1. Introduction of Fine Needle Aspiration (for cytotechs)
By Dr May Yu
3rd August 07

2. FNA- Use and Indications
Diagnosis – First, follow up to assess therapy response, recurrence, staging
Obtain tissue for other tests: e.g. cultures, biochemical tests (rare), molecular studies (uncommon in our lab).
Therapeutic – e.g. cyst compressing vital structures

3. FNA procedures In FNA clinics of pathology department
Radiological guided
e.g. CT, ultrasound, endoscopic ultrasound

4. FNA procedures Tools for FNA Suction retractors Syringes Fine needles
Glass slides
Fixatives
Sterile material
+/- culture bottles

5. FNA procedures Precautions for patients
Sterile to avoid contamination or cross-infection.
Control bleeding: adequate hemostasis by direct pressure of puncture site, avoid FNA on patients with bleeding tendency, avoid vessels
Avoid vital structures or puncturing trachea, pleural space.

6. FNA procedures Precautions for staff
- questionaire to assess patients’ risk
- avoid cross-infection: masks, gloves, eye-shield, safety cabinents, avoid smearing cases with high risk of infection, adequate fixation before further processing of these cases.
- avoid needle injury

7. FNA procedures For superficial procedures - usu no anasethesia needed
For deep seated procedures
+/- sedation or local anaesthesia.

8. FNA sites Superficial: palpable lesions
Lymph nodes, thyroid nodules or cysts, skin or subcutaneous nodules/cysts, salivary nodules/cysts, breast lumps/cysts, enlarged liver masses.
Deep seated – usually need CT, ultrasound, or endoscopic ultrasound guidance
Deep seated lymph nodes, masses/nodules/cysts.
e.g. lung, mediastinal, intra-abdominal, pelvic, retroperitoneal

9. Examples of FNA
Lymph node
Thyroid
Salivary gland
Breast