Fine Needle Aspiration Biopsy in a Rural Family Practice

  • D O’Mahony MBBCh, DCH, DTM&H, DPH, Dip Mid COG (SA), FRCGP, Family Practitioner, Bridge Street, Port St Johns
  • L Banach MDPhd, MIAC, Associate Professor, Department of Pathology, and Director, Telemedicine Unit, Faculty of Health Sciences, University of Transkei, Umtata

Abstract

Background: Fine Needle Aspiration Biopsy (FNAB) is a safe economic method of obtaining tissue from a suspicious mass for diagnostic purposes. This study describes the results of FNAB in a family practice in a poor rural community.

Methods: Any patient with a suspicious mass that the family practitioner considered could be safely aspirated percutaneously underwent FNAB. Masses for aspiration were located by means of palpation or ultrasound scan. A 21-gauge 1½-inch or 23-gauge 1¼-inch needle, attached to a 10mL disposable plastic syringe, was used for FNAB of superficial masses. For percutaneous FNAB of deep-seated organs and masses, a 23 gauge 1¼-inch needle or 3½-inch spinal needle was used. The aspirate was spread on slides and sent for cytopathology analysis

Results: The cytological diagnoses from 187 FNAB were: malignant 47 (25%) suspicious of malignancy 14 (7%), atypia 10 (5%), tuberculosis 31 (17%) and benign 60 (33%). Twenty-five (13%) were inadequate. The biopsy sites and number *%) were: lymph nodes 97 (52%), liver 30 (16%), subcutaneous masses 25 (13%), lung 18 (10%), thyroid 5 (3%), breast 8 (4%) and other 4 (2%). The yield for a diagnosis of malignancy or TB was 42%.

Conclusions: FNAB is a procedure that can be efficiently performed by a family practitioner and has a substantial diagnostic yield in rural practice in a developing country.

SA Fam Pract 2003:45(5):9-11

Keywords: Fine needle aspirations, biopsy, cytology, tumours, general practice.

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eISSN: 2078-6204
print ISSN: 2078-6190