fine needle aspiration biopsy in the
TRANSCRIPT
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Fine needle aspiration biopsy in the
oral cavity and head and neck regionAna Paula Candido dos Santos
Norberto Nobuo Sugaya
Dcio dos Santos Pinto Junior
Celso Augusto Lemos Junior
Braz Oral Res. 2011 Mar-Apr;25(2):186-91
Presented by:
Andries Pascawinata
Departement of Oral and maxillofacial
Faculty of Dentistry
Gadjah Mada University
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INTRODUCTION
FNAB
palpable
masses
deep lesions
with difficultaccess
Oral, head and
neck region
thyroid,lymph nodes,
major salivary glands
and Others neoplasias
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Advantages
the preoperative
diagnoses of lesions, clinical follow-up
the ability to avoidunnecessary damage tocrucial structures of theoral cavity
More comfort for thepatient and a low risk ofinfection and tissue
damage
Intra Oralodontogenic tumors
Intraosseous lesions
minor salivary gland
tumorssublingual salivary
glands
and other oral regions
Disvantages
little space to perform the
backward and forward
movement difficulty involved in fixing
the lesion
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The sensitivity
of FNAB80% to 100 %
The false
positive rate
0 to 3%
The falsenegative rate
0 to 20%
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Material and methods
The inclusion criteria:
both genders
all ethnicities
above 10 years old,
without anycomorbidity restrictionsand on whom both aFNAB and a regularbiopsy had been
performed
50 patients
The exclusion criteria:
patients under
10 years old and those on
whom only the FNAB
had been performed
without confirmation by
a regular Biopsy
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All of them were submitted to FNAB and to either
incisional or excisional biopsy
The diagnoses from the FNABs were compared
with the biopsy diagnosis as the gold standard
All the cases of FNAB were analyzed by a single
oral pathologist prior to the biopsy diagnosis
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TECHNIQUE
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The FNAB was performed with a Franzenpistol
96 GL alcohol for the setting of the samples
the area was prepared in an aseptic mannerand the area was anesthetized only if the
biopsy was performed at the same surgicaltime
the needle was inserted into the lesion, avacuum was applied and the operator madeback and forth movements with the needle toobtain a large amount of cells for the smears
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The pressure was then released and the needle
removed from the lesion The syringe was withdrawn from the gun and the
needle was removed from the syringe
removing the needle from the syringe
filled with air and the needle was placed near thesurface of a glass slide
The material was deposited onto six glass slides
and fixed in 96 GL alcohol Hematoxylineosin was used both for the FNAB
slides and the anatomic pathology slides
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sensitivity
is the ability of the test to identify malignantlesions
specificity
is the ability to identify benign lesions.
Accuracywas calculated as the number of FNAB resultsthat were similar to those of the regular biopsy
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Results
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Discussion
this study noted that result of the sensitivity
of FNAB is (75%) and specificity (96%).
FNAB could be the guide treatment for oral,
head & neck lesions
In this study difficulity is found in fibrous
lesions, lesions in high blood contain,
presence of lymphoid tissue and fatty tissue.
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The high rate of inconclusive samples can be
explained by some factors:
inexperience in the collection of cells,
difficulty in interpreting the smears,
poor or inadequate smears for interpretationand artifacts, such as necrosis and a high
content of blood in some samples
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Adequate clinical training must be conducted to ensurethat the smears are of a satisfactory quality forinterpretation
As a result, the experience of the pathologist for
interpreting these patterns in the cell smears should beconsidered.
The presence of a pathologist at the time of sample
collection, as well as during the staining for the rapidinterpretation, may help the clinician at the time ofaspiration. This can, therefore, help to minimize therate of inconclusive cases.
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FNAB in oral lesions has been shown to be an
important tool that should form part of the
arsenal of clinicians.
However, the indications and limitations of the
technique should be known to ensure that the
technique is used correctly and its results
interpreted correctly
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Conclusion
FNAB displays a high sensitivity for identifying
both malignant and benign lesions, but does
not have a high degree of success in making
the final diagnosis.
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