INTRODUCTION:
FNAC is the first choice for the initial investigation and diagnosis of both superficial and deep lesions though core needle biopsy is extremely valuable in selected cases.
FNAC is not only limited to neoplastic conditions, but FNAC is valuable in the diagnosis of inflammatory, infectious and degenerative conditions.
It is relatively painless and produces a speedy result. It is cost effective. Its accuracy in many situations can approach that of histopathology in providing an unequivocal diagnosis in the experienced hands. It is applicable when the lesions are easily palpable.
The risk of needle tract seeding is extremely low, when truly fine needles of twenty two gauge or less are used.
The success of FNAC depends on the representativeness,
adequacy of sample and high quality of preparation.
At the community level, FNAC may be regarded as a simple
screening test for serious disease, which needs further investigation and referral to a specialist.
In the majority of the hospitals, it is an essential component of the final preoperative or pretreatment investigations on which the management of the problem is based.
There would be little danger in extracting a small quantity of tissue from an obscure growth by the aid of a needle, trocar or cannula. So, little substance is necessary for the microscope that the diagnosis of cancer would no longer be equivocal or vague.
AIM OF THE STUDY:
1. To assess the cytological grading in fine needle aspiration cytology smears of common surgical swellings.
2. To compare the cytological grade with a histopathological grade in surgical specimens and biopsies of common surgical
swellings.
The most common surgical conditions included in this study are:
1. Salivary Gland Swellings,
2. Lymph node Swellings,
3. Thyroid Gland Swellings,
4. Breast Lumps,
5. Soft Tissue Swellings.
METHODOLOGY:
Cytologically confirmed surgical swellings cases with respective specimens received in the department of pathology, Thanjavur Medical College and Hospital, Thanjavur was studied over a period from August 2011 to Nov 2012.
MATERIALS:
1. Disposable hypodermic needles of size 23-24 and of length
between 1-1. Inches.
2. Disposable sterile 5 ml syringe .The pistol syringe holder is preferred. But here it is not used.
3. Swabs with spirit or skin sterilizing solutions.
4. Several 76 X 26 mm size microscope slides are suitably labeled and numbered.
5. Koplin jar for keeping the smeared slides in the fixative, the fixative being isopropyl alcohol.
Statistical analysis:
Data were analyzed by using Spearman’s correlation coefficient (r value) for correlation of cytological grading with histological grading. Also statistical test was applied to determine the p value to find the association between two grading systems.
CONCLUSION:
1. FNAC is highly sensitive in diagnosing neoplasms of breast, Thyroid and Parotid.
2. Lymphomas can be found out by FNAC but typing of
Lymphoma needs excision biopsy.
3. Benign swelling of the breast (Fibroadenoma), Parotid (Pleomorphic Adenoma), soft tissue (lipoma) can be diagnosed with high accuracy by FNAC.
4. FNAC is useful in conjunction with clinical radiological
findings to provide best possible initial assessment.
5. The diagnostic accuracy not only depends on responsiveness of the aspirate but also on the quality of cytological preparation.
6. Repeat FNAC sampling over a period of time reduces the false negative rates
