Introduction of Fine Needle Aspiration (for cytotechs)

1. Introduction of Fine Needle Aspiration (for cytotechs) By Dr May Yu 3rd August 07

2. FNA- Use and Indications • Diagnosis – First, follow up to assess therapy response, recurrence, staging • Obtain tissue for other tests: e.g. cultures, biochemical tests (rare), molecular studies (uncommon in our lab). • Therapeutic– e.g. cyst compressing vital structures

3. FNA procedures • In FNA clinics of pathology department • Radiological guided e.g. CT, ultrasound, endoscopic ultrasound

4. FNA procedures • Tools for FNA • Suction retractors • Syringes • Fine needles • Glass slides • Fixatives • Sterile material • +/- culture bottles

5. FNA procedures • Precautions for patients • Sterile to avoid contamination or cross-infection. • Control bleeding: adequate hemostasis by direct pressure of puncture site, avoid FNA on patients with bleeding tendency, avoid vessels • Avoid vital structures or puncturing trachea, pleural space.

6. FNA procedures • Precautions for staff • - questionaire to assess patients’ risk • - avoid cross-infection: masks, gloves, eye-shield, safety cabinents, avoid smearing cases with high risk of infection, adequate fixation before further processing of these cases. • - avoid needle injury

7. FNA procedures • For superficial procedures • - usu no anasethesia needed • For deep seated procedures • +/- sedation or local anaesthesia.

8. FNA sites • Superficial: palpable lesions • Lymph nodes, thyroid nodules or cysts, skin or subcutaneous nodules/cysts, salivary nodules/cysts, breast lumps/cysts, enlarged liver masses. • Deep seated – usually need CT, ultrasound, or endoscopic ultrasound guidance • Deep seated lymph nodes, masses/nodules/cysts. e.g. lung, mediastinal, intra-abdominal, pelvic, retroperitoneal

9. Examples of FNA • Lymph node • Thyroid • Salivary gland • Breast