What is the role of fine-needle aspiration biopsy (FNAB) in the workup of soft-tissue tumors?

Updated: Dec 03, 2018
  • Author: Vinod B Shidham, MD, FRCPath; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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FNAB is a cytologic technique involving the use of a fine-gauge (usually 21- to 25-gauge) needle to aspirate individual tumor cells and microfragments from the mass. The aspirated material can be examined as a cytology smear, with immediate evaluation of specimen adequacy.

Depending on the initial cytomorphologic features observed during the onsite adequacy evaluation, additional passes may be performed at the same time to obtain more material for cell-block preparation (for histomorphology and immunocytochemical evaluation), cytogenetic analysis (see Etiology and Atlas of Genetics and Cytogenetics in Oncology and Haematology), or examination using electron microscopy or microbiology cultures. [24]

With the help of relevant ancillary techniques, diagnostic accuracy with FNAB is very high, and soft tissue tumors can be graded. [25] This method is minimally invasive and relatively atraumatic.

Published literature highlights the rarity of needle-track seeding with FNAB. Core needle biopsy, on the other hand, has a higher rate of needle-track seeding.

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