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Infarction after fine needle aspiration. A report of four cases
R G Pinto1, F Couto, S Mandreker
1Pathology Department, Goa Medical College, Bambolim, India.
Background:
Fine needle aspiration (FNA) is a well-established and safe method for the rapid diagnosis of palpable and deep-seated masses. A few clinically important complications, including bleeding, pneumothorax, infection and inflammatory reactions, result from FNA. Little attention has been focused on tissue changes resulting from FNA. In a small number of cases FNA has been followed by varying degrees of necrosis. This has occurred in thyroid nodules, salivary glands, breast fibroadenomas, lymph nodes and renal cell carcinoma.
Cases:
Four cases of infarction followed FNA biopsy. All 4 (1 papillary carcinoma of the thyroid, 1 pleomorphic adenoma of the parotid gland and 2 fibroadenomas of the breast) were diagnosed by FNA. Subsequent histologic study of the surgical specimens revealed massive necrosis of the neoplasms.
Conclusion:
Necrosis associated with infarction may cause diagnostic problems in two settings. FNA yielding necrotic debris may result in a false negative diagnosis in repeat aspiration. Alternatively, post-FNA infarction may obscure the nature of a neoplasm diagnosed by FNA, making histologic confirmation difficult.
Insights
Fine needle aspiration (FNA) can cause tissue necrosis, potentially leading to misdiagnosis. This study highlights how post-FNA infarction complicates accurate cancer diagnosis and treatment planning.
Area of Science:
- Pathology
- Oncology
- Diagnostic Imaging
Background:
- Fine needle aspiration (FNA) is a standard diagnostic tool for various masses.
- While generally safe, FNA can rarely cause complications like bleeding and infection.
- Tissue changes, specifically necrosis, following FNA have received limited attention.
Observation:
- Four cases demonstrated infarction after FNA biopsy.
- Diagnoses included papillary thyroid carcinoma, parotid gland pleomorphic adenoma, and breast fibroadenomas.
- Histologic examination of surgical specimens revealed extensive necrosis in these neoplasms.
Findings:
- Post-FNA infarction can lead to diagnostic challenges.
- Necrotic debris from FNA may result in false-negative diagnoses on repeat aspirations.
- Infarction can obscure the original nature of a neoplasm, complicating histological confirmation.
Implications:
- Awareness of post-FNA infarction is crucial for accurate pathological interpretation.
- Clinicians should consider infarction as a potential cause of diagnostic discrepancies after FNA.
- This phenomenon may necessitate careful review of FNA findings and consideration of alternative diagnostic pathways.