Fine Needle Aspiration Cytology In Evaluation Research Articles

Retrospective evaluation of fine-needle aspiration cytology for a thyroid tumor that was histopathologically diagnosed as follicular carcinoma, oncocytic variant

Retrospective evaluation of fine-needle aspiration cytology for a thyroid tumor that was histopathologically diagnosed as follicular carcinoma, oncocytic variant

Preoperative Multiparametric Ultrasound and Fine Needle Aspiration Cytology evaluation of parotid gland tumors: which is the best technique?

To evaluate the pre-surgical diagnostic value of Multiparametric Ultrasound (MPUS) and Fine Needle Aspiration Cytology (FNAC) in differentiating parotid gland tumors, comparing the results with histology. The study enrolled 84 patients with parotid gland lesions surgically treated in a single tertiary center and evaluated by MPUS. Each patient underwent FNAC. Histological examination was considered the gold standard. Histology identified 62 benign tumors and 22 malignancies. In the differential diagnosis between malignant and benign lesions, B-mode Ultrasound (US), Color-Doppler US, Contrast-Enhanced US (CEUS), Elastography (USE) and FNAC showed the following values of sensitivity: 82%, 81%, 86%, 77%, 73% respectively; specificity: 97%, 61%, 95%, 71%, 97% respectively; PPV: 90%, 43%, 86%, 50%, 89% respectively; NPV: 93%, 90%, 95%, 88%, 91% respectively; and accuracy: 89%, 71%, 90%, 78%, 84% re-spectively. CEUS proved to be a valid and accurate method for identifying malignant tumors of parotid gland; the combination of B-mode US with CEUS showed similar diagnostic accuracy, but better sensitivity than CEUS taken alone. USE did not improve the diagnostic performance of the B-mode US, alone or in association with CEUS; however, it revealed the highest diagnostic accuracy in the differentiation between benign lesions. FNAC demonstrated lower values in comparison with CEUS and with USE. Therefore, according to our study, MPUS could be proposed as a valid alternative to FNAC.

Evaluation of peripheral lymphadenopathy by fine needle aspiration cytology: Our experience at a tertiary care center

Peripheral lymphadenopathy is frequently due to a local or systemic benign infectious disease. However, it could be a manifestation of underlying malignancy. Fine needle aspiration cytology (FNAC) acting as a reliable diagnostic tool to find out the cause underlying the lymphadenopathy enables the clinician to plan appropriate management for each patient.The present study was undertaken to assess the utility of FNAC in evaluation of peripheral lymphadenopathy cases in different age groups and sex and to study the cytomorphological patterns in these cases.A retrospective and prospective observational study was conducted in the Department of Pathology, Hind Institute of Medical Sciences over the duration of 2 years. A total of 331 lymph node FNA aspirates were studied. Aspirated material was routinely stained with Haematoxylin & Eosin and Papanicolauo stains. Ziehl Neelsen stain was used wherever required.Most of the patients were in the age group of ≤15 years (117/331). Cervical lymphnodes were the most commonly involved sites (222/331). The largest group of lesions belonged to the non-neoplastic category (227/331). Only 54/331 cases were in the neoplastic category. Amongst the non-neoplastic lesions, granulomatous lymphadenitis comprised the majority (128/277). Amongst the neoplastic lesions, 8 cases showed features of non-Hodgkin’s lymphoma (NHL); where as 3 cases were of Hodgkin’s lymphoma (HL). Non-neoplastic lesions were more common in the younger age group (117/257); where as neoplastic lesions were more common in the older age group (27/54).FNAC is a reliable method of diagnosing the pathology underlying enlarged superficial lymph nodes; thus acting as a triage to distinguish the cases with a suspicion of significant disease. At the same time, it also provides material for ancillary studies especially in lymphoproliferative lesions.

Potential role of mobile rapid on-site evaluation® in thyroid fine-needle aspiration cytology to reduce delayed repeated aspiration.

Rapid on-site evaluation of fine-needle aspiration cytology is time-consuming and requires specialized cytopathology staff. Mobile Rose® is a newly developed device for rapid on-site evaluation of fine-needle aspiration cytology. This study aimed to investigate the potential role of Mobile Rose® in reducing delayed repeated aspiration of the thyroid. A total of 120 cytological samples were collected and observed using Mobile Rose® after fine-needle aspiration cytology between September and October 2020, with immediate assessment of minimal or no cell clusters after conventional smear preparation. After qualifying and scoring, needle washout materials were prepared using the BD CytoRichTM method and correlated with cytology results. The average turn-around time of Mobile Rose® was found to be 1.5 minutes. Sensitivity, specificity, positive predictive value, and negative predictive value were 94.4%, 100%, 100%, and 57.1%, respectively. False-negative results were attributed to small aggregates of cells that were difficult to distinguish from the background and artifacts. Mobile Rose® may represent an important innovation for rapid on-site evaluation that is fast, has high diagnostic performance, does not require the presence of specialized cytology staff, and can reduce delayed repeated aspiration of the thyroid gland. However, further minor improvements and confirmation are required.

Fine-needle aspiration cytology evaluation of metaplastic breast carcinoma showing histological diversity

Fine-needle aspiration cytology evaluation of metaplastic breast carcinoma showing histological diversity

Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytologic Evaluation of Intraductal Papillary Mucinous Neoplasm and Mucinous Cystic Neoplasms of Pancreas.

To evaluate the role of endoscopic ultrasound-guided fine needle aspiration cytology in identifying mucinous cystic lesions (MCLs) in histologically proven cases of intraductal papillary mucinous neoplasm (IPMN) or mucinous cystic neoplasm (MCN) and risk of malignancy associated with each cytologic category based on the Papanicolaou Society of Cytopathology (PSC) guidelines. All resected cases with histologic diagnosis of IPMN or MCN at our institution from January 1, 2004, to August 31, 2019, with associated cytology were included. Available cytology slides of nondiagnostic (ND), negative/benign (BN), and atypical cytology (AC) cases were reviewed and reclassified based on the PSC guidelines. A total of 120 cases were identified, including 57 IPMNs with low-grade or moderate dysplasia (LGD/MD) and high-grade dysplasia (HGD), 34 MCNs with LGD/MD or HGD, and 29 IPMNs with invasive malignancy. After cytology slide review and reclassification, we observed that ND and BN cases were paucicellular and lacked ancillary testing (carcinoembryonic antigen levels or KRAS mutation analysis). The risk-of-malignancy rates were 33% for ND, 11% for BN, 28.5% for AC, 17% for MCL, and 100% for suspicious/positive cytologic diagnosis. A multidisciplinary approach including combined use of cytology and ancillary testing is helpful in establishing a diagnosis of MCL and identifying associated malignancy.

What do we know about the cytological features of pure intraductal carcinomas of the salivary glands?

Intraductal carcinomas (IDCs) are rare, poorly characterised salivary gland tumours. The cytological features of IDCs are even less known. In this paper, a systematic literature review of pure IDCs (without stromal invasion, not associated with other histotypes) of low-grade (LG-IDCs) and high-grade (HG-IDCs) was performed. The bibliographic research included multiple databases (PubMed, Scopus, Web of Science). Mild-moderate nuclear atypia favoured LG-IDCs, severe atypia favoured HG-IDCs. Preoperative fine-needle aspiration cytology (FNAC) was performed in 13/94 published cases (14%): 10 parotid; two oral; one submandibular. All the cases were histologically LG-IDCs, except two parotid IDCs. FNAC results included: negative for malignancy (three of 13 cases, 23%); tumour of uncertain malignant potential (seven of 13, 54%); malignancy (three of 13, 23%). The ductal component was identified in two cases; mucoepidermoid carcinoma was suggested in two additional cases. The grade was underestimated on FNAC evaluation in one HG-IDC as focal high-grade features were present on subsequent histological examination. The cases diagnosed as malignant tumours or describing intermediate atypia resulted in LG-IDCs on subsequent histology. Occasional mitoses were described only in one HG-IDC; this feature may have not been considered in the remaining published cases. FNAC and clinico-pathological correlation are important aids for clinicians and pathologists. FNAC could assist surgery even if an accurate diagnosis is sometimes impossible. Discrepancy in grading the nuclear atypia between the FNAC material and the resected specimen can occur, sometimes being unavoidable. Further studies are needed to better characterise this rare tumour.

Correlation of fine needle aspiration cytology with histopathology for thyroid swellings in a tertiary care hospital in South India

Fine needle aspiration cytology (FNAC) is documented to be a good tool in the diagnosis of thyroid lesions. It has good diagnostic accuracy and is an inexpensive investigation. Although a good instrument it does have its own limitations especially when it comes to distinguishing a follicular adenoma from follicular carcinoma thyroid. Objectives of the study was the evaluation of FNAC in the diagnosis of thyroid lesions by determining its sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value. Material and methods. This is a retrospective study of 580 cases of thyroid swelling admitted to our hospital and undergone thyroidectomy over a period of 5 years from 2015 to 2020. After thyroidectomy, FNAC reports (Bethesda system for reporting) of those patients were collected and were compared and analyzed with the histopathology reports. Category 1 and category 3 cases were excluded from calculation due to uncertainty in reporting. Data were analyzed to calculate the sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value of FNAC. Results. Our study included a total of 580 cases of thyroid swellings. The male to female ratio was 1:18.2 and the median age was 43 years. On FNAC, 428 cases (73.7 %) were benign, 35 cases (6 %) were indeterminate, 39 cases (6.7 %) were follicular neoplasm, 30 cases (5.1 %) were suspicious for malignancy and 34 (5.8 %) were malignant. 14 (2.4 %) cases were unsatisfactory. Cytology report was then compared with histopathological reports. FNAC had a sensitivity of 84.2 %, specificity of 97.2 % and a diagnostic accuracy of 94.5 %. The positive predictive value and negative predictive value were 88.3 and 96 % respectively. Conclusions. FNAC is a more specific than sensitive when distinguishing between benign and malignant lesions of thyroid. It has good diagnostic accuracy and hence should be used in all tertiary care hospitals prior to surgery in diagnosing thyroid lesions.

Role of FNAC in evaluation of Parotid Gland Swelling

Objectives: To find out the histological types of parotid neoplasm and to correlate thefindings of FNAC and final histological report in parotid gland neoplasm.
 Methods: A total 30 cases were studied from the inpatient departments of General Surgeryand Otolaryngology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka sinceJuly, 2011 to April, 2013. Fine Needle Aspiration Cytology (FNAC) was done in all cases andcompared with histopathology finding of postoperative specimen.
 Result: Regarding sex distribution benign neoplasm in female 13 (56.52%) and in male10(43.47%). As to the malignant parotid neoplasm in female 4(57.14%) and in male3(42.85%). All parotid neoplasm male: female ratio 1:1.3. Two cases involved in deep lobeof parotid & presented with inward and forward bulging of tonsil and pillars. Three cases ofwarthin'stumour only presented with swelling in the tail of parotid gland. In this series outof 30 cases of parotid neoplasm 23 (76.66%) cases were benign and rest 07 (23.33%)were malignant. Pleomorphic adenoma was the most common benign neoplasm 20(66.66%). Mucoepidermoid Carcinoma was most common malignancy 3 (10%) followed byadenoid cystic carcinoma 2 (6.66%). Out of 7, 3 were stage 3(42.85%) and 3 were stage4(42.85%). In histological grading 3 were low grade (42.85%) and 4 were high grade(57.14%). All the patient werepartotidectomy. Few were treated by radical parotidectomyplus radiotherapy.
 Conclusion: Though it is a small series to comment on the whole spectrum of the parotidgland neoplasm in Bangladesh, yet an idea about the frequency of disease can be establishedbut actual incidence in Bangladesh as a whole can not be ascertained from thisstudy.
 Journal of Surgical Sciences (2016) Vol. 20 (1) : 7-12

Study of fine needle aspiration cytology evaluation of peripheral lymph nodes

Introduction: Lymph nodes are an integral component of the immune system and their enlargement is commonly noted in clinical practice in a wide spectrum of diseases, including infections like tuberculosis and malignancy. FNAC is an important diagnostic tool for rapid evaluation of mainly superficial lesions, especially of lymph nodes. It is cost effective, relatively less traumatic, and enables the pathologist to provide the clinician with a diagnosis in a very short time, and hence is ideal especially for OPD patients. Objectives: 1. To study the age and sex distribution of the patients of FNAC of peripheral lymph node. 2. To study the spectrum of diseases diagnosed on FNAC of peripheral lymph nodes. Methods: Cross-sectional hospital based Observational study. Total 50 patients who had superficial lymphadenopathy were included in this study. Male patients were 21 (42%) and Female patients were 29 (58%). FNAC was performed on this 50 patients. Diagnosis was made by light Microscopy. Result was tabulated and statistical analysis was done. Results: Male patients were 21 (42%) and Female patients were 29 (58%). 50 % patients were in the age group of 21 to 40 years. Reactive hyperplasia was 46% and Granulomatous lymphadenitis was 18%. Cervical lymph nodes were most commonly involved. Conclusion: FNAC is a simple, quick, low cost, minimally invasive and easy diagnostic procedure which is very much helpful in the diagnosis of diseases causing superficial lymphadenopathy in all age groups. Reactive hyperplasia of lymph node was the most common cytological diagnosis followed by Granulomatous lymphadenitis.

Ultrasound Guided Fine needle aspiration Cytology evaluation of Solitary Thyroid Nodule – One year study

Ultrasound Guided Fine needle aspiration Cytology evaluation of Solitary Thyroid Nodule – One year study

Combined Core Needle Biopsy and Fine Needle Aspiration Cytology Using Returned Cell Block Method is Effective for Diagnosis of Cystic Lesions of the Breast

Background: Core needle biopsy (CNB) and fine needle aspiration cytology (FNAC) are useful methods to diagnose cystic lesions of the breast. The first English article describing the returned cell block method (RCBM: cell block from a Papanicolaou staining smear on a glass slide) was reported by us, and we also reported the usefulness of RCBM for the FNAC-based evaluation of tumors of the breast. In the present study, diagnostic procedures of CNB and FNAC using RCBM for cystic lesions of the breast were studied. Methods: Forty-seven patients with cystic lesions of the breast diagnosed by sonographic examination and sonographically-guided FNAC were evaluated. In all cases, the evaluation of FNAC was performed by Papanicolaou staining smears, and RCBM was added in cases that were difficult to evaluate. The data from CNB (26 cases) and surgery (15 cases) were also evaluated. Results: The accuracy of diagnosing carcinoma of FNAC from Papanicolaou staining smear was 56.2%. The diagnostic accuracy increased to 75% on using RCBM, and the same level of accuracy was found on CNB. In 4 cases, a diagnosis of carcinoma was made by CNB only (2 cases) or FNAC using RCBM only (2 cases). Subsequently, the accuracy increased to 87.5% due to the combination of CNB and FNAC using RCBM. Conclusions: Combined CNB and FNAC using RCBM is effective for the diagnosis of cystic lesions of the breast. Based on this new finding, we propose a procedure to diagnose cystic lesions of the breast by CNB and FNAC using RCBM.

Diagnostic Role of FNAC in Evaluation of Head and Neck Lesions

Background: Head and neck lesions encompass a multitude of congenital, inflammatory or neoplastic lesions including several anatomic sites and originating in different tissues and organs. Fine needle aspiration cytology (FNAC) is a simple, quick, feasible, cost effective and repeatable outpatient procedure with minimum risk of complications. Aim: 1. To evaluate the role of FNAC and its utility in the diagnosis of palpable head neck masses. 2. To study the spectrum of head neck lesions in rural population. Material and methods The study included 304 patients presented with palpable head and neck swellings from January 2015 to December 2015. Detailed clinical history of the patient was noted. Aspirations were done by using 10 ml syringe and 22/23 gauge needles. Smears were stained with Haematoxylin and eosin and Leishman stain. Cytomorphological diagnosis was given. Results: Out of 304 patients of head and neck lesions studied, lymph node (50.32%) was the predominant site aspirated with reactive lymphadenitis being the commonest lesion. Thyroid lesions constituted 44.07% followed by salivary gland (3.28%), and soft tissue 2.30% lesions. Conclusion: The head and neck lesions are very common conditions encountered, with most of them being on OPD basis. Our study found that FNAC is simple, quick, inexpensive and minimally invasive technique to diagnose different types of head and neck swellings. It could differentiate the infective process from neoplastic one and avoids unnecessary surgeries. Thus, FNAC can be recommended as a first line of investigation in the

Diagnostic Accuracy of FNAC in Evaluation of Breast Lumps

Background and objectives: This study was conducted to compare the diagnostic accuracy of fine needle aspiration cytology (FNAC)in differentiating the benign and malignant lesions of palpable breast lump with histopathological correlation. Methods: This study was conducted at MNR MEDICAL COLLEGE AND HOSPITAL, Sangareddy , Telangana. The study included 50 patients who presented with palpable breast lumps to the surgical out-patient department. Thorough physical examination was done and the patients were subjected to fine needle aspiration cytology of the palpable breast lump. The cytological examination was classified as: Insufficient sample - C1, Benign - C2, Probably Benign - C3, Suspicious of malignancy - C4, Malignant - C5.All these patients were subjected to open/excision biopsy followed by histopathological examination. The diagnostic accuracy of the fine-needle aspiration was then compared with the gold standard histopathology. Results: Most of the cases were of benign pathology of which Fibroadenoma were most common (64%). It was seen that all the patients were female patients in the age group of 15-75 years. Majority of the lumps were found to be in the upper outer quadrant (46%). The sensitivity of fine needle aspiration cytology was found to be 83.33% , The specificity 100%, Positive predictive value 100% and Negative predictive value 97.77% . Conclusion: In patients with a palpable breast lump fine needle aspiration cytology can help to rule out a malignant lesion. This can hence afford as a cost –effective method in diagnosing breast lesions. Also due to its good tolerability and high diagnostic accuracy the patient need not be subjected to further evaluation which helps in the psychological well being of the patient. But, FNAC results when negative or suspicious should be correlated with clinical examination and imaging findings to prevent false positives and false negatives. A diagnosis suspicious for malignancy should be confirmed by open biopsy.

Role of fibreoptic bronchoscopy and CT guided FNAC in diagnostic evaluation of Non resolving Pneumonia with special emphasis on clinical outcome

Background: Nonresolving pneumonia is a pneumonia with a delayed or slow resolution of radiographic infiltrates or clinical symptoms despite adequate treatment with antibiotics for a minimum period of 10 days. Fibreoptic bronchoscopy (FOB) and CT guided FNAC has a specific role in diagnosis of Non resolving pneumonia. Aims and Objectives: To assess the diagnostic efficacy of fibreoptic bronchoscopy (FOB) and computed tomography (CT)- guided fi ne needle aspiration cytology (FNAC) in evaluation of non-resolving or slowly resolving pneumonia with special emphasis on clinical outcome. Material and Methods: The study was designed as a prospective observational study. We reviewed FOB in Sixty-five consecutive patients of Non-resolving pneumonia admitted under Respiratory Medicine unit of Sri aurobindo medical college and PG Institute Indore from June 2012 to May 2014. We also reviewed role of CT guided FNAC in selected case where FOB result was inconclusive. Result: Out of total Sixty-five case of non resolving pneumonia, Fifty-two patient (81%) were diagnosed with the help of FOB and Eleven patients (91%) were diagnosed with help of CT guided FNAC out of Twelve patient subjected for procedure. Conclusion: FOB should be the first option before CT-guided FNAC in evaluating non-resolving pneumonia. Both the procedures were safe and no major complication was observed. DOI: http://dx.doi.org/10.3126/ajms.v6i3.10727 Asian Journal of Medical Sciences Vol.6(3) 2015 66-71

Comparison of aspiration VS non- aspiration techniques in fineneedle cytology of thyroid lesions

AIM: To compare the efficacy of fine – needle non – aspiration cytology (FNNAC) with that of fine – needle aspiration cytology (FNAC) of thyroid lesions. Materials and Methods: FNAC and FNNAC techniques were studied in 88 cases of thyroid lesions. All the needle – sampling procedures were done by a single operator. The samples were assessed cytologically and evaluated using five parameters, that is, background blood or clot, amount of cellular material, degree of cellular degeneration, and degree of cellular trauma and retention of appropriate architecture. Statistical Analysis: Wilcoxon signed rank test was performed using SPSS 14 software. Differences between all the individual parameters as observed in FNAC and FNNAC smears were insignificant. Results and Conclusion: After evaluation of FNAC and FNNAC on the basis of these scores, greater numbers of diagnostically superior samples were obtained by FNNAC; however, by FNAC more number of diagnostically adequate smears were observed. The numbers of unsuitable smears were also more by FNNAC technique.

Ultrasound Guided FNAC for Evaluation of Neck Lumps to Improve Inadequacy Rates; A Complete Audit Cycle

We present a completed audit cycle evaluating inadequacy rates in neck lump and thyroid fine needle aspiration cytology with and without ultrasound scan guidance. The first cycle of the audit was from January to July 2010 comparing free hand fine needle aspiration cytology (FNAC) with ultrasound guided fine needle aspiration cytology (USS+FNAC). Changes to practice were made, firstly all thyroid FNAC would be performed with USS+FNAC and a reduced threshold for referral for USS+FNAC for non-thyroid neck masses. The second audit cycle was completed sixteen months later to assess for an improvement in practice. 1st phase; 155 patients, 70 freehand, 85 USS+FNAC. 50% of the thyroid FNAC freehand were inadequate compared to 18% of the thyroid USS+FNAC. 2nd phase; 196 patients, USS+FNAC 134, freehand 62. Thyroid FNAC 105 (USS+FNAC-104, freehand-1). Inadequate USS+FNAC = 21/104 (20%). The completed audit cycle shows an increased proportion of thyroid FNACs performed by ultrasound guidance, improving from 82% to 99%, with an overall reduction of inadequate thyroid FNACs from 24% to 21%. There was a noticeable variability in the inadequacy rates from radiologist to radiologist with the head and neck senior radiologist demonstrating the lowest inadequacy rate at 9.6% in the second cycle. Although ultrasound guidance for FNAC is important for the reasons of increased sensitivity, specificity and accuracy, we have demonstrated that the operator experience and skill are just as important.

Role of FNAC in Evaluation of Neck Masses

Background: Despite fine needle aspiration cytology (FNAC) has a well recognized role in investigation neck masses, insufficient cellular yield in FNA remain an issue. The aim of this study is to evaluate the effectiveness of FNAC as a primary investigation tool in neck masses. Methods: This is a retrospective study of 47 cases with FNAC performed from February 2008 till June 2009 at Otorhinolaryngology Department, Ampang Hospital. The result were compared with results of 44 patients with neck masses and subjected for excision/incision biopsy as first line investigation of tissue diagnosis during the same period of time. Results: A total of 37 out of 47 patients with FNAC have a conclusive result (78.7% diagnostic yield). Inflammatory lesions (46%) are the common pathology followed by benign lesions (41%) and malignant lesions (13%). Excision/incision biopsy have 100% tissue diagnostic yield with 48% were haematological malignancies followed by reactive lymphadenopathy (27%), tuberculosis lymphadenopathy (16%) and metastatic carcinoma (9%). Conclusion: Despite lower tissue diagnostic yield compared to excision/incision biopsy, FNAC remains a safe and appropriate first line investigation of neck masses. doi: http://dx.doi.org/10.4021/jcs178e

Granulocytic Sarcoma Presenting as an Orbital Mass: Report of Two Cases

Granulocytic sarcoma is a rare variant of a myeloid malignancy, which shows an extra-medullary tumour mass which is composed of myeloblasts and myeloid precursors with varying degrees of differentiation. It occurs most commonly in bone, periosteum, soft tissue, lymph nodes, and skin; although it can occur anywhere throughout the body. Here, we are reporting two cases of orbital granulocytic sarcoma in children, which presented clinically with proptosis and periorbital swellings, which were first diagnosed by Fine Needle Aspiration Cytology (FNAC). Later, peripheral blood and bone marrow aspirate examinations revealed the evidence of Acute Myeloid Leukaemia (AML). These cases are being documented to demonstrate the utility and diagnostic accuracy of FNAC in evaluation of this entity, in cases of unsuspected AML. Recognition of this rare entity is important, because giving an early aggressive chemotherapy can cause regression of the tumour and thus improve the patient survival.

Comparison of aspiration vs non-aspiration techniques in fine-needle cytology of thyroid lesions

Aim:To compare the efficacy of fine-needle non-aspiration cytology (FNNAC) with that of fine-needle aspiration cytology (FNAC) of thyroid lesions.Materials and Methods:FNAC and FNNAC techniques were studied in 50 cases of thyroid lesions. All the needle-sampling procedures were done by a single operator. The samples were assessed cytologically and evaluated using five parameters, that is, background blood or clot, amount of cellular material, degree of cellular degeneration, and degree of cellular trauma and retention of appropriate architecture.Statistical Analysis:Wilcoxon signed rank test was performed using SPSS14 software. Differences between all the individual parameters as observed in FNAC and FNNAC smears were insignificant.Results and Conclusion:After evaluation of FNAC and FNNAC on the basis of these scores, greater numbers of diagnostically superior samples were obtained by FNNAC; however, by FNAC more number of diagnostically adequate smears were observed. The numbers of unsuitable smears were also more by FNNAC technique.