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  • #10417

    Needle aspiration biopsy (NAB), may refer to fine needle aspiration cytology (FNAC), fine needle aspiration biopsy (FNAB) and fine needle aspiration (FNA), is a diagnostic procedure sometimes used to investigate superficial (just under the skin) lumps or masses. In this technique, a thin, hollow needle is inserted into the mass for sampling of cells that, after being stained, will be examined under a microscope. There could be cytology exam of aspirate (cell specimen evaluation, FNAC) or histological (biopsy – tissue specimen evaluation, FNAB). [1]. Fine needle aspiration biopsies are very safe, minor surgical procedures. Often, a major surgical (excisional or open) biopsy can be avoided by performing a needle aspiration biopsy instead. In 1981, the first fine needle aspiration biopsy in the United States of America was done at Maimonides Medical Center, eliminating the need for surgery and hospitalization. Today, this procedure is widely used in the diagnosis of cancer.[2]

    A needle aspiration biopsy is safer and less traumatic than an open surgical biopsy, and significant complications are usually rare, depending on the body site. Common complications include bruising and soreness. There is a risk, because the biopsy is very small (only a few cells), that the problematic cells will be missed, resulting in a false negative result. There is also a risk that the cells taken will not enable a definitive diagnosisApplications

    This type of sampling is performed for one of two reasons:
    A biopsy is performed on a lump or a tissue-mass when its nature is in question.
    For known tumors, this biopsy is performed to assess the effect of treatment or to obtain tissue for special studies.
    When the lump can be felt, the biopsy is usually performed by a cytopathologist or a surgeon. In this case, the procedure is usually short and simple. Otherwise, it may be performed by an interventional radiologist, a doctor with training in performing such biopsies under x-ray or ultrasound guidance. In this case, the procedure may require more extensive preparation and take more time to perform.
    Also, fine needle aspiration is the main method used for chorionic villus sampling,[3] as well as for many types of body fluid sampling.
    ]Preparation

    Several preparations may be necessary before this procedure.
    No use of aspirin or non-steroidal anti-inflammatory medications (e.g. ibuprofen, naproxen) for one week before the procedure;
    No food intake a few hours before the procedure;
    Routine blood tests (including clotting profile) must be completed two weeks before the biopsy;
    Suspension of blood anticoagulant medications;
    Antibiotic prophylaxis may be instituted.
    Before the procedure is started, vital signs (pulse, blood pressure, temperature, etc.) may be taken. Then, depending on the nature of the biopsy, an intravenous line (I.V.) may be placed. Very anxious patients may want to be given sedation through this line. For patients with less anxiety, oral medication (Valium) can be prescribed to be taken before the procedure.

    #15343

     Micrograph of a needle aspiration biopsy specimen of a salivary gland showing adenoid cystic carcinomaPap stain.

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