FNAC
FNAC stands for “fine needle Aspiration cytology”. It is a
method of cytopathoLogical examination.
Modalities
of FNAC:
Ø
Direct vision FNAC for superficial masses.
Ø
Computed tomography guided FNAC for deep seated
masses. Such as intraabdominal organs, pelvic organs or masses in the brain
substances.
Method of
FNAC performance:- 20ml of plastic disposable syringe with 21 gauge. Fine
needle of variable length are used for aspiration.
Tumour mass
is fixed with one hand and with other hand aspiration is carried out. When
needle enters tumour, plunger of syring is retracted to create a vaccum in
barrel. The needle is moved to and fro for sevral times (10-15 times in
different directions 3-4 directions.) The plunger is kept retracted during
needle is drawn. Outside the tumour mass plunger is released, needle is
disconnected and contents of barrel is discharged over a slide. Smear is
prepared by pressing it with another slide and with drawing it in close
contact. Smear is immediately fixed in 90% ethyl alcohol for 3-5 minutes. The
smear is now ready for staining.
Method of
staining:
Ø
Wet fixed smear is stained by Papanicolauou
method of H &
E method.
Ø
Air dried smear is stained by May Grunewald –
giemsa stain or Leishman stain.
Method of FNAC
performance:- 20ml of plastic disposable syringe with 21 gauge. Fine needle
of variable length are used for aspiration.
Tumour
mass is fixed with one hand and with other hand aspiration is carred out. When
needle enters tumour, plunger of syringe is retracted to create a vaccume in
barrel. The needle is moved to and fro for sevral times (10-15)times in
different directions (3-4 directions). The plunger is kept retracted during
needle is drawn. Outside the tumour mass plunger is released, needle is
disconnectedand contents of barrel is discharged over a slide. Smear is
prepared by pressing it with another slide and with drawing it in close
contact. Smear is immediately fixed in 90% ethyl alcohol for 3-5 minutes, The
smear is now ready for staining.
Method of staining
1)
Wet fixed smear is stained by papanicolauou
method of H&E method.
2)
Air dried smear is stained by may
grunwald-Giemsa stain or Leishman stain.
Advantage of FNAC
1)
Aspiration is done by cytopathologiest himself
who can interact with patient.
2)
Diagnistic basis is call pattern and moephology
of group of cells.
3)
Nuclear characteristics and cytoplasmic
characteristic are both available for diagnosis.
4)
It is quick, convenient economic and painless
procedure.
5)
Local anaesthesia is not requirsd.
6)
The process can be attempted at multiple site.
7)
It is a good diagnostic aid for radiotherapy and
chemotherapy.
Limitation of FNAC
1)
False negative result is possible due to
a)
Fibrosis and selerosis in tumour.
b)
Highly vaseular tumour.
c)
Tumour necrosis.
2)
Aspirated material may not be adequate for
proper diagnosis.