Fine Needle Aspiration

WHAT IS FNA?

Fine needle aspiration (FNA) is a procedure where a small needle is placed into a growth that allows a biopsy of various bumps and lumps. In doing the fine needle biopsy your doctor will take out a few drops of cells or tissue. These cells will be placed on slides and they will have special staining done so that a microscopic analysis can be done by a pathologist. The purpose of a fine needle aspiration is to make an accurate diagnosis of a number of problems and to determine if a growth is from a cause such as inflammation or cancer.

WHY IS FNA DONE?

A mass or lump sometimes indicates a serious problem, such as a growth a benign tumor or cancer. While this is not always the case, the presence of a mass may require FNA for diagnosis. Your age, sex, and habits, such as smoking and drinking, is also important factors that help diagnosis of a mass. Symptoms of ear pain, increased difficulty swallowing, weight loss, or a history of familial thyroid disorder or of previous skin cancer (squamous cell carcinoma) may be important as well.
* When found early, most cancers in the head and neck can be cured with relatively little difficulty. Cure rates for these cancers are greatly improved if people seek medical advice as soon as possible. So play it safe. If you have a lump in your head and neck area, see your otolaryngologist right away.

WHAT ARE SOME AREAS THAT CAN BE BIOPSIED WITH AN FNA?

FNA is generally used for help in diagnosis for masses in the head and neck. Some of the types of masses which FNA is used for are masses in the parotid glands (in front of the ear), the submandibular salivary glands (just below the jaw), masses of the thyroid gland and masses cysts or enlarged lymph nodes in the neck. Masses of the scalp, face and other areas inside the mouth or throat can be aspirated as well. Virtually any lump or bump that can be felt (palpated) can be biopsied using the FNA technique.

HOW IS FNA DONE?

Your doctor will insert a small needle into the mass. Suction is created in the syringe, and as a result of this negative pressure difference between the syringe and the mass, cellular material can be drawn into the syringe. The needle is moved in and out of the mass, obtaining enough material to make a diagnosis. This procedure is generally accurate and frequently prevents the patient from having an open surgical biopsy (which is more painful and costly). The FNA biopsy procedure generally does not require anesthesia. It is usually about as painful as drawing blood from the arm. The needle used for FNA is smaller than that used for drawing blood. Although it is not painless, discomfort associated with the FNA procedure is usually minimal.

WHAT ARE THE COMPLICATIONS OF THE FNA PROCEDURE?

No medical procedure is without risks. Due to the small size of the needle, the chance of spreading a cancer or leaving cancer in the needle path is very small. Complications of FNA biopsy are very rare. The most common problem occurring with FNA biopsy is bleeding. If bleeding occurs at all, it is generally seen as a small bruise. Patients who take aspirin, ibuprofen or blood thinners, such as Warfarin (Coumadin), Plavix, are more at risk to bleed. However, the risk is minimal. Infection after a FNA is rarely seen.