Fine Needle Aspiration
What is Fine Needle Aspiration?
Fine Needle Aspiration (FNA) is a reliable method of sampling virtually any lump, nodule, or mass often eliminating the need for a larger tissue biopsy. FNA is a very simple procedure, usually requiring an appointment of only 20 to 30 minutes. After cleaning and numbing the skin overlying the lump, a very thin needle (thinner than the needle use to draw blood) is inserted in the lesion, nodule, or mass usually for about 2 to 3 seconds. The material obtained is smeared onto glass slides, stained, and immediately examined under the microscope. A preliminary interpretation is rendered in minutes, and communicated to your referring physician.
What is involved in the FNA procedure?
First we ask you several questions about your lump, nodule, or mass: Where it is located, when did you or your doctor first notice it, and have there been any changes in it? It is also important to know what might have caused the lump, nodule, or mass such as trauma or infection. Next, we review x-rays or other reports, which you or your doctor might provide. Finally, we ask if you have any questions about the biopsy.
The examination begins by pressing (palpation) of your lump, nodule, or mass, subsequently the overlying skin is marked with a special ink, which is washed off later. The size of the lump, nodule, or mass is measured and the location is noted so that you and your physician can be sure exactly what area was sampled when the results are available..
Usually, your FNA physician numbs the skin over the lump, nodule, or mass by injecting a few drops of a mild anesthetic. Both the needle size and amount of medication we use are smaller than what a dentist would use to numb a tooth and most patients note less discomfort. In performing over hundreds of these anesthetic injections, no significant complications have been encountered.
Depending on the location of the lesion, an ultrasound imager may be utilized to assist in locating the abnormality and guide the FNA.
The actual biopsy is brief, lasting only a few seconds. The biopsy needle we use is smaller than that used to draw blood from your arm. The needle is gently inserted through the numbed skin and into your lump for two or three seconds. That’s it! Usually, we take about two to four samples of your lump, nodule, or mass. This assures you and your physician that the specimen obtained is reasonably representative.
What are the possible complications?
An FNA performed by an experienced practitioner is virtually free of significant complications. The most common complication, which occurs in only about one quarter of our FNA patients, is a small bruise or mild tenderness in the area of the biopsy. In our experience this is very mild, requires no specific medical attention, and disappears within a few hours or days. Application of an ice pack and mild non-aspirin medication (such as Tylenol®) helps in most cases. Complications such as rapid swelling, bleeding, or infection are extra-ordinarily rare. If these or any unusual symptoms occur, please call your doctor or our office immediately.
Even though the risk of a significant complication is very small, an FNA does have a risk, like every medical procedure. We will not perform the biopsy if we feel the procedure would not benefit you. In that case, a written report describing our findings, and an explanation of why we did not perform the biopsy, will be sent to your physician..
How are the FNA results obtained?
We have found that FNA results are more accurate when the doctor who performed the biopsy also interprets the sample. The FNA physician who takes your biopsy will personally examine your slides and determine the diagnosis. In all cases, we phone the results of this test to your physician by 5 p.m. the following work day. We also mail and fax a written report to your doctor’s office. If you wish to know the results of your FNA before your next scheduled appointment, you can contact your doctor directly. He or she can best explain exactly what the test results mean for you and what, if anything should be done next. However, if you are unable to reach your doctor, please call our office at 419-383-3482.
What are the goals and limits of FNA?
Our goal is to determine the cause of your nodule, mass or lesion which we can do in about 92% of cases. For another 7% of cases, we can usually narrow the cause of the lump, nodule, or mass to two or three likely possibilities. In only about 1% of cases is the sample too limited to help your doctor.
We practice personalized medicine
We practice personalized medicine, which is the systematic use of individual patient information to select and optimize the best resources available for the best possible patient care.
Our full attention is devoted to the particular needs of patients receiving FNAs, whether this takes place inside or outside of the hospital. To the best of our knowledge, our Aspiration Biopsy Cytology Service is by far the best needle biopsy practice in the Northwest Ohio area. Our experience is an important consideration in your physician’s decision to refer you to us.
Assuring always a second opinion, your FNA material will be reviewed by at least two Board-certified cytopathologists. Our goal is to provide the highest level of professional care while maintaining an environment sensitive to your personal needs. We strive to make your biopsy an easy experience.
Department of Pathology, Room 2010
University of Toledo Medical Center
3000 Arlington Avenue