Fine Needle Aspiration cytology(FNAC) cyroscreening preoperative investigation

1. FNAC
Ajay Subedi
Janamaitri foundation institute of
health sciences,Balaju,Kathmandu

2. • FNAC is a short form of Fine Needle Aspiration
Cytology.
• This technique is an inexpensive,simple and
quick way to sample extraneous lumps and
masses that could be found in neck(thyroid
gland),salivary gland ,breasts etc.
• The sample is collected by inserting a fine gauge
needle into the suspected mass that is later studied
under microscope.

3. • The test primarily helps diagnose the presence
of inflammatory conditions and also cancer.
• Unlike the open surgical biopsy is much more
simpler,quicker and safer.

4. prepration
• Use of aspirin or other anti-inflammatories
(ibuprofen,naproxen) should be stopped at
least one week prior to the test.
• Fasting for a few hours before the test is to be
conducted.
• Anti-coagulants mustn´t be used.
• Routine blood tests must be in place at least
two weeks before biopsy.

5. • Other things that would be checked before
the test start are: a)Pulse rate
b)Blood pressure
c)Temperature
• In case patient feels anxious she may be given
sedation through an intravenous line.For
normal case oral medication is suggested.

6. procedure
• Determine the gross characteristics of the
mass to be aspirated including location
relative to other structures,estimated
depth,consistency,and any evidence of
pulsation or bruit.
• Assemble the syringe and syringe pistol with
attached needle(23-25 gauge).

7. • Label slide (using pencil),fixative and rinsing
solution containers with patients name.
• Clean the skin over the puncture site with an
alcohol skin prepration pad.
• Grasp the mass firmly with the free hand and
insert the needle in one swift motion.
• Apply full vacuum pressure to the syringe with
the pistol finger.
• Conclude the aspiration if the hub of a needle is
filled with a material or after about dozen passes
by releasing the trigger of the syringe pistol.

8. Lymph node aspiration
Salivary gland aspiration

9. Breast lump aspiration
Thyroid gland aspiration

11. • Withdraw the needle from the mass and place
pressure on the puncture site with a sterile gauze
pad.
• Detach the needle from the syringe,fill the
syringe with air and reattach the needle.
• Express a small drop of aspirated material on one
slide and gently spread the material by using a
second slide.
• Immediately fix one slide by dropping it into 95%
alcohol.air dry the second slide.
• Stain air-dried slide with diff quick.

12. Label slide
Small amount of
material
Prepare smear
Express needle
content into
rinsing solution
Air dry slides
Fix on
alcohol

13. • Then the slide is observed under microscope.

14. Result
• If the fluid is clear,the lump is most likely a
cyst.
• Bloody or cloudy fluid can mean either a cyst
that’s not cancer or, very rearly cancer.

15. Benefits
• Minimallay invasive, produces a speedy
result and is inexpensive.
• Regarded as an essential component of the
preoperative/ pretreatment investigation of
pathological processes, in combination with
clinical, radiological and other laboratory data.

16. RISK
• Bleeding at site of biopsy.
• Infection.
• Injury to structures adjecent to the affected
site(mainly in thyroid).

17. Thank you