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Cytology: fine needle aspirate

ISSN 2398-2969

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Synonym(s): FNA

Overview

  • Microscopic study of cells obtained from skin, abnormal masses or internal organs.
  • Cells are smeared onto a slide and stained, then viewed by light microscopy.
  • Rapid, requires minimal equipment.
  • Direct evaluation of neoplastic or inflammatory changes provided representative sample obtained.
  • Failure to obtain a representative sample can give misleading results.

Uses

Alone

  • Cutaneous masses.
  • Intra-abdominal masses (liver, spleen, kidney, mesenteric lymph node).
  • Intra-thoracic masses.
  • Intra-operative evaluation of masses.

In combination

  • To assess the nature of a mass during surgical excision, prior to histopathology.
  • Diagnostic imaging: in assessment of intra-abdominal or thoracic masses.

Sampling

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Tests

Methodologies

  • Modified Wright's stain or Giemsa stain: best for inflammatory lesions.
  • Diff-quick stain: can adjust color as blue and yellow components are separate; poor nuclear detail.
  • New Methylene Blue: good for examination of cell nuclei, bacteria and fungi, yeast and fat globules.
  • Light microscopy: scan at x4 and x10; use x50 and x100 for fine detail.

Validity

Sensitivity

  • Less sensitive than histopathology because more difficult to obtain representative sample.

Specificity

  • Low compared to histopathology as may miss diagnostic cells.

Technique intrinsic limitations

  • Information about tissue architecture cannot be obtained.
  • May require confirmation by histopathology.

Technician extrinsic limitations

  • May be difficult to obtain representative sample.
  • Blood contamination of sample can dilute relevant cells.
  • Requires some experience to obtain consistently reliable samples.

Result Data

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Further Reading

Publications

Refereed papers

Other sources of information

  • Campbell T W & Ellis C K (2007) Avian and Exotic Hematology and Cytology. 3rd edn. Wiley-Blackwell. ISBN: 978-0813818115.