 My name is Dr. Vishal Kumar. I hail from Nasek. This is my peripheral center at Jagatpuri. My expertise are ultrasound and guided injections. Today I will be speaking on ultrasound guided FNA and its uses and how it is performed. Thank you. Now we just see what are the instruments which we require for an FNA. Here we can see there is a needle and a syringe. Syringe is fiamol. Needle is specifically 23 or 24 gauge. In this case this is a 23 gauge needle and one and a half inch in size. Okay. Inches we don't cut. Indians are not used to inches. So it's around 3.8 centimeters. So it's a 23 gauge 3.8 around 4 centimeters in length. Okay. So you know where you can take this needle for a lesion FNA. These are glass slides where we will take the sample of the FNA and smear upon it. This is alcohol based solution. Basically it is a cytospray which is used to stain the slides and make them alcohol dry. This is again a lignokine jelly solution which I use as an apposition for my probes so that I can see the lesion properly. This is a bandaid. These are some gauze pieces. This is a very important aspect of an FNA. This is a slide holding or a coupling jar where we transport the slides from the site where we do the FNA to the histopathology lab. The first case is a very interesting case. This is a case of male breast which is enlarged. And on ultrasound the working diagnosis was generating mastitis. You can easily see this hypoechoic area in the region of subarular part of the nipple and multiple tentacles going away from this area. So I think this most likely is male gynecomastia. I was requested by the gynecologist to just get an FNA to confirm what it is. Now we are going to do an FNA for this male gynecomastia that is dendritic mastitis lesion. Okay. I am going to enter the lesion from the medial aspect of the subarular region. Okay. I am just entering. One more thing I want to tell. I am not using any local anesthesia. I am directly doing the FNA just to avoid two needles. So only one needle I will be using. What I am doing is smearing whatever material I have collected in the needle onto the slides. And with the help of this another slide just 180 degrees. Smear it off. Smear it. Smear it like this. Okay. Spraying this with the Algon solution. Let us take it. So this is case 4, second FNAC and the last of what the interventions we are going to do today. This is a young girl who has a large three and a half centimeter lymph node just next to the left submandibular gland. Okay. What are the clinching points? There are multiple calcific densities within the node. So chances of it being infective like cox are pretty high. But it is very much stuck to the left submandibular. So we need to get a good window to do an FNA from the most important part of the node so that we get a good cytological yield. I think we will do this FNA again because we have not got too much material. Okay. We did this. We have run the FNA for this girl before but we could not get good diagnostic material. Okay. In such cases the node might be a little solid tightly packed. So what do we do? We can put some aspiration method, put some back pressure in the syringe so that cells get accumulated in the needle. Okay. We will do that. Hello Naka. Is it done? Hello Naka. Putting some back pressure on the syringe so that I can get some more material than what I did last day. Okay. The slide is ready. Putting it into the copling jar, packing it off and this will directly go to the cytological treatment.