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Fine-needle aspiration (FNA) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin (23–25 gauge (0.52 to 0.64 mm outer diameter)), hollow needle is inserted into the mass for sampling of cells that, after being stained , are examined under a microscope ( biopsy ).
It is important to note that a NIFTP diagnosis cannot be made on the basis fine needle aspiration alone. Evaluation of a surgical resection specimen is required to rule out invasive growth. If molecular studies are applied to the fine needle aspiration material, an RAS mutation is the most common identification. [4] [15] [16]
The doctor will typically use a 22 or 27 gauge needle to aspirate out free fluid and cells. [12] It can be done in an outpatient setting and is associated with minimal pain. [12] However, in up to 30% of cases, pathological slides from fine-needle aspiration of breast lesions may be inconclusive, necessitating the need for further testing. [12]
One way that fine-needle aspiration biopsy cytology is reported is via the International Academy of Cytology (IAC) Yokohama System, which "defines five categories for reporting breast cytology, each with a clear descriptive term for the category, a definition, a risk of malignancy (ROM) and a suggested management algorithm."
Fine-needle aspiration is essential in order to obtain a sample of the thyroid tissue to allow for microscopic examination. This allows an experienced pathologist to differentiate ATC from other diseases, such as other forms of thyroid cancer. [2]
Fine-needle aspiration: biopsy with a fine needle trying to obtain tissue diagnosis by examining the tumour cells. Core needle biopsy: similar to fine-needle aspiration, only involving the use of larger needles to excise the tissue. Vacuum-assisted biopsy: similar to core needle aspiration but using vacuum assistance to gather the sample ...
To achieve a definitive diagnosis, a fine needle aspiration cytology test may be performed and reported according to the Bethesda system. [28] After diagnosis, to understand potential for spread of disease, or for follow up monitoring after surgery, a whole body I-131 or I-123 radioactive iodine scan may be performed. [29]
The Bethesda System for Reporting Thyroid Cytopathology is the system used to report whether the thyroid cytological specimen is benign or malignant on fine-needle aspiration cytology (FNAC). It can be divided into six categories: