FNA | Diseases and conditions: Medical tests.

What is the Fna

Fna are some acronyms that refer to the Fine needle puncture aspiration, a test in which a sample of tissue is obtained puncionando it with a needle fine, but wide enough as to make cells, or even small pieces of material bodies will aspire. It is a simple test that allows the cell study of mass and nodules whose origin is unknown or doubt of whether they are benign or malignant.
PAAF first held in 1981 in New York (USA). The medical team that made her studying diagnostic methods minimally invasive that avoid perform biopsies open through conventional surgery. Thanks to the development of the FNAP have avoided thousands of surgeries in the world, and the complications of infections, necrosis or scarring injuries has declined precipitously.
The test can get two kinds of material: pieces of tissue or cells. When cells are obtained only a cytological study is possible. The pathologist (which specializes in the microscopic evaluation of tissues) can tell if obtained cells are benign, malignant, or describe alterations, but cannot define if it's a tumor or its degree of malignancy.
When pieces of tissue are obtained can be a histological study. In this case Yes you can see what kind of cancer are and what is the degree of malignancy. Sometimes refers to BAG (thick needle biopsy) when the material obtained is large enough.

When doing a Fna

The Fna or fine needle aspiration is a test that is performed when the following alterations in a person:
Thyroid nodule: before a nodule in the thyroid gland that does not capture iodine on a scan or does not produce thyroid hormone, a Fna should be done to rule out malignancy.
Breast nodule: when it is a recent appearance in a breast nodule felt should be a Fna. In young women most of the time will be benign fibroids that have no importance. If the nodule is not palpable and it was only detected through mammography this test can not be and will have to perform a biopsy with a Harpoon.
Adenopathy: lymph nodes are called to the lymph nodes that are swollen or enlarged. Occur most frequently in the neck, armpits, or English primarily, although they can appear anywhere on the body. When duran enlarged more than 2 - 4 weeks with no identifiable cause should study by PAAF.
Skin growths: when it appears a nodule or a lump in the skin without any reason their cells using Fna can study. Sometimes decides to perform a skin biopsy directly if it is superficial.
Study of internal organs: some organs which are within us not you can study directly with a needle blind. In such cases used computed tomography (CT) as a guide. Thus studies of the pancreas, kidney, unknown masses can be...
Samples of liver and lung: although they are internal organs is not necessary to use TC as a guide because its size and location allowed puncturing them directly through the skin.

Preparation for the Fna

If you will perform (FNAB) fine needle aspiration cytology these are the issues that you must take into account:
Duration: the test will last a total of 15 to 20 minutes. The biopsy itself will be one minute, the rest consists of the preparation of the material and the biopsy area.
Income: PAAF can be a query or a room of cures, in such a way that it does not require hospital admission. If you are entered they made you the FNAP in the same bedroom whenever possible.
Is necessary to be accompanied?: there is no why he accompanied, but yes it is recommended, as there are sensitive people who are sore or something queasy after the test.
Drugs: don't need to take any prior medication. Must be communicated to the doctor all the medicines taken regularly, and will decide if we will suspend any. Ibuprofenos, aspirin and other anti-inflammatory drugs should be avoided one week before the test. It may be necessary to suspend blood thinners such as warfarin or acenocoumarol the drugs. It is important to also inform of allergies to medications or other products, if you have them. Sometimes the doctor will prescribe you an antibiotic to take a few hours before the test and thus prevent the emergence of possible infections.
Food: should remain in fasting 8 hours before the test. If it is in the morning simply that not you breakfast or drink anything before the FNAP.
Clothes: you can perform the test with the same clothes every day. When you get to the hospital or doctor can give you a gown to change you should see fit, although often is enough to discover the part of the body that is going to puncture it.
Documents: it is important to bring with you the steering wheel which shows the performance of this test. The health insurance card is recommended. Normally you will not you any document after the test because it takes time to analyze the results.
Pregnancy and breast-feeding: the FNAB is not contraindicated in pregnancy or lactation, but that State should be aware that some organs studied will be altered from itself during these stages.
Contraindications: the masses that may not be felt can be a limitation for the test, unless they are in the abdomen or chest and it can guide the puncture with the TC.

How the Fna

First your doctor will assess in a consultation if necessary or not to perform (FNAB) fine needle aspiration. If deemed necessary will inform you of why it thinks, how it's performed, what information we can provide, and what are the possible risks. It will give you an informed consent document summarizing the main characteristics and you will have to sign it if you agree with its realization.
PAAF may make you it that day, but the most common is that you cited in another time. It is common to perform a blood test prior to put you to the test with an included study of coagulation. When they go it to ask you first of all that you change your clothes and views a comfortable gown for you and for the pathologist. You have to keep in mind is a minimally invasive and not particularly painful, so it is not necessary that monitor you vital signs (blood pressure, heart rate, etc.) thoroughly.
Sometimes they will offer you some relaxing drug to make you stay sedated during the test; It is recommended if you are nervous or are particularly sensitive to pain. Once you are ready ask you you to tumbes on a stretcher in a position that facilitates the realization of the test. If the Fna in thyroid ask you stay seated.
To proceed to biopsy the first thing that will is clean the skin in the area where it is made with alcohol or iodine compounds. So remove any contaminants germs from the skin surface. Then they inject an anesthetic and deeper levels from the skin surface. You will feel a slight prick of the needle, and then a burning sensation at the very moment in which penetrates the anesthesia. So that part of the body will be asleep and insensitive. Then they entered a long, hollow needle to reach the nodule to study. Through this needle is introduced another fine that will be sucked to get loose cells, and then catch a small cylinder of tissue if necessary.
Once the FNAP be removed the needles. It is normal that the puncture point blood a little; apply pressure continued for a few minutes to stop the bleeding. Then they placed a bandage or a compression dressing and you'll be ready to go home. It will not need to wait on the results, since they need to be processed for a time, and at first glance not seen any alteration. The bandage must hold for at least two days, and it is normal that the days after the test have manipulated pain in the area and need to take some pain reliever you your doctor will prescribe.

Complications of PAAF

All tissue sample outlets have risks to dealing with evidence that invade the body organs, albeit slightly.
The complications of the Fnac or fine-needle aspiration cytology tend to be rare and in most cases have a easy solution. They can appear during or after the test, and whenever they arise you should go to the emergency room.
Some of the most common complications associated with PAAF are:
Local infection with fever, swelling and heat.
Bleeding from the point of biopsy.
Uncontrollable pain.
Reaction to anesthesia during the test.
Pneumothorax (at the Fnac of lung).
Perforation of other organs (very unlikely).
Local spread of a tumor (unlikely).

The FNAB results

The results of the Fnac or puncture fine needle aspiration may take from one week up to a month. The waiting time, it therefore tends to be long, and requires patience and tranquility. The reason is that the aspirate sample can not be analyzed at the time. The following analysis will be carried out on this sample:
Cytological study: are the cells one by one and in small clusters. Their nuclei, which may be signs of malignancy can be studied as well.
Histological staining: using special dyes cells are colored and can be observed under the microscope directly. The most widely used staining is hematoxylin-eosin.
Immunofluorescence studies: you can attach fluorescent substances to certain components of the cells and thus verify its existence.
Microbiological cultures: If infection is suspected sample can be grown in appropriate media that allow the growth of microorganisms. It is a common in the lymph nodes that are suspected secondary to tuberculosis.
Molecular studies: specific proteins that classified the types of cells that contain the sample can be identified.
All of these tests will be performed by the physician. Along with the symptoms, analytical studies and the FNAP, specialist can make a diagnosis most of the times. So you can explain what happens to you, and what are the treatments available to solve your disease.
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