3. Two techniques: fine needle aspiration
cytology (FNAC) and fine-needle non
aspiration cytology (FNNAC)
FNAC is essential component of the
preoperative/ pretreatment investigation of
pathological processes, in combination with
clinical, radiological and other laboratory
data
4. FNAC is valuable in the diagnosis of
neoplastic conditions , inflammatory,
infectious and degenerative conditions
Is minimally invasive, produces a speedy
result and is inexpensive
5. To assess the quality of non aspiration
technique in comparison to aspiration
technique
To find out whether non aspiration
technique could be promoted as a better
technique for cytodiagnosis
6. To compare the smear quality between
aspiration and non aspiration techniques of
cytology by using the following parameters:
Background blood or clot
Amount of cellular material
Degree of cellular degeneration
Degree of cellular trauma
Retention of appropriate architecture
7. There is no significant difference between
aspiration and non aspiration technique [Ho (null
hypothesis)]
There is significant difference between
aspiration and non aspiration technique [Ha
(alternate hypothesis)]
8. In our setting , we have been using FNAC
technique in all type of lesions (swelling)
FNAC may yield more material because of
the suction effect, but may aspirate more
blood which will affect the quality of the
sample. FNNAC may produce less material,
but may cause less bleeding and produce a
specimen of higher quality.
9. “The purpose of the study is to assess the
efficiency and quality of non aspiration
technique in comparison to aspiration
technique and to find out whether non
aspiration technique could be promoted as a
superior cytodiagnostic technique”
10. A. Study population:
Patients advised for FNAC
Performed in the Department of Pathology
(Cytopathology) at BPKIHS, Dharan
B. Type of study:
Cross-sectional, comparative study
11. C. Sample size:
47
D. Sampling method:
Systematic random sampling technique
where one patient will be taken every
seventh day.
13. E. DURATION OF STUDY:
One year
F. STATISTICAL ANALYSIS:
Percentage, Proportion, Mean, SD (descriptive
statistic analysis)
Independent test or Mann Whitney U-test, Paired
T- test or Wilcoxson Sign Rank Test (Inferential
statistics analysis)
the significant difference between the variables at
95 % confidence interval where p value = 0.05 will
be calculated
14. G. Inclusion criteria:
Patients who come for FNAC in the cytology
laboratory with palpable superficial swelling
H. Exclusion criteria:
Patients with non palpable swelling
Patients who are advised for USG guided
FNAC
Uncooperative patients
15. Patients of all age group advised for FNAC
investigation coming to cytopathology lab
Consent from the patient
Perform aspiration technique and non
aspiration technique on superficial swelling
Stain all smears with Giemsa stain and
Papanicolaou (pap) stain
16. Method of analysis:
Examine the smears
Analyze using a point scoring system given by Maier
et al.
In each of these criteria, smear will be given a score
of 0-2. The total score will be calculated, which
varies from 0-10. The smear of each technique will
be arranged to one of the three categories based on
the total score.
Unsuitable for cytodiagnosis: 0-2
Adequate for cytodiagnosis: 3-6
Diagnostic superior: 7-10
17.
18. REFERENCE:
1) Bharati K, Anuradha S, Abdul K, S Venkatesh. A prospective study to
compare the aspiration and non-aspiration in Fine-neede cytology
of lymphnode and to evaluate the diagnostic accuracy of aspiration
cytology in lymph node lumps. Int J Biol Med Res; 2012; 3 (3): 2147
– 2152.
2) Orell SR, Sterret GF,Indrotuction: Fine Needle Aspiration Cytology
Fifth Edition:Churchill Livingstone,2012;1-7
3) Webb Aj.Early microscopy:History of fine needle aspiration (FNA)
with particular reference to goiter. Cytopathology 2001;12:1-7.
4) David D Pothier, AA Narula. Should we apply suction during fine
needle cytology of thyroid lesions? A systematic review and meta-
analysis. Ann R Coll Surg Engl 2006; 88: 643 – 645.
5) Leo F. Tauro et al. A Comparative Study on Fine Needle Aspiration
Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules.
Oman Med J (2012) Vol. 27, No.2: 151 – 156.
6) Kumarasinghe MP, Sheriffdeen AH. Fine Needle Sampling
without aspiration. Pathology 1995 Oct; 27 (4): 330-332
19. 7. Sanjeev S, Siddaraju N. A comparative analysis of fine needle
capillary vs fine needle aspiration cytology in superficial lymph
node lesions. Diagn Cytopathol 2009 Nov; 37 (11): 787-791
8. Baksh S, Masih K, Singh S, Das S. Diagnostic utility of fine-needle
non aspiration cytology vs fine-needle in breast masses. Indian J
Pathol Microbiol 2004 Jul; 47(3): 319-321
9. Joshi A, Maimoom S. Limitations Fine Needle aspiration Cytology
in Subtyping Breast Malignancies: A Report of Three Cases. Journal
of Cytology 2007;24 (4) :203-206.
10. CV Raghuveer, L Leekha, MR Pai, P Adhikari. Fine needle
aspiration cytology versus fine needle sampling without
aspiration, A prospective study of 200 cases. Indian J Med Sci
2002; 56: 431 – 439.
11. Bharathi K. Comparison of Aspiration Technique in Fine needle
cytology of Breast lesions. Jour of Med Sc and Tech; (may 2012),
1(2), 6-16.
12. Stewart CJ. Immediate assessment of fine needle aspiration
cytology of lung. J Clin Pathol; 1996; Oct; 49 (10); 839 – 43.
13. Kinney TB et al. Fine needle biopsy, prospective comparison of
aspiration versus non-aspiration techniques in the abdomen.
Radiology (1993); Feb; 186 (2): 549 – 52.
21. Local Examination of the swelling:
Site:
Shape and Size:
Surface:
Margins:
Consistency:
Signs of inflammation:
Fixity to skin:
Fixity to underlying structures:
Investigations:
o AFB
o Ultrasound:
Clinical Diagnosis:
22. Cytology report
FNAC FNNAC
Background blood
Amount of cellular material
Retention of architecture
Degree of cellular degeneration
Degree of cellular trauma
Cumulative score
