Fine Needle Aspiration Biopsy in The

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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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