Fine needle aspiration

Question 1

Define

Answer 1

Type of biopsy procedure used to investigate cystic lumps/masses (not solid masses)

A thin, hollow needle is inserted into the mass for sampling of cells which are then stained and examined under a microscope

Local anaesthesia is used

Question 2

Indications

Answer 2

Part of breast triple assessment

Any cystic mass of unknown nature e.g. in thyroid, non-thyroid neck, breast, liver, lymph nodes, lung, bone, GI tract, mediastinum

Basically everywhere!

Question 3

Complications

Answer 3

• Uncommon
• Infection
• Bruising
• Bleed
• Lung biopsies can cause pneumothorax – common
• Liver biopsies can cause bile leakage
• Breast biopsies can cause bleeding, bruising, infection and very rarely pneumothorax

NOTE: on ultrasound, a solid mass will be hyperechoic and a fluid-filled cyst will be hypoechoic

Question 4

Scoring

Answer 4

Scoring System in MDT

The letters refer to triple assessment

P: physical examination

R: radiological examination

C: cytology – FNA

B: biopsy – CB

Each letter is then given a score out of 5

1: normal or inadequate sample (cytology)
2: benign
3: probably benign
4: probably malignant
5: malignant