Fine Needle Aspiration Cytology or FNAC

Fine Needle Aspiration Cytology (FNAC) is a technique whereby cells are obtained from a lesion using a thin bore needle and smears are made for cytopathological diagnosis. This technique is based on the fact that tumor cells are less cohesive and are easily aspirated. Used in the diagnosis of breast lumps, thyroid nodules, liver disease, subcutaneous soft
tissue mass, salivary gland diseases and oral diseases.

Oral cavity is a site where mucosa is very vascular and an open biopsy leads to a lot of bleeding which is difficult to
control. In recent times FNAC solves these problems, adequate material can easily be obtained by using a 10 ml. syringe
from an intraoral or extraoral site without any discomfort to the patient and with no bleeding. In some cases a subsequent surgery is not needed and patient can be put on appropriate treatment. FNAC report is prepared within 24 hours of sampling gives early, quick information to the surgeon about the type of lesion he is dealing with.

History Of Fine Needle Aspiration Cytology or FNAC

1. The technique was introduced in the 1930s by Martin and Ellis in the United States, but it never became widespread.
2. Since the 1950s it has been used extensively in Scandinavia and in Holland.
3. Fine Needle for aspiration were first introduced in Europe in the 1950’s by Lopez-Cardozo in the Netherlands and Soderstrom in Sweden
4. Publication by Zajicek from Karolinska Hospital in Stockholm that brought aspiration cytology to international alterations.

Indications of Fine Needle Aspiration Cytology

1. Diagnoses of palpable mass lesions such as in breast, lymph nodes, thyroid, soft tissue lesions etc.
2. Diagnoses of nonpalpable mass lesions is also done using FNAC under assistance of radiological techniques such as ultrasound, CT scan, MRI, stereotactic localization and FNAC or endoscopy guided FNAC.
3. Salivary gland FNAC, diagnoses of abdominal lesions, liver or lung lesions, prostate, retroperitoneal lumps, etc. are also diagnosed using FNAC.

FNAC should not be done in the following situations:

• Presence of a skin infection
• Patient is on anticoagulant therapy
• Patient has a bleeding disorder
• Patient does not give consent
• Presence of a coagulopathy
• The lesion is deep and not palpable

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