FNAC & Biopsy

What is FNAC ?

FNAC stands for Fine Needle Aspiration Cytology. It is a medical diagnostic procedure used to obtain a tissue sample from a lump, mass, or suspicious area in the body for examination under a microscope. FNAC is commonly performed to determine whether the tissue is benign (non-cancerous) or malignant (cancerous) and to help guide further diagnostic and treatment decisions.

How is it done ?

Here's how the FNAC procedure is typically performed:

1. Preparation: The patient may need to change into a hospital gown, and the area to be examined is cleaned and sterilized.

2. Local Anesthesia: In some cases, a local anesthetic may be administered to numb the area and reduce discomfort during the procedure.

3. Needle Insertion: A thin, fine needle is inserted into the lump or mass. The needle is typically attached to a syringe, which creates a vacuum to draw a small sample of tissue and cells into the needle.

4. Aspiration: The healthcare provider may move the needle back and forth within the lump to obtain an adequate sample of cells. Multiple insertions may be made from different angles to ensure a representative sample.

5. Sample Collection: Once the sample is obtained, it is placed onto glass slides. In some cases, the sample may also be preserved in a liquid medium for further analysis.

6. Slide Preparation: The collected cells are spread onto glass slides and stained with special dyes to enhance visibility under a microscope.

7. Microscopic Examination: A pathologist examines the stained slides under a microscope. They analyze the appearance and characteristics of the cells to determine if they are normal, benign, or malignant.

8. Results: The pathologist provides a report based on their findings, which is then shared with the referring physician. The results help guide further diagnostic or treatment decisions.

FNAC is a minimally invasive procedure and is often performed as an outpatient service. It is commonly used to evaluate lumps or masses in various parts of the body, including the breast, thyroid gland, lymph nodes, salivary glands, and other soft tissues. FNAC can provide valuable information about the nature of a lesion, which is important for determining the appropriate management plan. However, it's important to note that in some cases, additional tests such as biopsy or surgical excision may be needed to confirm a diagnosis or obtain a larger tissue sample for further analysis.

What is biopsy ?

A biopsy is a medical procedure in which a small sample of tissue or cells is taken from a person's body for examination under a microscope. Biopsies are commonly performed to diagnose various medical conditions, determine the nature of a lesion or abnormality, and guide treatment decisions. The examination of the tissue sample helps healthcare providers gather important information about the presence of disease, the extent of damage, and the characteristics of the cells.

Biopsies can be performed on different parts of the body, depending on the suspected condition or area of concern. There are several methods of performing a biopsy, each tailored to the specific circumstances. Here are some common types of biopsies:

1. Needle Biopsy: A thin needle is used to extract a small tissue sample. There are different types of needle biopsies, including:

• Fine Needle Aspiration Biopsy (FNAB): Similar to FNAC, a thin needle is used to extract cells from a lump or mass.
• Core Needle Biopsy: A slightly larger needle is used to obtain a core of tissue from the target area.
• Vacuum-Assisted Biopsy: A vacuum device is used to obtain multiple tissue samples through a single insertion of the needle.

2. Surgical Biopsy: A surgical procedure is performed to remove a larger piece of tissue. Different types of surgical biopsies include:

• Incisional Biopsy: A portion of the abnormal tissue is removed.
• Excisional Biopsy: The entire abnormal area, along with a margin of healthy tissue, is removed.
• Punch Biopsy: A small, circular piece of tissue is removed using a punch tool.

3. Endoscopic Biopsy: A flexible tube with a camera (endoscope) is inserted into the body to visualize and biopsy tissue from internal organs.

4. Bone Marrow Biopsy: A sample of bone marrow is extracted from the hip bone to evaluate blood disorders, cancers, and other conditions.

5. Skin Biopsy: Used to diagnose skin conditions, a small sample of skin tissue is taken for examination.

6. Lymph Node Biopsy: A lymph node is removed or sampled to diagnose infections or cancers affecting the lymphatic system.

After the biopsy, the tissue sample is sent to a laboratory where it is prepared, stained, and examined by a pathologist. The pathologist analyzes the cells and tissue under a microscope, looking for signs of disease, abnormal growth, inflammation, or other relevant characteristics.

The results of the biopsy help healthcare providers make accurate diagnoses and develop appropriate treatment plans. It's important to follow your healthcare provider's instructions before and after the biopsy procedure to ensure accurate and reliable results. Biopsies are essential tools in modern medicine, aiding in the diagnosis and management of a wide range of medical conditions.

How are FNAC and Biopsy different ?

Fine Needle Aspiration Cytology (FNAC) and biopsy are related procedures but are not exactly the same. Both FNAC and biopsy involve the collection of tissue samples for examination, but they differ in terms of the type of sample obtained, the technique used, and the specific purposes for which they are performed.

Here's a comparison between FNAC and biopsy:

Fine Needle Aspiration Cytology (FNAC):

• FNAC is a type of biopsy, but it specifically involves the aspiration (removal) of cells from a lump, mass, or suspicious area using a thin needle.
• The goal of FNAC is to obtain cellular material for cytological examination. Cytology involves studying the individual cells under a microscope to determine their characteristics and identify any abnormalities.
• FNAC is often used to diagnose lesions, lumps, or masses that are easily accessible and can be sampled using a fine needle.
• FNAC is less invasive than some other biopsy methods and is commonly used to assess thyroid nodules, breast lumps, and superficial lesions.
• FNAC is particularly useful for diagnosing conditions where cellular morphology (structure and appearance of cells) is important, such as differentiating between benign and malignant tumors.

Biopsy :

• Biopsy is a broader term that encompasses various methods of obtaining tissue samples for examination.
• In a biopsy, a tissue sample is collected, which includes cells and surrounding tissue. The goal is to obtain a larger piece of tissue that can be examined histologically.
• Biopsies are used to assess the architecture and organization of tissues, in addition to cellular characteristics. Histology involves studying the tissue structure and arrangement of cells.
• Biopsies can be performed using various techniques, including needle biopsies (such as core needle biopsy), surgical biopsies (such as incisional or excisional biopsy), and endoscopic biopsies.
• Biopsies are used to diagnose a wide range of conditions, including cancer, infections, inflammatory diseases, and structural abnormalities.
• The term "biopsy" is often used to refer to procedures that involve the removal of tissue for examination, whereas FNAC specifically refers to the aspiration of cells using a fine needle.

In summary, while FNAC is a specific type of biopsy that focuses on obtaining cellular material for cytological examination, biopsy encompasses a broader range of techniques for obtaining tissue samples for histological examination. Both FNAC and biopsy play important roles in diagnosing medical conditions and guiding treatment decisions, and the choice of procedure depends on the specific clinical situation and the type of information needed.