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Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion

CPT4 code

Name of the Procedure:

Fine Needle Aspiration Biopsy (FNAB), including fluoroscopic guidance; first lesion

Summary

A Fine Needle Aspiration Biopsy (FNAB) with fluoroscopic guidance is a minimally invasive procedure where a thin needle is used to remove a small sample of tissue or fluid from a lesion for examination. The process is guided by fluoroscopy, a type of real-time X-ray imaging, to accurately target the lesion.

Purpose

The primary purpose of an FNAB is to diagnose abnormalities such as lumps or masses that may be suspicious. This procedure can determine if a lesion is benign (non-cancerous) or malignant (cancerous). The information gathered helps guide further treatment decisions.

Indications

  • Unexplained lumps or masses found in imaging studies.
  • Suspected cancer or infections in specific areas.
  • Lymph node enlargement.
  • Thyroid nodules.
  • Breast lumps.

Preparation

  • Patients may need to avoid eating or drinking several hours before the procedure.
  • Certain medications, especially blood thinners, may need to be paused. Always consult the healthcare provider.
  • Routine blood tests may be performed to assess clotting function.

Procedure Description

  1. The patient is positioned on an examination table.
  2. The targeted area is sterilized and may be numbed with a local anesthetic.
  3. Under fluoroscopic guidance, the healthcare provider inserts a fine needle into the lesion.
  4. Samples of tissue or fluid are collected through the needle.
  5. The needle is removed, and pressure is applied to the site to prevent bleeding.
  6. The sample is sent to a laboratory for analysis.

Duration

The procedure typically takes about 20-30 minutes, though it may vary depending on the lesion's complexity and location.

Setting

FNAB procedures are usually performed in a hospital radiology department, outpatient clinic, or specialized surgical center.

Personnel

  • Radiologist or interventional radiologist.
  • Nurse or medical assistant.
  • Pathologist (who analyzes the sample in the laboratory).

Risks and Complications

  • Minor bleeding or bruising at the site.
  • Infection.
  • Pain or discomfort.
  • Very rare, but possible, nerve damage or significant bleeding if a major blood vessel is punctured.

Benefits

  • Minimally invasive with a lower risk compared to surgical biopsy.
  • Quick recovery time.
  • Provides crucial diagnostic information that can guide further treatment.
  • Immediate results in some cases.

Recovery

  • Patients can usually go home the same day.
  • Instructions include keeping the site clean and dry and avoiding strenuous activities for a day.
  • Pain can be managed with over-the-counter pain relievers.
  • Follow-up appointment to discuss results and additional treatment options if necessary.

Alternatives

  • Core needle biopsy: Uses a larger needle to remove a larger tissue sample.
  • Surgical biopsy: Involves making an incision to remove tissue, which is more invasive.
  • Observation: Monitoring the lesion with regular imaging studies without immediate biopsy.

Patient Experience

  • Mild discomfort or pressure during the procedure.
  • Possible slight pain at the biopsy site afterward, manageable with medication.
  • Quick return to normal activities, with minimal recovery time required.

This markdown text provides a comprehensive yet straightforward overview of the Fine Needle Aspiration Biopsy with fluoroscopic guidance for the first lesion, making it easy for patients and healthcare professionals to understand the procedure and its context.

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