CT Guided Fine Needle Aspiration (FNAC)

[helpmom07]

Hi,

My 69 year old mom had CT and PET scans done very recently.  The PET showed a left lung ovoid mass of ~3.8x2.3cm (SUV 4.1) - a suspicision of adenocarcinoma.  She will be going through the FNAC in a couple of days to get the biopsy. We are very nervous to have her do this procedure because I've heard that 1) there is risk of spreading the possible cancer as the needle is pulled out and contaminate the trail  2) bleeding (and thus spreading the cancer to other parts of the body) 3) air leak which may cause frequent pain in the area going forward.  What are your thoughts on the above concerns we have?  Is the procedure considered safe and effective?  Will this procedure find out the origin of the cancer (say the mass is in the lung but actually originated from the ovary)?  

Thanks so much for your input!

[subshr]

Kindly advise the outcome of the test and present status

[helpmom07]

Thank you Dean536 and DrGodofredoMD, I appreciate your helpful comments!

[Fernando Roque, MD]

Hi.  The concerns you raised regarding the safety of fine needle aspiration are all valid.  Aside from the air leak, which DrGodofredoMD has already discussed, there is also a possibility of bleeding and of cancer spread.  Bleeding can be avoided as long as certain serum parameters, such as the prothrombin time, is checked (and corrected if abnormal) before the procedure is done.  There is always a risk of cancer spread along the tract made by the needle, but this is extremely small (less than 0.5%).

[Godofredo MD]

Hi.

The only main complication that can happen during fine needle aspiration of the lung is leakage of air from the lung, causing the lung to partially collapse. This occurs in approximately 20 percent of patients who have needle biopsy of the lung, but it is usually only a small amount of air leakage that does not require any treatment.

Depending on whether the mass is benign or malignant, and the histopathological presentation, it might provide clues as to the origin of the tumor, in the unfortunate event that it is a metastasis.

Hope this helps.