Article

Fine-needle aspiration (FNA) biopsy: historical aspects

Department of Cytopathology, Naval Hospital of Athens, Athens, Greece.
Folia Histochemica et Cytobiologica (Impact Factor: 1). 12/2009; 47(2):191-7. DOI: 10.2478/v10042-009-0027-x
Source: PubMed

ABSTRACT This study aims to present the origins and the historical evolution of fine-needle aspiration biopsy and to also underline its importance in the history of modern cytology. The article focuses on the advances made in the 20th century that have led to the modern techniques associated with the procedure. The authors conducted a thorough review of early reports on needle biopsy, particularly those published during 19th and 20th century, examining in brief also the origins of the needle biopsy. The first report on the use of needle puncture is referred in early writings of Arab medicine. In the early 20th century, Martin and Ellis are considered to be the founders of modern needle aspiration techniques. The German doctor Mannheim was the first to publish reports suggesting the use of fine needles with a small gauge. The establishment and world-wide expansion of FNA should be attributed to the representatives of the Swedish School of Cytopathology. The school embraced FNA in the second half of the 20th century while serving as a training ground for doctors around the world. The history of needle biopsy spans ten centuries. However, the development and establishment of the technique in its modern form took place primarily during the twentieth century. Today, FNA is considered an important cytologic technique with sufficient diagnostic accuracy, especially when applied in cases of lung and prostate cancer.

Download full-text

Full-text

Available from: Emmanouil Magiorkinis, Aug 21, 2014
0 Followers
 · 
261 Views
  • Source
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Fine-needle aspiration (FNA) of breast lesions provides indeterminate (C1, C3, and C4) diagnoses in a high proportion of cases. The aim of the present study was to retrospectively determine whether repeat FNA or core needle biopsy (CNB) most frequently provides a correct and more conclusive diagnosis. All patients who had an indeterminate primary FNA followed by repeat FNA or CNB within 1 month from 1992 to 2007 were included. FNA was diagnosed as C1-C5; CNB was diagnosed as B1-B5. Improvement in preoperative diagnosis by repeat FNA or CNB was defined as C2/B2 in benign lesions, C3/B3 in premalignant lesions, C4/B4 or C5/B5 in malignant lesions where primary FNA was C1, and C5/B5 in malignant lesions where primary FNA was C3 or C4. Among 255 eligible cases, CNB improved the preoperative diagnosis more often than did repeat FNA (78.0% vs. 54.8%, odds ratio = 2.9, P < .001). When corrected for patient age, appearance on mammogram (mass or not), clinical findings (palpable or not), tumor size, and aspiration mode (freehand vs. image guided), this difference slightly increased (odds ratio = 3.0, P = .001). CNB should be performed after an indeterminate FNA of a breast lesion to obtain a reliable and clear preoperative diagnosis.
    Annals of Surgical Oncology 01/2009; 16(2):281-4. DOI:10.1245/s10434-008-0246-y · 3.94 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Core wash or touch imprint cytology is often used to obtain a quick, preliminary diagnosis on a core needle biopsy (CNB) of breast lesions, essential for the management of the 1-day breast clinic. Contradictory results of both techniques in the literature led to this preclinical study investigating an alternative method of touch imprint and core wash cytology. Thirty breast lesions were biopsied by a core needle in a laboratory setting. The CNBs were collected in RPMI fluid (Roswell Park Memorial Institute fluid). The touch imprint cytology was performed taking the biopsy out of the fluid and smearing it on a microscopic slide and May-Grunwald Giemsa stained. The core wash cytology was made by fixating the remaining cells in Fixcyt and prepared with a liquid-based preparation method and Papanicolaou stained. The cytologic findings were categorized into benign, atypical favoring benign, atypical, suspicious, and malignant and compared with the histologic CNB results. The CNBs showed 20 of 30 samples to be malignant, 2 to be phylloides tumors, 7 to be benign, and 1 to be unsatisfactory. Both techniques showed a sensitivity of 95% and specificity of 100%. Touch imprint yielded insufficient diagnoses (13.3%), compared with core wash (6.6%). Of the core wash cases, 86% showed a good quality versus 30% in touch imprint cytology. This preclinical study on modified touch imprint and core wash techniques led to results that were comparable to or better than those in the literature. The core wash cytology is preferred to touch imprint because of the better morphology.
    Cancer 10/2009; 117(5):333-7. DOI:10.1002/cncy.20047 · 4.90 Impact Factor
Show more