FINE NEEDLE ASPIRATE; A VITAL TECHNIQUE IN THE CHARACTERIZATION OF MASSES AND LESIONS
Keywords:
Fine needle aspirate, specificity, sensitivity, core biopsy, Triple test
Abstract
Fine needle aspiration is a cost-effective, non-invasive, less painful, rapid reporting bedside diagnostic procedure for obtaining a small amount of samples from palpable and non-palpable masses or lesions in the body using a needle. The objective of FNA is to provide information on the nature of the sampled tissue in order to focus on appropriate diagnostic and therapeutic decisions, all at minimal risk to the patient. Its sensitivity in distinguishing benign from malignant tumors varies from 58% to 96% with specificity usually between 90 to 100%. In the characterization of lesions and masses using FNA, the concept of ‘‘triple test’’, that is the combination of physical examination, imaging findings and cytologic examination is recommended. The test is positive if any of the three components is positive, and negative if all the components are negative. The triple test has a sensitivity (true positive rate) of 99.6%, and a specificity of 93%. More so, a combination of FNA and Cell-block technique revealed a sensitivity of 94% and specificity of 98%. However, a minimum number of epithelial cells (5–10 cells/group) for FNA made diagnoses have been advocated, and samples containing fewer than the specified minimum be considered non-diagnostic. Despite the reported specificity and sensitivity of FNA, proper training of personnel and adherence to recommendations are quite important in producing a reliable results.
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References
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2. Vargas HI. Implementation of a minimally invasive breast biopsy program in countries with limited resources. Breast J. 2003; 9 (Suppl 2): S81- 85.
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4. Brown LA, Coghill SB. Cost-effectiveness of a fine needle aspiration clinic. Cytopathol. 1992; 3: 275–280.
5. Ahmad T, Naeem M, Ahmad S, Samad A, Nasir A. Fine Needle Aspiration Cytology (Fnac) and Neck Swellings in the Surgical Outpatient. J Ayub Med Coll Abbottabad. 2008; 20(3): 30-32
6. Woeber KA. Cost-effective evaluation of the patient with a thyroid nodule. Surg Clin North Am. 1995; 75: 357-63.
7. Afridi S, Malik K, Waheed I. Role of fine-needle aspiration biopsy and cytology in breast lumps. J Coll Physicians Surg Pak. 1995; 5: 75–7.
8. Burnand KG, Young AE, Lucas J, Rrolands BJ, Scholefield J. The new Aird’s companion in surgical studies. 3rd ed.China: Elsevier; 2005.
9. Layfield LJ. Fine-needle aspiration of the head and neck. Pathol (Phila) 1996; 4: 409–38.
10. Kirk RM, Ribbans WJ. Clinical Surgery in General. 4th ed. Edinburgh: Elsevier; 2004.
11. Kline TS, Kline IK, Howell LP. Guides to Clinical Aspiration Biopsy Breast. Philadelphia: Lippincott Williams & Wilkins Publishers, 1999.
12. Orell SV, Sterrett GF, Walters MN, Whitaker D. Atlas of fine needle aspiration cytology. London: Churchill Livingston, 1999.
13. Arisio R, Cuccorese C, Accinelli G, Mano MP, Bordon R, and Fessia L, Role of fine needle aspiration biopsy in breast lesions: analysis of a series of 4,100 cases. Diagn Cytopathol. 1998; 18(6): 462–7.
14. National Breast Cancer Centre (NBCC). Breast fine-needle aspiration cytology and core biopsy: a guide for practice, National Breast Cancer Centre, Camperdown, NSW. First Edition. 2004; Pp. 1-109. http://www.nbcc.org.au
15. Irwig L, Macaskill P. Evidence relevant to guidelines for the investigation of breast symptoms.Woolloomooloo: National Breast Cancer Centre, 1997.
16. Zubaida R, Bhat ML, Nuzhat S, Khalil B, Rumana M, Ruby R, Shafi M. Utility of Fine Needle Aspiration Cytology in Diagnosis of Soft Tissue Lesions with Histopathological Correlation. Global J Med Public Health. 2013; 2(2):1-7 www.gjmedph.com
17. Roy S, Manna A K, Pathak S, Guha D. Evaluation of fine-needle aspiration cytology and its correlation with histopathological findings in soft tissue tumors. J Cytol. 2007; 24: 37-40
18. Alphs HH, Eisele DW, Westra WH. The role of fine needle aspiration in the evaluation of parotid masses. Current opinion in Otolaryngology Head & Neck Surgery. 2006; 14: 62-66
19. Stewart CJ, MacKenzie K, McGarryGW, Mowat A. Fine-needle aspiration cytology of salivary gland: a review of 341 cases. Diagn Cytopathol 2000; 22: 139–46.
20. Que Hee CG, Perry CF. Fine-needle aspiration cytology of parotid tumours: is it useful? ANZ J Surg 2001; 71: 345–8.
21. Masood S. Cytopathology of the Breast. ASCP theory and practice of cytopathology, Chicago:ASCP Press, 1996.
22. Brennan PA, Davies B, Poller D, Mead Z, Bayne D, Puxeddu R. Fine needle aspiration cytology (FNAC) of salivary gland tumours: Repeat aspiration provides further information in cases with an unclear initial cytological diagnosis. Br J Oral Maxillofac Surg. 2010; 48(1): 26-9. Doi: 10.1016/j.boms.2008 PMID: 19233526
23. Seningen JL, Nassar A, Henry MR. Correlation of thyroid nodule fine-needle aspiration cytology with corresponding histology at Mayo Clinic, 2001-2007: an institutional experience of 1,945 cases. Diagn Cytopathol. 2012; 40: Suppl-32.
24. Cheung YS, Poon CM, Mak SM, Suen MWM, Leong HT. Fine-needle aspiration cytology of thyroid nodules—how well are we doing? Hong Kong Med. 2007; 13(1): 12-15
25. Teague MW, Wolberg WH, Street WN, Mangasarian OL, Lambremont S, Page DL. Indeterminate Fine-Needle Aspiration of the Breast, Image Analysis-Assisted Diagnosis. Cancer (Cancer Cytopathol) 1997; 81: 129–35.
26. Sidawy MK, Stoler MH, Frable WJ, Frost AR, Masood S, Miller TR et al. Interobserver variability in the classification of proliferative breast lesions by fine-needle aspiration: results of the Papanicolaou Society of Cytopathology Study. Diagn Cytopathol. 1998; 18: 150–165.
27. Masood S, Frykberg ER, McLellan GL, Dee S, Bullard JB. Cytologic differentiation between proliferative and nonproliferative breast disease in mammographically guided fine-needle aspirates. Diagn Cytopathol. 1991; 7: 581–590.
28. Frost AR, Aaksu A, Kurstin R, Sidawy MK. Can nonproliferative and proliferative breast disease without atypia be distinguished by fine needle aspiration cytology? Cancer Cytopathol. 1997; 81: 22–28.
29. Layfield LJ, Mooney EE, Glaskow B, Hinchowitz S, Coogan A. What constitutes an adequate smear in needle aspiration cytology of the breast? Cancer Cytopathol. 1997; 81: 166–121.
30. Sneige N. Should specimen adequacy is determined by the opinion of the aspirator or by the cells on the slides. Cancer Cytopathol. 1997; 81: 3–5.
31. Rubenchik I, Sneige N, Edeiken B, Samuels B, Fornage B. In search of specimen adequacy in fine-needle aspirates of nonpalpable breast lesions. Am J Clin Pathol. 1997; 108: 13–18.
32. Liao J, Davey DD, Warren G, Davis J, Moore AR, Samayoa LM, Ultrasound-guided fine-needle aspiration biopsy remains a valid approach in the evaluation of nonpalpable breast lesions. Diagn Cytopathol. 2004; 30(5): 325-31.
33. RA Hegazy, AA Hegazy, FA Fetouh, S Ibrahim. Fine needle aspiration cytology and cell-block study of various breast lumps. American Journal of Biomedical and Life Sciences 2014; 2(1): 8-17
34. DeMay RM. The Art and Science of Cytopathology, vol 2. Aspiration Cytology. Chicago: ASCP Press; 1996. pp 464–474.
35. Ljung B. Techniques of fine-needle aspiration, smear preparation, and principles of interpretation. In: Koss_ Diagnostic Cytology and its Histopathologic Bases, 5th edn. Koss LG, Melamed MR (eds). Philadelphia: Lippincott, Williams and Wilkins; 2006: Chapter 28.
36. Kocjan G, Chandra A, Cross P, Denton K, Giles T, Herbert A et al. BSCC Code of Practice – fine needle aspiration cytology. Cytopathology 2009; 20: 283–296. DOI:10.1111/j.1365-2303.2009.00709.x
37. Martin HE, Ellis EB. Biopsy by needle puncture and aspiration. Ann Surg. 1930; 92: 169-181. PMCI1398218
38. Erickson RA. EUS-guided FNA. Gastrointestinal Endoscopy. 2004; 60(2): 267-79.
39. Al-Haddad M, Wallace MB, Woodward TA, Gross SA, Hodgens CM, Toton RD, et al. The safety of fine-needle aspiration guided by endoscopic ultrasound: a prospective study. Endoscopy. 2008; 40(3): 204-8.
40. Technology Assessment Status Evaluation: tissue sampling during endosonography. ASGE. American Society for Gastrointestinal Endoscopy. Gastrointestinal Endoscopy. 1998; 47(6): 576-8.
41. Jhala NC, Jhala DN, Chhieng DC, Eloubeidi MA, Eltoum IA. Endoscopic ultrasound-guided fine-needle aspiration. A cytopathologist's perspective. Am J Clin Pathol. 2003; 120: 351-67. [PMID 14502798]
42. Stelow EB, Barbales RH, Stanley MW. Pitfall in endoscopic ultrasound-guided fine-needle aspiration and how to avoid them. Adv Anat Pathol. 2005; 12:62-73. [PMID 15731574]
43. Maire F, Couvelard A, Hammel P, Ponsot P, Palazzo L, Aubert A, et al. Intraductal papillary mucinous tumors of the pancreas: the preoperative value of cytologic and histopathologic diagnosis. Gastrointest Endosc. 2003; 58:701-6. [PMID:14595305]
44. Layfield LJ, Cramer H. Fine-needle aspiration cytology of intraductal papillary-mucinous tumors: a retrospective analysis. Diagn Cytopathol 2005; 32:16-20. [PMID 15584051]
45. Stelow EB, Stanley MW, Barbales RH, Malery S, Lai R, Linzie BM, Pambuccian SE. Intraductal papillary-mucinous neoplasm of the pancreas. The findings and limitations of cytologic samples obtained by endoscopic-ultrasound-guided fine needle aspiration. Am J Clin Pathol. 2003; 120: 398-404. [PMID 14502804]
46. Shimizu M, Hirokawa M, Manabe T, Mikami Y, Kanahara T, Miyake Y, et al. Cytologic findings in non-invasive intraductal papillary-mucinous carcinoma of the pancreas: a report of two cases. Acta Cytol. 1999; 43: 243-6. [PMID 10097718]
47. Salla C, Chatzipantelis P, Konstantinou P, Karoumpalis I, Sakellariou S, Pantazopoulou A. JOP. J Pancreas (Online) 2007; 8(6): 715-724.
48. Nasuti JF, Gupta PK, Baloch ZW. Diagnostic value and cost-effectiveness of on-site evaluation of fine-needle aspiration specimens: a review of 5,688. Diagn Cytopathol. 2002; 27: 1–4.
49. Vural G, Hagmar B, Lilleng R. A one-year audit of fine needle aspiration cytology of breast lesions. Factors affecting adequacy and a review of delayed carcinoma diagnoses. Acta Cytol. 1995; 39: 1233–6.
50. O’Donnell ME, Salem A, Badger SA et al. Fine needle aspiration at a regional head and neck clinic: a clinically beneficial and cost-effective service. Cytopathol. 2009; 20: 81–6.
51. Robinson IA, Cozens NJ. Does a joint ultrasound-guided cytology clinic optimize the cytological evaluation of head and neck masses? Clin Radiol. 1999; 54: 312–6. 19.
52. Cai XJ, Valiyaparambath N, Nixon P et al. Ultrasound-guided fine-needle aspiration cytology in the diagnosis and management of thyroid nodules. Cytopathol. 2006; 17: 251–6.
53. Boerner S, Fornage BD, Signletary E, Sneige N. Ultrasound- guided fine-needle aspiration (FNA) of nonpalpable breast lesions: a review of 1885 FNA cases using the National Cancer Institute-supported recommendations on the uniform approach to breast FNA. Cancer. 1999; 87: 19–24.
54. Frable WJ. (2001) Needle aspiration biopsy: past, presnt and future. Hum Pathol. 2001; 20:504-517.
55. Suen KC. Altas and text of aspiration cytology. Baltimore:Williams & Wilkins, 1990: 254–263.
56. Greenebaum E. Aspirating nonneoplastic ovarian cysts. Rationale, technique, and controversy. Lab Med. 1996a; 27: 462–467.
57. Greenebaum E. Aspirating malignant ovarian cysts. Lab Med. 1996b; 27: 607–611.
58. Orell SR. Radial scar/complex sclerosing lesion: a problem in the diagnostic work-up of screen-detected breast lesions. Cytopathol. 1999; 10(4): 250-8. PMID: 16511846
59. Evans AT, Hussein KA. A micro glandular adenosis-like lesion simulating tubular carcinoma of the breast.A case report with cytological and histological appearances. 2005; 1(5): 311-6. PMID: 2101677
60. Bhatari S, Kapil K, Verma K. Phyllodestumour of the breast.A cytopathologic study of 80 cases. Acta Cytol. 2000; 44: 790-796.
61. Wong NL, Wan SK. Comparative cytology of mucocelelike lesion and mucinous carcinoma of the breast in fine-needle aspiration. Acta Cytol. 2000; 44(5): 765-770. Doi: 10.1159/000328559
62. Shin HJC, Sniege N. Is a diagnosis of infiltrating versus in situ ductal carcinoma of the breast possible in fine-needle aspiration specimens. Acta Cytol. 2000, 84:186-191. Doi: 10.1002/(SICI)1097-0142(19980625) 84:3 <186
63. Masood S. Cytopathology of the Breast. ASCP theory and practice of cytopathology, Chicago: ASCP Press, 1996: 51-56
64. Rosen PP. Rosen’s breast pathology. Philadelphia: Lippincott-Raven Publishers, Am J Surg Pathol. 1997; 21: 653-7.
65. Chare M. Results of ultrasound guided core biopsy. In Flowers C, ed. Image guided core biopsy of the breast: a practical approach. London: Greenwich Medical Media. 1998: 183–92.
66. Rosen PP. Breast pathology: diagnosis by needle core biopsy. Philadelphia: Lippincott Williams & Wilkins Publishers, 1999; 86: 91-92.
67. Britton PD, McCann J. Needle biopsy in the NHS Breast Screening Programme 1996/97: how much and how accurate? The Breast. 1999; 8: 5–11.
68. Pinder SE, Elston CW, Ellis IO. The role of pre-operative diagnosis in breast cancer. Histopathol. 1996; 28: 563–6.
69. BreastScreen Australia. National Accreditation Standards. Canberra ACT. BreastScreen Australia Quality Improvement Program, 2001.
70. Dahlstrom JE, Jain S, Sutton T, Sutton S. Diagnostic accuracy of stereotactic core biopsy in a mammographic breast cancer screening program. Histopathol. 1996; 28: 421–7.
2. Vargas HI. Implementation of a minimally invasive breast biopsy program in countries with limited resources. Breast J. 2003; 9 (Suppl 2): S81- 85.
3. Saleh HA, Khatib G. Positive economic and diagnostic accuracy impacts of on-site evaluation of fine-needle aspiration biopsies by pathologists. Acta Cytol 1996; 40: 1227–1230.
4. Brown LA, Coghill SB. Cost-effectiveness of a fine needle aspiration clinic. Cytopathol. 1992; 3: 275–280.
5. Ahmad T, Naeem M, Ahmad S, Samad A, Nasir A. Fine Needle Aspiration Cytology (Fnac) and Neck Swellings in the Surgical Outpatient. J Ayub Med Coll Abbottabad. 2008; 20(3): 30-32
6. Woeber KA. Cost-effective evaluation of the patient with a thyroid nodule. Surg Clin North Am. 1995; 75: 357-63.
7. Afridi S, Malik K, Waheed I. Role of fine-needle aspiration biopsy and cytology in breast lumps. J Coll Physicians Surg Pak. 1995; 5: 75–7.
8. Burnand KG, Young AE, Lucas J, Rrolands BJ, Scholefield J. The new Aird’s companion in surgical studies. 3rd ed.China: Elsevier; 2005.
9. Layfield LJ. Fine-needle aspiration of the head and neck. Pathol (Phila) 1996; 4: 409–38.
10. Kirk RM, Ribbans WJ. Clinical Surgery in General. 4th ed. Edinburgh: Elsevier; 2004.
11. Kline TS, Kline IK, Howell LP. Guides to Clinical Aspiration Biopsy Breast. Philadelphia: Lippincott Williams & Wilkins Publishers, 1999.
12. Orell SV, Sterrett GF, Walters MN, Whitaker D. Atlas of fine needle aspiration cytology. London: Churchill Livingston, 1999.
13. Arisio R, Cuccorese C, Accinelli G, Mano MP, Bordon R, and Fessia L, Role of fine needle aspiration biopsy in breast lesions: analysis of a series of 4,100 cases. Diagn Cytopathol. 1998; 18(6): 462–7.
14. National Breast Cancer Centre (NBCC). Breast fine-needle aspiration cytology and core biopsy: a guide for practice, National Breast Cancer Centre, Camperdown, NSW. First Edition. 2004; Pp. 1-109. http://www.nbcc.org.au
15. Irwig L, Macaskill P. Evidence relevant to guidelines for the investigation of breast symptoms.Woolloomooloo: National Breast Cancer Centre, 1997.
16. Zubaida R, Bhat ML, Nuzhat S, Khalil B, Rumana M, Ruby R, Shafi M. Utility of Fine Needle Aspiration Cytology in Diagnosis of Soft Tissue Lesions with Histopathological Correlation. Global J Med Public Health. 2013; 2(2):1-7 www.gjmedph.com
17. Roy S, Manna A K, Pathak S, Guha D. Evaluation of fine-needle aspiration cytology and its correlation with histopathological findings in soft tissue tumors. J Cytol. 2007; 24: 37-40
18. Alphs HH, Eisele DW, Westra WH. The role of fine needle aspiration in the evaluation of parotid masses. Current opinion in Otolaryngology Head & Neck Surgery. 2006; 14: 62-66
19. Stewart CJ, MacKenzie K, McGarryGW, Mowat A. Fine-needle aspiration cytology of salivary gland: a review of 341 cases. Diagn Cytopathol 2000; 22: 139–46.
20. Que Hee CG, Perry CF. Fine-needle aspiration cytology of parotid tumours: is it useful? ANZ J Surg 2001; 71: 345–8.
21. Masood S. Cytopathology of the Breast. ASCP theory and practice of cytopathology, Chicago:ASCP Press, 1996.
22. Brennan PA, Davies B, Poller D, Mead Z, Bayne D, Puxeddu R. Fine needle aspiration cytology (FNAC) of salivary gland tumours: Repeat aspiration provides further information in cases with an unclear initial cytological diagnosis. Br J Oral Maxillofac Surg. 2010; 48(1): 26-9. Doi: 10.1016/j.boms.2008 PMID: 19233526
23. Seningen JL, Nassar A, Henry MR. Correlation of thyroid nodule fine-needle aspiration cytology with corresponding histology at Mayo Clinic, 2001-2007: an institutional experience of 1,945 cases. Diagn Cytopathol. 2012; 40: Suppl-32.
24. Cheung YS, Poon CM, Mak SM, Suen MWM, Leong HT. Fine-needle aspiration cytology of thyroid nodules—how well are we doing? Hong Kong Med. 2007; 13(1): 12-15
25. Teague MW, Wolberg WH, Street WN, Mangasarian OL, Lambremont S, Page DL. Indeterminate Fine-Needle Aspiration of the Breast, Image Analysis-Assisted Diagnosis. Cancer (Cancer Cytopathol) 1997; 81: 129–35.
26. Sidawy MK, Stoler MH, Frable WJ, Frost AR, Masood S, Miller TR et al. Interobserver variability in the classification of proliferative breast lesions by fine-needle aspiration: results of the Papanicolaou Society of Cytopathology Study. Diagn Cytopathol. 1998; 18: 150–165.
27. Masood S, Frykberg ER, McLellan GL, Dee S, Bullard JB. Cytologic differentiation between proliferative and nonproliferative breast disease in mammographically guided fine-needle aspirates. Diagn Cytopathol. 1991; 7: 581–590.
28. Frost AR, Aaksu A, Kurstin R, Sidawy MK. Can nonproliferative and proliferative breast disease without atypia be distinguished by fine needle aspiration cytology? Cancer Cytopathol. 1997; 81: 22–28.
29. Layfield LJ, Mooney EE, Glaskow B, Hinchowitz S, Coogan A. What constitutes an adequate smear in needle aspiration cytology of the breast? Cancer Cytopathol. 1997; 81: 166–121.
30. Sneige N. Should specimen adequacy is determined by the opinion of the aspirator or by the cells on the slides. Cancer Cytopathol. 1997; 81: 3–5.
31. Rubenchik I, Sneige N, Edeiken B, Samuels B, Fornage B. In search of specimen adequacy in fine-needle aspirates of nonpalpable breast lesions. Am J Clin Pathol. 1997; 108: 13–18.
32. Liao J, Davey DD, Warren G, Davis J, Moore AR, Samayoa LM, Ultrasound-guided fine-needle aspiration biopsy remains a valid approach in the evaluation of nonpalpable breast lesions. Diagn Cytopathol. 2004; 30(5): 325-31.
33. RA Hegazy, AA Hegazy, FA Fetouh, S Ibrahim. Fine needle aspiration cytology and cell-block study of various breast lumps. American Journal of Biomedical and Life Sciences 2014; 2(1): 8-17
34. DeMay RM. The Art and Science of Cytopathology, vol 2. Aspiration Cytology. Chicago: ASCP Press; 1996. pp 464–474.
35. Ljung B. Techniques of fine-needle aspiration, smear preparation, and principles of interpretation. In: Koss_ Diagnostic Cytology and its Histopathologic Bases, 5th edn. Koss LG, Melamed MR (eds). Philadelphia: Lippincott, Williams and Wilkins; 2006: Chapter 28.
36. Kocjan G, Chandra A, Cross P, Denton K, Giles T, Herbert A et al. BSCC Code of Practice – fine needle aspiration cytology. Cytopathology 2009; 20: 283–296. DOI:10.1111/j.1365-2303.2009.00709.x
37. Martin HE, Ellis EB. Biopsy by needle puncture and aspiration. Ann Surg. 1930; 92: 169-181. PMCI1398218
38. Erickson RA. EUS-guided FNA. Gastrointestinal Endoscopy. 2004; 60(2): 267-79.
39. Al-Haddad M, Wallace MB, Woodward TA, Gross SA, Hodgens CM, Toton RD, et al. The safety of fine-needle aspiration guided by endoscopic ultrasound: a prospective study. Endoscopy. 2008; 40(3): 204-8.
40. Technology Assessment Status Evaluation: tissue sampling during endosonography. ASGE. American Society for Gastrointestinal Endoscopy. Gastrointestinal Endoscopy. 1998; 47(6): 576-8.
41. Jhala NC, Jhala DN, Chhieng DC, Eloubeidi MA, Eltoum IA. Endoscopic ultrasound-guided fine-needle aspiration. A cytopathologist's perspective. Am J Clin Pathol. 2003; 120: 351-67. [PMID 14502798]
42. Stelow EB, Barbales RH, Stanley MW. Pitfall in endoscopic ultrasound-guided fine-needle aspiration and how to avoid them. Adv Anat Pathol. 2005; 12:62-73. [PMID 15731574]
43. Maire F, Couvelard A, Hammel P, Ponsot P, Palazzo L, Aubert A, et al. Intraductal papillary mucinous tumors of the pancreas: the preoperative value of cytologic and histopathologic diagnosis. Gastrointest Endosc. 2003; 58:701-6. [PMID:14595305]
44. Layfield LJ, Cramer H. Fine-needle aspiration cytology of intraductal papillary-mucinous tumors: a retrospective analysis. Diagn Cytopathol 2005; 32:16-20. [PMID 15584051]
45. Stelow EB, Stanley MW, Barbales RH, Malery S, Lai R, Linzie BM, Pambuccian SE. Intraductal papillary-mucinous neoplasm of the pancreas. The findings and limitations of cytologic samples obtained by endoscopic-ultrasound-guided fine needle aspiration. Am J Clin Pathol. 2003; 120: 398-404. [PMID 14502804]
46. Shimizu M, Hirokawa M, Manabe T, Mikami Y, Kanahara T, Miyake Y, et al. Cytologic findings in non-invasive intraductal papillary-mucinous carcinoma of the pancreas: a report of two cases. Acta Cytol. 1999; 43: 243-6. [PMID 10097718]
47. Salla C, Chatzipantelis P, Konstantinou P, Karoumpalis I, Sakellariou S, Pantazopoulou A. JOP. J Pancreas (Online) 2007; 8(6): 715-724.
48. Nasuti JF, Gupta PK, Baloch ZW. Diagnostic value and cost-effectiveness of on-site evaluation of fine-needle aspiration specimens: a review of 5,688. Diagn Cytopathol. 2002; 27: 1–4.
49. Vural G, Hagmar B, Lilleng R. A one-year audit of fine needle aspiration cytology of breast lesions. Factors affecting adequacy and a review of delayed carcinoma diagnoses. Acta Cytol. 1995; 39: 1233–6.
50. O’Donnell ME, Salem A, Badger SA et al. Fine needle aspiration at a regional head and neck clinic: a clinically beneficial and cost-effective service. Cytopathol. 2009; 20: 81–6.
51. Robinson IA, Cozens NJ. Does a joint ultrasound-guided cytology clinic optimize the cytological evaluation of head and neck masses? Clin Radiol. 1999; 54: 312–6. 19.
52. Cai XJ, Valiyaparambath N, Nixon P et al. Ultrasound-guided fine-needle aspiration cytology in the diagnosis and management of thyroid nodules. Cytopathol. 2006; 17: 251–6.
53. Boerner S, Fornage BD, Signletary E, Sneige N. Ultrasound- guided fine-needle aspiration (FNA) of nonpalpable breast lesions: a review of 1885 FNA cases using the National Cancer Institute-supported recommendations on the uniform approach to breast FNA. Cancer. 1999; 87: 19–24.
54. Frable WJ. (2001) Needle aspiration biopsy: past, presnt and future. Hum Pathol. 2001; 20:504-517.
55. Suen KC. Altas and text of aspiration cytology. Baltimore:Williams & Wilkins, 1990: 254–263.
56. Greenebaum E. Aspirating nonneoplastic ovarian cysts. Rationale, technique, and controversy. Lab Med. 1996a; 27: 462–467.
57. Greenebaum E. Aspirating malignant ovarian cysts. Lab Med. 1996b; 27: 607–611.
58. Orell SR. Radial scar/complex sclerosing lesion: a problem in the diagnostic work-up of screen-detected breast lesions. Cytopathol. 1999; 10(4): 250-8. PMID: 16511846
59. Evans AT, Hussein KA. A micro glandular adenosis-like lesion simulating tubular carcinoma of the breast.A case report with cytological and histological appearances. 2005; 1(5): 311-6. PMID: 2101677
60. Bhatari S, Kapil K, Verma K. Phyllodestumour of the breast.A cytopathologic study of 80 cases. Acta Cytol. 2000; 44: 790-796.
61. Wong NL, Wan SK. Comparative cytology of mucocelelike lesion and mucinous carcinoma of the breast in fine-needle aspiration. Acta Cytol. 2000; 44(5): 765-770. Doi: 10.1159/000328559
62. Shin HJC, Sniege N. Is a diagnosis of infiltrating versus in situ ductal carcinoma of the breast possible in fine-needle aspiration specimens. Acta Cytol. 2000, 84:186-191. Doi: 10.1002/(SICI)1097-0142(19980625) 84:3 <186
63. Masood S. Cytopathology of the Breast. ASCP theory and practice of cytopathology, Chicago: ASCP Press, 1996: 51-56
64. Rosen PP. Rosen’s breast pathology. Philadelphia: Lippincott-Raven Publishers, Am J Surg Pathol. 1997; 21: 653-7.
65. Chare M. Results of ultrasound guided core biopsy. In Flowers C, ed. Image guided core biopsy of the breast: a practical approach. London: Greenwich Medical Media. 1998: 183–92.
66. Rosen PP. Breast pathology: diagnosis by needle core biopsy. Philadelphia: Lippincott Williams & Wilkins Publishers, 1999; 86: 91-92.
67. Britton PD, McCann J. Needle biopsy in the NHS Breast Screening Programme 1996/97: how much and how accurate? The Breast. 1999; 8: 5–11.
68. Pinder SE, Elston CW, Ellis IO. The role of pre-operative diagnosis in breast cancer. Histopathol. 1996; 28: 563–6.
69. BreastScreen Australia. National Accreditation Standards. Canberra ACT. BreastScreen Australia Quality Improvement Program, 2001.
70. Dahlstrom JE, Jain S, Sutton T, Sutton S. Diagnostic accuracy of stereotactic core biopsy in a mammographic breast cancer screening program. Histopathol. 1996; 28: 421–7.
How to Cite
1.
Okoye JO, Okoye FO. FINE NEEDLE ASPIRATE; A VITAL TECHNIQUE IN THE CHARACTERIZATION OF MASSES AND LESIONS. Med. res. chronicles [Internet]. 2015Jul.28 [cited 2024Nov.25];2(4):491-02. Available from: https://medrech.com/index.php/medrech/article/view/112
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