Chapter 11 Answers to self-check questions

Fine needle aspiration cytology

11.1 What is the role of FNA in breast disease?

Investigation of axillary lymph nodes and local recurrence of breast cancer, evaluation of cystic areas with atypical features, confirmation of clinically benign lesions, or in diagnosis of breast cancer when carrying out a core biopsy is contraindicated. Confirming the nature of benign masses when surgery is not indicated, particularly in younger women.


11.2 What is the place of FNA in the investigative sequence of thyroid nodules?

Thyroid nodules are relatively common. The majority of thyroid nodules are benign and only a small percentage may be cancerous or equivocal and require surgery. The main role of FNA is to confirm the benign nature of nodules and reduce unnecessary diagnostic surgery. Nodules that are equivocal on cytology or malignant require clinical follow-up and require surgical excision for histological diagnosis.


11.3 What is the main role of FNA in lymph node diagnosis?

FNA cytology is useful in assessment of reactive hyperplasia, diagnosis of metastatic malignancy, and initial diagnosis of lymphoid malignancy.


11.4 What are the indications for FNA of salivary glands?

Any enlarged salivary gland is an indication for FNA of salivary gland. FNA can be useful in differentiation of inflammatory from neoplastic disease and differentiation of benign from malignant tumours.


11.5 What are the main indications for FNA in the GI tract?

FNA combined with EUS (EUS-FNA) allows sampling of masses suspicious of malignancy in pancreatic, GI, pelvic, hepatobiliary, or mediastinal lesions. EUS-FNA can also be used for the staging of known GI or pulmonary malignancies.


11.6 What is the most common use of FNA in skin and soft tissue masses?

FNA in experienced hands is useful in diagnosis of soft tissue tumours, but it is most useful in assessing skin and soft tissue lesions suspicious for metastatic disease or tumour recurrences.

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