Safe, Simple and Accurate.
Ultrasound guidance is used to perform fine needle aspiration biopsy so the needle path can be watched on the screen to ensure safe and accurate sampling. The procedure is fast, least painful, and has minor or no complications, and often saves patients from having to undergo more invasive procedures for diagnosis.
Answers to Commonly Asked Questions:
What is Ultrasound-Guided Fine Needle Aspiration (USFNA)?
FINE NEEDLE ASPIRATION (FNA) is a minimally invasive diagnostic procedure that involves using a very thin needle — smaller than the needle used to draw blood. Because of this, no general anesthesia or sedation is needed — only a mild topical numbing agent like lidocaine gel and freeze spray works in almost all cases. Using the ultrasound to find the proper place to locate the needle, a small sample of cells is recovered for diagnosis. Results are available to the referring physician in hours to a few days after the procedure.
Why would you need an FNA?
The most common reason for people to have an FNA is to find out the cause of a lump or mass and in some cases, to rule out a cancer. This lump might be something that you or your doctor noticed. It is important for your doctor to determine whether or not it is a tumor – either benign or malignant – and gain information necessary for making a treatment plan.
How long does the FNA procedure take?
The FNA testing itself takes only approximately 30 minutes. However, you should arrive at AENT Central Registration Area at least 30 minutes prior to your FNA appointment if you have not pre-registered, or 15 minutes prior to your appointment if you have pre-registered.
How should you prepare yourself for your FNA appointment?
Usually, no special preparations are required for this procedure. Please eat normally before coming for the procedure and take all your regular morning medications EXCEPT blood thinners like Aspirin, Lovenox®, Plavix®, Xeralto® or Coumadin® that need to be stopped 48 hours prior to the FNA in order to avoid any potential biopsy site bleeding complications.
Please notify your referring doctor if you are taking any of the above blood thinning agents and ask them if you can stop these blood thinners 48 hours prior to your FNA appointment.
Please also notify our attending FNA clinic nurse if you are allergic to Lidocaine® (a topical anesthetic used during the biopsy to numb the area) or latex gloves.
What happens during a scheduled FNA appointment?
The doctor will first ask you questions about your medical history and about the lump and will then perform a physical examination of that area. Next, the doctor will use the ultrasound machine to see what the lump looks like. If the doctor decides to biopsy the lump, she will clean the skin and apply lidocaine anesthetic along with freeze spray to numb the area. Then, using the ultrasound as a guide, the doctor will place the needle in the lump and withdraw a small sample of cells from it through the needle. Depending on the lump, this may happen only once or may require several passes of the needle. After each pass the needle site will be compressed by an assistant to prevent bleeding. Each pass takes about 10 to 30 seconds, and the procedure takes about 15 to 30 minutes from start to finish. The doctor will do a rapid on-site evaluation of the sample using a microscope, usually after each pass, to ensure that the sample is adequate for a diagnosis.
How will you feel following your biopsy?
The procedure does not have any major complications, and you may continue regular activities the same day. Most patients experience no more discomfort than when they have a routine blood test. Occasionally patients experience mild bruising and tenderness which resolves quickly and can be treated with an over-the-counter pain reliever such as Tylenol or the application of an ice pack for short periods after returning home. Infection is rare because the skin is cleansed with alcohol prior to the biopsy and only sterile needles are used. If your biopsy is on a salivary gland, you may experience a small amount of blood in your saliva after the procedure.
Benefits of Pathologist-performed Fine Needle Aspirations (FNAs):
- Safer than Open Biopsy
- Anesthesia Unnecessary
- No Incision or Scar
- No Hospitalization
- Onsite immediate assessment for adequacy and rapid preliminary diagnosis
- Additional specimens collected at same time for special studies, if required
Our FNA doctor is a pathologist, specially trained in all aspects of the USFNA procedure to ensure that the best specimen is obtained and handled properly for the best possible diagnosis.
Gitika Aggarwal, MD, FCAP is Board-Certified in Anatomic and Clinical Pathology and Cytopathology, and she completed an Anatomic and Clinical Pathology Residency at the Medical College of Georgia (now Augusta University) and a Cytopathology Fellowship at Memorial Sloan-Kettering Cancer Center. Dr. Aggarwal is experienced in a broad range of cytopathology procedures including immediate assessment of imaging-guided/CT-navigational FNAs, body fluid and exfoliative cytology, and surgical pathology. Dr. Aggarwal completed the intensive Ultrasound Guided Fine Needle Aspiration Advanced Practical Pathology Program through the College of American Pathologists and has been performing USFNA procedures for past several years.
How are the results reported?
The tissue will be examined under the microscope, and you and your physician will be notified of the results in a timely manner along with a pathology report for your reference.
If you have further questions regarding Augusta – Aiken ENT & Allergy’s Ultrasound guided Fine Needle Aspiration Clinic, please feel free to call our office at (706) 868-5676.