Unusual Findings With Imaging-Guided Fine Needle Aspiration

For deep-seated lesions, fine needle aspiration (FNA) under imaging guidance may be crucial to secure material for definitive diagnosis and further management. Rarely, components other than cells and tissue fragments may be visualized upon microscopic scrutiny following biopsy. These findings may lead to confusion in diagnosis. We describe two cases in which refractile foreign materials caused diagnostic challenges. The material in the first case turned out to be barium crystals left at a prior procedure for imagining study. The material in the second case was most likely starch-based material the patient aspirated or inhaled. These two cases highlight the importance of attention to details and judicious use of polarized microscopy.