PATIENT PREPARATION

A Clear explanation of procedure to patient to get his/her consent and cooperation

Procedure is usually carried out with patient lying supine on a simple examination couch.

Disinfect the skin using the spirit swab.

Pre aspiration sedation is rarely necessary and the only in deep aspiration in anxious or agitated patients.

PROCEDURE With practice and experience, the operator acquires the ability to feel the consistency of tissue through the needle.

Position the 20-23 gauge needle within the target tissue.

Pull the plunger to apply the negative pressure.

Move the needle back and forth inside the target, so good part of aspirate is often drawn into the hub of needle.

Release the negative pressure while needle remains in target tissue and withdraw needle.

Needle is detached and air is drawn into syringe.

Blow sample on microscopy slide and with the help of other slides, spread the material.

FINE NEEDLE SAMPLING WITHOUT ASPIRATION

Usually preferred for thyroid and vascular lesion.

It is based on observation that capillary pressure in a fine needle is sufficient to keep detached cells inside Lumen of needle.

So needle is held directly with tips, inserted into target lesion, is moved back and forth in several directions for a few seconds depending on Cellularity and vascularity of tissue and is then withdrawn.

By these techniques, operator gets an excellent feel of consistency of tissues as well as admixture with blood is less than with aspiration.

After completing procedure, pressure should be applied over that site to minimize bruising and to decrease the chance of hematoma.

In case of central focus of necrosis, hemorrhage or cystic changes in a tumor, FNAC should be done from Peripheral area to get representative material.

FNAC/ FNC must be repeated if any remaining palpable abnormality after evacuation of cyst.