockholm – FNAC to international attention in 1980s till than not used because : Lack of confidence in sensitivity & specificity Fear of tumor implantation along the tract Apprehension of lawsuits Reluctance .

palpable abdominal lesions testicles. other accessible sites prostrate. bones . pelvic organs. salivary gland. joints & lung .FNAC Application: Diagnosis of palpable lesion Breast. superficial soft tissue mass. thyroid.

FNAC : Advantages FNAC OPD procedure Minimal invasive cost effective No anaesthesia Rapid safe & painless Multiple /repeated attempt possible No fibrosis Definitive diagnosis in inoperable cases Rapid Diagnosis .

200mm (Transrectal/vag)  Syringer holder Franzen handle  Glass Slides  Fixatives: 95% ethanol/ ether – alcohol 50:50 .25-20 g 38mm(l)0.10/ 20 ml  Needle .Procedure : Materials :  Syringe.9mmin ext diameter. Std 21 g 38 mm  Larger needles 80-120.6-0.

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Method of aspiration  Position  Examination  Cleaning  Fixing-mass  Needle insertion  Withdrawl of plunger  To & fro movement  Termination of aspiration  Release of suction  Application of pressure with fingers .

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Preparation of FNA smears Wet fixed Dry Fixed .

Congo red } Amyloid Bacteria.PAS} carbohydrate Methyl violet. Fungus .STAINING  H&E  PAP  MGG  SPECIAL STAINING. Alcian blue Mucicarmine.

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PARA UMBILICAL FOR AMYLOIDOSIS  GUIDED FNAC -USG.ASPIRATION FROM SPECIAL LESION/BODY SITES  CYST  THYROID  LUNG  PROSTRATE  TESTIS  ABDOMINAL FAT. CT .

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Microbiological study Cell Block Immunocytochemical study Image analysis & morphometry Flow cytometry Ultrastructural studies Mol Biology Tech .

COMPLICATIONS & HAZARDS OF FNAC  HAEMATOMA  INFECTION  PNEUMOTHORAX  DESSEMINATION OF TUMOR  VASOVAGAL ATTACK .

P Time (PTI >80%)/OBST JAUNDICE  LUNG.PRECUTIONS & CONTRAINDICATIONS  BLEEDING DISORDER  LIVER FNA.EMPHYSEMATOUS/ PULMO HYPERTENSION  PANCREATITIS  ADRENAL TUMORPHEOCHROMOCYTOMA .

LIMITATIONS  SMALL NO OF CELL POPULATION IN SAMPLE  ADEQUACY  LACK OF CLINICAL DATA  ARTIFACTS .