What is fnac report

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Conclusion: It is concluded that tuberculous lymphadenitis is still the commonest condition in patients presenting with neck swellings followed by non-specific lymphadenitis and malignant neoplasms especially metastatic carcinoma. FNAC is an easy and suitable tool for the assessment of patients with neck swellings in the outpatient clinics. Although its diagnostic accuracy is limited as compared to tissue biopsy but it is a good test for both screening and follow-up.

Lesions were identified and measured in three dimensions on ultrasound examination. Then, the pathologist performed the FNAC under ultrasound guidance.

FNAC was performed as commonly described in the literature. The excess specimen at the needle rinse was processed for cellblock. The same pathologist who performed the FNAC examined the slides and made the diagnosis. In doubtful cases, the diagnosis was made in consensus with the opinion of one or more pathologists from the same department. Data were collected from anatomopathological reports.

Subsequently, we searched the related reports on the histopathological diagnosis corresponding to the sampled lesion and the subsequent cytohistological correlation Fig. Flowchart of the study design. Abbreviations: FNAC, fine-needle aspiration cytology. The FNAC of these small lesions were performed for women 1. The average sizes of the benign and malignant lesions were 7. The average patient age was Of the lesions, 12 were classified as insufficient group 1 ; , benign group 2 ; , atypical, group 3 ; , suspicious of malignancy group 4 ; and , malignant group 5 Fig.

Of the sampled lesions, 9. None of the lesions in group 1 had a corresponding histopathological diagnosis. Three lesions were subjected to a second FNAC analysis and were classified as benign two fatty necrosis and one benign lesion without cytological atypia.

In group 2, lesions had a corresponding histopathological examination, with confirmed as benign and 6 as malignant, resulting in a negative predictive value NPV of In group 3, lesions had a histopathological exam that confirmed as benign In group 4, 27 In group 5, lesions were confirmed as malignant and only one was confirmed as benign as fatty necrosis , resulting in a positive predictive value PPV of The sensitivity was Table 1 lists the main diagnoses obtained in each group using the FNA and surgical specimen.

The risk of malignancy for each group was: 0 group 1 , 2. The lesions considered malignant in groups 2, 3, and 4 accounted for a substantial percentage of neoplasms in situ. The main benign lesions or those with low potential for malignancy that were diagnosed in each group are listed in Table 1. FNAC and core-needle biopsy are the two most common modalities for the initial evaluation of breast lesions, but the accuracy of FNAC has been controversial. The mean age of the patients in this study was 49,3 group 3 , for both benign and malignant lesions, similarly to the incidence rate peaks reported of 40 to year-olds.

Bray et al. Most breast lesions detected by palpation or imaging examinations are benign or have a low potential for malignancy and have a higher incidence between the fourth and fifth decades of life Orr and Kelley Benign lesions are usually followed up by clinical or radiological examination and, in most cases, there is no indication for a surgical approach, except in certain conditions e.

In the present study, the majority of the lesions were benign on FNAC, and most of the patients with such lesions were only followed up clinically. Only of the patients with benign lesions underwent surgery or biopsy Fig.

The combination of correlated imaging examinations and cytopathological characteristics improves the FNAC. Some authors suggest FNAC as the first-line modality for assessing breast lesions, except in cases with only microcalcifications. When the combination of three assessments is used, treatment can be based solely on the result of FNAC, without the need for a complementary histopathological study Kocjan et al.

The diagnostic accuracy of FNAC for breast lesions has varied among previous studies. A literature review by Mitra et al. In general, the accuracy varies between In contrast, other authors reported favorable accuracy of FNAC, suggesting that FNAC should be preferred over core-needle biopsy for small lesions considering that biopsy procedures can completely remove the lesion, leading to difficulties in assessing surgical margins Tse and Tan Yamaguchi et al.

Another strategy for improving the accuracy of FNAC is implementation of the appropriate technique; this allows for obtaining specimens representative of the lesion and the use of different staining to obtain more cytological information, as one gives some nuclear or cytoplasmic details that can improve the analyses.

Proper slide preparation, adequate technical quality control, analysis by an experienced cytopathologist, discussion of doubtful cases with other cytopathologists, and correlating with radiologic findings will help improve the reliability of FNAC Perry et al. The values obtained in the present study accuracy, With these conditions, adequate specimens for examination and for accurate analyses Fig. In our experience, the use of complementary stains MGG and HE and cellblocks provides additional important information that improves the accuracy of the diagnosis by FNA.

Usually, the cellblocks have enough material to perform immunohistochemistry for different prognostic and predictive markers, as well as for molecular techniques. In these cases, the FNAC can provide all the information necessary for proper management or treatment, without the need for any surgical procedure to obtain additional material.

There is an increasing emphasis on the accurate classification of malignancy using smaller specimens. Currently, tumor-specific subtyping with prognostic and predictive biomarker testing has become a significant component of cytopathology VanderLaan In this context, the material obtained by FNA to conduct these studies using ancillary or molecular techniques showed results equivalent to those obtained by core biopsy, which may renew the interest of FNA as a first-line diagnostic modality for the diagnosis of different types of neoplasms VanderLaan Mammographic examination a and ultrasound examination b demonstrate a suspected irregular lesion for malignancy.

On MGG d and HE e staining, the specimen show characteristics of a well-differentiated carcinoma, consisting of loose cells or forming small clusters with low cohesiveness. Histological sections of the cellblock show atypical epithelial cells similar to smears f.