Name of the Procedure:

Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site

Summary

Fine needle aspiration (FNA) cytopathology is a diagnostic procedure where a thin, hollow needle is inserted into a lesion or mass to extract cells for examination. An immediate cytohistologic study is performed to ensure the sample is sufficient for an accurate diagnosis.

Purpose

The main purpose of this procedure is to diagnose conditions such as infections, inflammatory diseases, or cancer. The immediate study helps in confirming that enough tissue has been collected for a definitive diagnosis, potentially reducing the need for repeat procedures.

Indications

• Presence of a lump or mass that needs to be evaluated.
• Symptoms like unexplained swelling.
• Follow-up on abnormal imaging results.
• Evaluation of suspicious areas detected during physical examinations.

Preparation

• Patients might be advised to avoid certain medications, such as blood thinners.
• No specific fasting is usually required.
• Basic blood tests and imaging studies might be performed beforehand.

Procedure Description

1. The skin over the targeted site is cleaned and sterilized.
2. Local anesthesia may be applied to numb the area.
3. A thin needle is inserted into the mass to withdraw cells.
4. The sample is placed on slides and immediately examined under a microscope.
5. This process is repeated until a satisfactory sample is obtained.

Tools used include a fine-gauge needle, syringes, microscope slides, and staining supplies.

Duration

The procedure typically takes about 15 to 30 minutes.

Setting

This procedure is usually performed in an outpatient clinic, hospital, or specialized cytopathology laboratory.

Personnel

• Cytopathologist or pathologist
• Trained technician or nurse
• Sometimes, radiologist or ultrasound technician if imaging guidance is needed

Risks and Complications

• Bruising or swelling at the puncture site
• Infection
• Minimal bleeding
• Rarely, inadequate sample requiring repeat procedure

Benefits

• Quick diagnosis of various conditions
• Minimally invasive
• Immediate feedback on sample adequacy can avoid multiple procedures

Recovery

• Minimal downtime; patients can often resume normal activities immediately.
• Instructions may include monitoring the site for signs of infection and keeping it clean.
• Mild discomfort or slight bleeding can be managed with over-the-counter pain relief.

Alternatives

• Core needle biopsy: More tissue is extracted but is more invasive.
• Surgical biopsy: Larger tissue sample but involves surgery.
• Observation and follow-up imaging: Non-invasive but may delay diagnosis.

Patient Experience

The patient might feel a brief pinch or pressure during needle insertion. Discomfort is generally mild and short-lasting. Post-procedure, mild soreness can be managed with pain killers. Keeping the area clean and dry is usually recommended, with follow-up consultations to discuss results and next steps.