A fine needle aspiration (FNA) is a type of biopsy in which a very thin needle and syringe are used to remove (aspirate) a small amount of fluid or cells from a lump or mass. This test may also be called fine needle aspiration biopsy.
Why FNA is done
FNA may be used to:
- remove fluid if a lump or mass is thought to be a cyst (a sac filled with fluid or semi-fluid material)
- remove a few cells from a lump for examination
- rule out cancer
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How FNA is done
FNA is usually done in the doctor’s office on an outpatient basis. It does not usually need any special preparation and does not take very long.
- FNA may be done with or without local anesthetic.
- The doctor inserts a very thin (fine) needle attached to a syringe into the lump.
- For deep lumps or lumps that cannot be felt, ultrasound or computed tomography (CT) scan can be used to guide the needle into the lump.
- Fluid or cells are withdrawn through the needle into the syringe.
- The woman may feel minor discomfort during the procedure, especially in sensitive areas.
- A small bandage may be used to cover the site where the needle entered.
- The sample is sent to a laboratory to be examined under a microscope.
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What the results mean
If the lump is a cyst filled with fluid, it will usually disappear after the fluid is withdrawn.
- The fluid can be a variety of colours, including clear, bloody, green, white or yellow.
- Green or yellow fluid may be a sign of infection.
- Blood in the fluid may mean a blood vessel was nicked by the needle or may suggest a more serious problem.
- Some cysts can come back and fine needle aspirations may need to be repeated.
Biopsy samples from FNA are sent to the pathology lab. A pathologist (a doctor who specializes in the causes and nature of disease) will look at the cells in the tissue to see if they contain cancer. The pathology report indicates the characteristics and type of cells present and if cells are normal, non-cancerous or cancerous.
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What happens if a change or abnormality is found
The doctor will decide whether further tests, procedures, follow-up care or additional treatment are needed.
A biopsy of the tissue may be done if the:
- laboratory tests find cancer cells in the fluid
- cyst does not disappear after it has been aspirated several times
- tests do not find cancer cells in the fluid, but the doctor is still concerned
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Special considerations for children
Being prepared for a test or procedure can reduce anxiety, increase cooperation and help the child develop coping skills. Parents or caregivers can help prepare children by explaining to them what will happen, including what they will see, feel and hear during the test.
- Tell children that they will be going to the hospital for the procedure and what will happen at the hospital.
- Tell children when they will have the procedure and how long it will take.
- The child can bring a favourite toy, doll, pacifier or blanket to the hospital.
- Have books, magazines, games or music to keep the child entertained while waiting for the biopsy.
- There may be certain restrictions before the procedure.
- Children may not be allowed to eat solid food for 8 hours before the procedure.
- They may not be able to drink clear fluids for 3 hours before the procedure.
- If children will have general anesthetic, let them know:
- They will not feel, hear or see anything during the operation because of a special sleep medicine.
- They will wake up when it is over.
- If children have local anesthetic and will be awake during the procedure, they may feel some pressure or “tugging.”
- The child may feel a burning or stinging when the anesthetic is injected.
- The area of the biopsy may be sore for about a week after.
The preparation you can provide for this test depends on the age and experience of the child. See the following for more age-specific information on helping children cope with tests and treatment.
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