Fine Needle Aspiration
WHAT IS FNA?
Fine needle aspiration (FNA), also called fine needle
biopsy, is a technique that allows a biopsy of various bumps and lumps. It
allows your otolaryngologist to retrieve enough tissue for microscopic analysis
and thus make an accurate diagnosis of a number of problems, such as
inflammation or even cancer.
FNA Is Used for Diagnosis In:
• Thyroid Gland
• Neck lymph nodes
Neck cysts
Salivary glands (i.e.
parotid gland, submandibular gland)
Inside the mouth
Any lump that can be
felt
Lumps that are found on imaging tests (such as ultrasound)
even if they can’t be felt
WHY IS FNA IMPORTANT?
A mass or lump sometimes indicates a serious problem, such
as a growth 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, are also important factors that help in the 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 IN THIS FASHION?
FNA is generally used for diagnosis in areas such as neck
lymph nodes or for cysts in the neck. FNA is the most commonly performed test
to determine whether thyroid nodules are benign or suspicious for malignancy.
The parotid gland (the mumps gland), submandibular gland, and other areas in the
neck and inside the mouth or throat can be biopsied as well. Virtually any lump
or bump that can be felt (palpated) or identified by ultrasound can be biopsied
using the FNA technique. Tests for infection and certain chemical substances
can also be done on the material that is obtained.
HOW IS FNA DONE?
Your doctor will insert a small needle into the mass. A
small amount of tissue can be drawn back into the needle using negative
pressure on the syringe. Under a microscope, this tissue can be identified leading
to a diagnosis. This procedure is generally accurate and frequently prevents
the patient from having an open, surgical biopsy, which is more painful and
costly. Local anesthesia (numbing
medicine) may be used but is frequently not required. If the mass is small or difficult to feel, an
ultrasound device can be used to help direct the needle into the mass. FNA is
about as painful as drawing blood from the arm for laboratory testing
(venipuncture). In fact, the needle used for FNA is smaller than that used for
venipuncture. Although not painless, any discomfort associated with FNA 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 finding cancer in the needle
path is very small. Other complications are rare; the most common is bleeding.
If bleeding occurs at all, it is generally seen as a small bruise. Patients who
take aspirin, Advil®, or blood thinners, such as Coumadin®, are more at risk to
bleed. However, the risk is minimal. Infection is rarely seen. Sometimes the
results of an FNA are indeterminate, leading to the need to repeat the FNA or
use alternative tissue sampling techniques.
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