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Fine needle aspiration cytology in cancer diagnosis

BMJ 2004; 329 doi: (Published 29 July 2004) Cite this as: BMJ 2004;329:244
  1. Derek E Roskell, consultant pathologist (,
  2. Ian D Buley, consultant pathologist
  1. Department of Cellular Pathology, John Radcliffe Hospital, Oxford OX3 9DU

    Is quick, cheap, and accurate when used appropriately

    Fine needle aspiration cytology (FNAC) entails using a narrow gauge (25-22G) needle to collect a sample of a lesion for microscopic examination. It allows a minimally invasive, rapid diagnosis of tissue but does not preserve its histological architecture. In some cases this limits the ability to make a definitive diagnosis. As with any invasive procedure there are risks, and as with all diagnostic tests involving sampling and interpretation, important diagnoses can be missed. False negative results and occasional complications of the technique have been reported as proof that it is “useless and dangerous.”1 However, accuracy and complications need to be compared with robust published data about alternative techniques before abandoning fine needle aspiration. Clinicians require clear communication with the cytopathologist to ensure that the procedure is appropriate for the question being addressed and that both understand the answer in the same terms. The rapid diagnosis possible with fine needle aspiration can shorten or avoid hospital admissions, and speed a patient's route to an appropriate specialist. In one …

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