Fine needle aspiration ( FNA ) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin needle (23-25 ​​â € <â €
Needle aspiration biopsy is safer and less traumatic than open surgical biopsy, and significant complications are usually rare, depending on the location of the body. Common complications include bruising and pain. There is a risk, because the biopsy is very small (only a few cells), that the problematic cells will be lost, resulting in false negative results. There is also a risk that the cells taken will not allow a definitive diagnosis.
Video Fine-needle aspiration
Medication using
This type of sampling is done for one of two reasons:
- A biopsy is performed on a lump or mass of tissue when its nature is questioned.
- For known tumors, this biopsy is performed to assess the effects of treatment or to obtain tissue for special studies.
When a lump can be felt, a biopsy is usually performed by a cytopathologist or surgeon. In this case, the procedure is usually short and simple. Otherwise, this can be done by an interventional radiologist, a doctor with training in performing a biopsy such as under x-rays or ultrasound guidance. In this case, procedures may require more extensive preparation and require more time to perform.
Also, fine needle aspiration is the main method used for sampling chorionic villus, as well as for many types of body fluid sampling.
It is also used for aspiration of breast abscess, breast cyst, and seromas.
Maps Fine-needle aspiration
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Some preparation may be required before this procedure.
- Not using aspirin or non-steroidal anti-inflammatory drugs (eg ibuprofen, naproxen) for a week before the procedure;
- There is no food intake a few hours before the procedure;
- Regular blood tests (including clotting profiles) should be completed two weeks before biopsy;
- Suspension of blood anticoagulant medication;
- Antibiotic prophylaxis may be institutionalized.
Before the procedure begins, vital signs (pulse, blood pressure, temperature, etc.) can be taken. Then, depending on the nature of the biopsy, an intravenous line may be placed. Anxious patients may want to be sedated through this pathway. For patients with less anxiety, oral medication (Valium) may be prescribed to be taken before the procedure.
Procedures
The skin above the area to be biopsied is wiped with an antiseptic solution and wrapped in a sterile surgical towel. The skin, underlying fat, and muscle may be numb with local anesthesia, although this is often not necessary with a shallow mass. After finding a mass for biopsy, using x-rays or palpation, a special needle with very fine diameter is passed into the mass. The needle can be inserted and drawn several times. There are many reasons for this:
- One needle can be used as a guide, with another needle placed along it to reach a more precise position.
- Sometimes, some passes may be necessary to get enough cells for complicated testing performed by cytopathologists.
Once the needle is placed into the mass, the cells are drawn by aspiration with a syringe and spread on a glass slide. The patient's vital signs are taken again, and the patient is transferred to the observation area for about 3 to 5 hours.
- For biopsy in the breast, ultrasound guided fine-needle biopsy is the most common. Biopsy recommended.
Post-operative care and complications
As with any surgical procedure, complications may occur, but major complications due to thin needle aspiration biopsy are rare, and when complications actually occur, they are generally mild. The type and severity of the complications depends on the organ from which the biopsies are taken or the organs pass through to obtain the cells.
After the procedure, mild analgesics are used to control post-operative pain. Aspirin or aspirin substitute should not be taken for 48 hours after the procedure (unless aspirin is prescribed for heart or nerve condition). Because sterility is maintained during the procedure, infections are rare. But if an infection occurs, it will be treated with antibiotics. Bleeding is the most common complication of this procedure. A slight bruise may also appear. If a pulmonary or renal biopsy has been performed, it is common to see small amounts of blood in sputum or urine after the procedure. Just a little bleeding must happen. During the post-procedure observation period, bleeding should decrease over time. If more bleeding occurs, it will be monitored until it subsides. Rarely, major surgery will be needed to stop the bleeding.
Other complications depend on the part of the body where the biopsy occurs:
- Pulmonary biopsy is often complicated by pneumothorax (collapsed lung). This complication can also accompany a biopsy in the upper abdomen near the base of the lung. About a quarter to a half of patients undergoing pulmonary biopsy will develop pneumothorax. Usually, the degree of collapse is small and self-limiting without treatment. A small percentage of patients will develop a serious enough pneumothorax to require hospitalization and placement of a chest tube for treatment. While it is not possible to predict who this will be, lung collapse is more frequent and more serious in patients with severe emphysema and in patients with biopsy is difficult.
- For a liver biopsy, a bile leak may occur, but this is quite rare.
- Pancreatitis (inflammation of the pancreas) may occur after biopsy in the area around the pancreas.
- In biopsies in the breast area, bleeding and bruising may occur, less frequently as well as infections (rare) or (very rare, and only if done near the chest wall) of the pneumothorax.
- Death has been reported from a needle aspiration biopsy, but such results are very rare.
Criticism
A new study showed that in one case a liver tumor needle biopsy resulted in the spread of cancer along the needle line, and concluded that the needle aspiration was dangerous and unnecessary. The conclusions drawn from this paper were subsequently criticized vigorously.
See also
- Barcode antibodies, techniques for identifying proteins in small tissue samples such as aspiration
- FNA mapping, application for male-factor infertility assessment.
References
- Originally adapted from Preparing a needle aspiration biopsy (634 KB). Public domain text from National Institutes of Health, Warren Magnuson Grant Clinical Center.
- The video shows a fine ultrasound guided biopsy
External links
- Aspiration, Fine-Needle Biopsy at US National Library of Medicine's Medical Subject Headings (MeSH)
Lung
- MedlinePlus Encyclopedia 003860 - "Biopsi jarum paru"
Leher
- ent/561 di eMedicine - "Aspirasi Fine-Needle of Neck Masses"
- MedlinePlus Encyclopedia 003899 - "Benjolan aspirasi jarum halus tiroid"
Bones
- MedlinePlus Encyclopedia 003658 - "Bone marrow aspiration"
- med/2971 in eMedicine - "Bone Marrow Aspiration and Biopsy"
Risk
- Risk of tumor cell cultivation through 2014 aspiration biopsy and cytology
Source of the article : Wikipedia
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