Fine Needle Aspiration Cytology (FNAC)

Biopsy sampling tools..

Fine needle-aspiration cytology, or FNAC, is a procedure in which a needle is inserted into a site and a small amount of tissue is sucked out to provide the laboratory with a sample of cells. Fine needle aspiration is sometimes done with the assistance of ultrasound and image-based guidance for the placement of the needle. Sometimes fine needle aspiration is used to sample a lymph node affected by an unknown disease, and this sample could turn out to be lymphoma.

Initial diagnosis of lymphoma is based on more than just symptoms, and with regard to the biopsy, experts note the importance of as much certainty as possible from the start. According to current guidelines, a fine-needle aspirate, or FNA, is not adequate for an initial diagnosis of lymphoma. Instead, an incisional or excisional biopsy is generally preferred, which involves taking a larger sample of tissue to provide adequate material for a number of different laboratory tests.

When appropriate, however, FNA has its advantages in that it the procedure is considered less disruptive, with a low risk of trauma, and is generally cost-effective. It is a quicker and less painful procedure than a biopsy, but doctors still prefer a biopsy for lymphomas as it gives results with more certainty.

Sources

Cheson B, Fisher R, Barrington S, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32(27):3059-68.

Eisendrath P, Ibrahim M. How good is fine needle aspiration? What results should you expect? Endosc Ultrasound. 2014;3(1):3-11.

Muddegowda PH, Srinivasan S, Lingegowda JB, Kurpad R R, Murthy KS. Spectrum of Cytology of Neck Lesions: Comparative Study from Two Centers. J Clin Diagn Res. 2014;8(3):44-45.

Khashab M, Mokadem M, DeWitt J, et al. Endoscopic ultrasound-guided fine-needle aspiration with or without flow cytometry for the diagnosis of primary pancreatic lymphoma - A case series. Endoscopy. 2010;42:228–31.

Updated October 2015.

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