Complications Of Fine-needle Aspiration Biopsy Research Articles

Appraising the Role of Fine Needle Aspiration Cytology in Non-Thyroidal Head and Neck Masses: A Single Referral Institute Experience.

Background: Fine needle aspiration biopsy (FNAB) is a widely recognized and sensitive technique, in which a fine needle is introduced into a mass, cellular material is aspirated and a cytological diagnosis is made. It provides initial diagnosis for masses in the head and neck region, enables appropriate management plans for individual patients to be made and separates masses that are reactive or inflammatory in origin and do not require surgical intervention, from masses of neoplastic origin. Furthermore, FNAB can differentiate benign from malignant neoplasms. Objective: To study the value of fine needle aspiration biopsy (FNAB) in the diagnosis of palpable non-thyroidal neck masses in Dammam Medical Complex. Study design: Patients with palpable non-thyroidal neck masses, who had their FNAB during the three-year study period, were reviewed. The FNAB results were analyzed into two groups according to the tissue of origin, into lymph node and salivary gland in origins. The study groups were also classified based on the histopathology findings into; inflammatory, congenital and neoplastic. FNAB diagnoses were retrospectively correlated from patient’s file, with available histological findings or with the outcome of treatment. Accuracy, sensitivity and specificity of FNA were analyzed. Results: A total of 258 patients had FNAB during the study Period. All patients who lost follow-up, those who were referred from other hospitals so the full medical records could not be retrieved and those with inadequate FNAB specimens to make the diagnosis were excluded from our study. Out of the 178 FNABs included in our study, 159 FNAB were done in adult patients and only 19 FNAB were carried out in pediatric age group. For the masses from palpable lymph node, the most common diagnoses were reactive/nonspecific lymphadenitis in pediatric (73.7%) and in adult were reactive/nonspecific lymphadenitis and tuberculosis lymphadenitis (50.8% and 32.5%, respectively). The next most common masses were neoplasm (16.7%), of these 45% of the cases were metastatic in origin, while diagnosis of lymphoma made in 55% of the cases. FNA from major salivary glands were 12.6% of the cases, mainly parotid and submandibular gland (65% and 35%, respectively). In our experience, the overall FNA sensitivity was 96.77%, with specificity of 92.1% and accuracy of 95.68%. Conclusion: FNAB of head and neck masses is a simple and cost effective tool in reaching an initial diagnosis and road map the clinician’s management approach. It aids in separating inflammatory non-thyroidal neck masses from neoplastic lesions, enhances surgical planning for malignant diseases and allows rapid referral of lymphomas and cancer cases for a higher center for further management. FNAB carries a high sensitivity and specificity rate with high overall accuracy in both adult and pediatric patients if done by experienced physician and interpreted by experienced histopathologist. The complications of FNAB are negligible and the associated pain and discomfort is short lived and well tolerated by most patients. This advantage encourages the clinician to consider FNAB as first step in approaching non-resolving, non-vascular, non-thyroidal head and neck masses in both adult and pediatric population.

Fine-needle aspiration biopsy of uveal melanoma: outcomes and complications

PurposeTo report outcomes and complications of fine-needle aspiration biopsy (FNAB) of uveal melanoma performed for diagnostic and prognostic purposes.MethodsProspective interventional case series of 150 consecutive patients with a clinical diagnosis...

Trans-thoracic biopsy of lung lesions: FNAB or CNB? Our experience and review of the literature

This study was performed to determine the type and incidence of complications of fine-needle aspiration biopsy (FNAB) and core biopsy (CNB) performed under computed tomography (CT) guidance to characterise lung lesions, and assess the diagnostic accuracy of the two techniques. In 2009-2011, we performed 124 lung biopsies (66 CNB and 56 FNAB) on 121 patients with a mean age of 72.4 years. Exclusion criteria were pulmonary resection, pleural lesions and/or effusions, and inadequate blood-coagulation profile. All examinations were acquired after contrast-agent administration in a craniocaudal direction from the lung apex to base during a single inspiratory breath-hold, with standardised parameters. Each lesion was scanned with 13-15 slices that could be repeated whenever necessary to document the needle track and for lesion centring, by positioning a metallic marker perpendicular to the centring light to indicate the point of needle access. Unless otherwise clinically indicated, 4 h after the procedure chest radiography was performed. Age was found to be a factor influencing the complications: pneumothorax in young subjects (31 %) and parenchymal haemorrhage in the elderly (30 %), with CNB but not with FNAB. We had more complications with the right lung: 50 % of pneumothorax cases in the upper lobe with CNB and 40 % of cases of haemorrhage in the lower lobe with FNAB. The anterior approach gave rise to more complications with CNB, while the posterior approach with FNAB. CNB had more complications than FNAB for lesions ≤ 3.5 cm (31 vs. 18 % pneumothorax), and >3.5 cm (34 vs. 9 % haemorrhage). There was no significant correlation with lesion histology, needle calibre or number of passes (probably due to the small number of procedures done with needles other than 18 G in CNB or 22 G in FNAB or involving more than one needle pass). The diagnostic accuracy of FNAB, done with a pathologist's extemporaneous assessment of sample adequacy, was 94.83 % against 81.82. % of CNB. FNAB under CT guidance is subject to a lower rate of complications and, if performed in the presence of the pathologist, has a greater diagnostic accuracy compared to CNB.

Extraocular Extension of Uveal Melanoma After Fine-Needle Aspiration, Vitrectomy, and Open Biopsy

The most potentially devastating complication of fine-needle aspiration biopsy (FNAB) or open biopsy is extraocular extension of the tumor. In this collaborative case series, we report 4 cases of orbital recurrence of malignant melanoma as a late complication of biopsy and/or vitrectomy performed at referring institutions and then sent to us for evaluation. Four cases of extraocular extension of melanoma are documented following multiple procedures including FNAB, vitrectomy, and open biopsies. Three of the patients in this series underwent more than 1 FNAB, biopsy, and/or vitrectomy. One underwent FNAB only but did not undergo brachytherapy afterward. Most of the FNABs, open biopsies, and vitrectomies reported in these cases were not performed by us, so details of the technique are not available. From these cases, we are not able to determine whether the FNAB or additional invasive procedures caused the subsequent extraocular disease or if growth of the tumor into the extraocular space occurred independent of or prior to the procedures. Large series of FNAB for uveal melanoma with no extraocular recurrence have been reported by multiple experienced centers, and the vast majority of these procedures are performed without effect on the patient's prognosis. However, the patients described in this series demonstrate that this complication is rarely possible.

Thyroid Abscess as a Complication of Fine-Needle Aspiration Biopsy

Abstract:Thyroid abscess is a rare condition with a dramatic clinical course. Most commonly, thyroid abscess develops in a multinodular goiter. Rarely, the infection is iatrogenic. This report describes an abscess developing after fine-needle aspiration biopsy. The infectious agent was Escherichia c

Fine-Needle Aspiration Biopsy of Iris Tumors in 100 Consecutive Cases: Technique and Complications

To evaluate the technique and complications of fine-needle aspiration biopsy (FNAB) for iris tumors. Retrospective, nonrandomized, single-center case series. One hundred eyes of 100 patients with diagnostically challenging iris tumors evaluated with FNAB. Biopsy technique and complications. Of more than 1400 patients referred with an iris tumor over a 24-year period, 100 underwent FNAB for diagnostic purposes. The median patient age was 44 years. The median basal dimension of the lesion was 9.0 mm and median thickness was 2.5 mm. A limbal entry with transaqueous approach parallel to the iris was used in 100% of patients. Entry was from the superotemporal (52%) or inferotemporal (42%) direction. Needle gauge size was 22 (9%), 25 (55%), 27 (25%), or 30 (9%), depending on the friability and vascularity of the tumor. Adequate tumor sample was achieved in 99 eyes (99%). At the time of FNAB, the only immediate complication was partial hyphema (34%). Two weeks after FNAB, persistent hyphema was found in 6 eyes (6%), requiring surgical washout in 1 patient. There were no cases of recurrent hyphema, vitreous hemorrhage, prolonged hypotony, lens damage, endophthalmitis, or extraocular tumor seeding. At mean follow-up of 5 years, there was no incident of tumor recurrence on the iris, along the needle tract, or on the corneal or epibulbar surface. Using our technique, FNAB for diagnostically challenging iris tumors can achieve high yield with relatively few complications.

Biliary Venous Fistula: An Unusual Complication of Fine-Needle Aspiration Biopsy of the Liver

Biliary Venous Fistula: An Unusual Complication of Fine-Needle Aspiration Biopsy of the Liver