Patient Education_150

Patient Education
Frequently Asked Questions (FAQs)

Fine Needle Aspiration (FNA) 

  1. What is a Fine Needle Aspiration (FNA)?
  2. What is the advantage of this test?
  3. Who performs this test?
  4. What do I have to do to prepare for an FNA?
  5. Is it painful?
  6. How accurate is the result?
  7. Are there any complications?

Fine Needle Aspiration (FNA)

What is a Fine Needle Aspiration (FNA)?

A fine needle aspiration (FNA) is a biopsy technique to sample potentially abnormal tissue.  In the usual scenario, a patient will have a bump or mass that can be felt by the patient or doctor or seen with an x-ray.  Using sterile technique, a small needle is introduced into the mass and cells removed, which are then placed on glass slides and examined under a microscope.  The pathologist or cytotechnologist may look at the glass slides on the spot and render a judgment as to whether more sample is needed to make a diagnosis in the laboratory [this is called an on-site adequacy assessment].  Depending on the type of tissue, other tests may be performed to determine what kind of cells are present.
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What is the advantage of this test?

FNA is a rapid procedure, lasting between 10 minutes to 1 hour.   On-site adequacy assessment reduces the chance that the biopsy will have to be repeated if diagnostic material isn’t there, saving the patient a trip back to the doctor’s office or hospital.  FNA is relatively pain-free and typically requires little recuperation afterward.  Results are usually available within a few days.
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Who performs this test?

FNA is performed by a physician.  On-site adequacy assessment, if available, may be performed by a pathologist or a cytotechnologist.  All of the slides and additional tests, if needed, are examined by a pathologist who issues the final report to the treating physician.
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What do I have to do to prepare for an FNA?

If the site to be biopsied is superficial (can be felt by the patient or doctor), no preparation is needed.  Discuss with your doctor beforehand if you are taking aspirin or other blood thinners.  If the mass to be biopsied is visualized with an x-ray only (for example, in the lung), you will receive pre-procedure instructions from the radiology or surgery team.
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Is it painful?

One of the advantages of FNA is that it is a relatively pain-free procedure.  Often the needle used is so small, anesthetic (example: lidocaine) is not necessary, though it may be used.  Patients report a feeling of pressure and ‘poking,’ but the needle is so small and in place for such a short time, this discomfort is minimal.  Biopsies of deeper locations, visualized by an x-ray, require some sedation.  Sedation is not indicated for FNAs of superficial or palpable (‘feel-able’) masses performed in the clinic or doctor’s office.
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How accurate is the result?

FNA is a quick and accurate way to diagnose infectious, inflammatory and cancerous processes. Often the FNA diagnosis will provide all the information the clinician needs to decide on a treatment plan.  In some cases, further diagnostic testing, either by repeat FNA or other tissue sampling technique may be necessary.
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Are there any complications?

Any time the skin is broken there is a chance of infection.   To minimize this risk, the skin is vigorously cleaned and brand-new sterile needles and syringes used for each sampling pass.  Bleeding, usually very minimal, is controlled with pressure and a bandage or Band-Aid placed over the FNA site.  Slight bruising and mild soreness afterward are common.  Risk of damage to adjacent anatomical structures is a rare event.   As with any health concern, it is best to call your doctor to report any unexpected post-procedure developments, such as moderate to severe pain, swelling, heat, or numbness, and to proceed to the emergency department if severe.
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