10021 Fine needle aspiration biopsy, without imaging guidance; first lesion

Name of the Procedure:

Fine Needle Aspiration Biopsy (FNAB)

Summary

A Fine Needle Aspiration Biopsy (FNAB) involves using a thin, hollow needle to extract a small sample of tissue or fluid from a lesion or lump for microscopic examination. This procedure helps diagnose the nature of the lump, whether it is benign or malignant.

Purpose

The FNAB is primarily used for diagnosing lumps or masses, particularly in the thyroid, breast, lymph nodes, and other accessible areas. The goal is to detect any abnormal cells that might indicate conditions like cancer or other diseases, enabling prompt and appropriate treatment.

Indications

• Presence of a suspicious lump or mass.
• Unexplained swelling of lymph nodes.
• Monitoring previously detected abnormalities.
• Investigating thyroid nodules.

Preparation

• No fasting is usually required.
• Inform the healthcare provider of any medications, particularly blood thinners.
• Arrange for transportation if advised, as some patients might feel lightheaded after the procedure.
• Potential pre-procedure blood tests to assess bleeding risk.

Procedure Description

1. The area over the lesion is cleaned with an antiseptic solution.
2. Local anesthesia is applied to numb the area.
3. A thin, hollow needle is inserted into the lesion.
4. The healthcare provider uses a syringe to extract a small sample of tissue or fluid.
5. The sample is placed on a slide or in a preservative solution for laboratory analysis.
6. The needle is removed, and pressure is applied to minimize bleeding, followed by a small bandage.

Duration

Typically, the procedure takes about 10 to 15 minutes.

Setting

FNAB is often performed in an outpatient clinic, hospital, or a specialized medical center.

Personnel

• Performing Physician (often a radiologist, pathologist, or surgeon)
• Nurse or Medical Assistant

Risks and Complications

• Minor bleeding or bruising at the site.
• Slight risk of infection.
• Rarely, a hematoma (collection of blood) may form.
• Possible need for a repeated biopsy if the sample is inconclusive.

Benefits

• Minimally invasive with minimal discomfort.
• Rapid diagnosis enabling timely treatment.
• Can often be performed without general anesthesia.

Recovery

• Apply ice packs if there is swelling or bruising.
• Keep the biopsy site clean and dry for 24 hours.
• Avoid strenuous activities for 24 hours.
• Monitor for signs of infection and report them promptly.
• Follow-up appointment to discuss results.

Alternatives

• Core Needle Biopsy: Uses a larger needle, potentially providing a more comprehensive tissue sample.
• Surgical Biopsy: Involves removing part or all of a lesion but is more invasive.
• Imaging-guided FNAB: Provides precise targeting with ultrasound or CT guidance but requires imaging equipment.

Patient Experience

• Mild discomfort or pressure during the biopsy.
• Slight soreness at the site afterwards, manageable with over-the-counter pain relievers like acetaminophen.
• Most patients can resume normal activities shortly after the procedure.