Study of FNAC

                                                             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.