 Hello everyone, in this video we shall be discussing short note on fine needle aspiration cytology. Fine needle aspiration cytology or FNAC is a technique whereby the cells are obtained from a lesion using a thin bore needle and snares are made for cytopathology diagnosis. This technique is based on the principle that the tumor cells are less cohesive and are easily aspirated through the thin needle. This technique is usually used in the diagnosis of breast lumps, thyroid nodules, liver disease, subcutaneous soft tissue mass, salivary gland diseases and other oral diseases. Let's see what are the advantages of FNAC. It is a very simple office technique which gives a rapid diagnosis. This technique is economical and sampling can be made from multiple sites in the same setting. Also it has a high diagnostic accuracy. Many techniques such as bacterial culture, immunocytochemistry, flow cytometry, cytogenetics, PCR reactions, all these tests are possible from FNAC material. As you all know oral cavity is a site where mucosa is very vascular and an open biopsy leads to a lot of bleeding which is difficult to control. So in recent times FNAC has solved all these problems. Adequate material can be easily obtained by using a 10 ml syringe from an incroyoral or extraoral site without much discomfort to the patient and with less or no bleeding. In some cases a subsequent surgery is not needed and the patient can be put on appropriate treatment. Also FNAC report is prepared within 24 hours of sampling so this gives an early quick information to the surgeon about the type of lesion he is dealing with. What are the limitations of this technique? FNAC will lead to loss of tissue architecture of the lesion. So capsular invasions and lymphovascular invasions in case of malignancy and metastasis cannot be detected. It is difficult to differentiate in C2 lesions versus invasive cardcinoma by FNAC. Also considerable cloning is needed for accurate interpretation of the result. Let's see what are the various applications of FNAC. This technique was initially used as a means to confirm a clinical suspicion of local recurrence of metastasis of known cancer without subjecting the patient to further surgical intervention. Inflammation, infection, degenerative conditions in diagnosis and monitoring of graft rejection in transplantation surgery can be performed using this technique. This technique is also an alternative or complement to frozen section. Also it is an intra-operative cytology, so these are the various applications of FNAC. The equipments required for FNAC are very simple. You need needles, routinely 22-23 gauge needles are used, syringes of about 20 ml, a pistol handle, sterile container which contains physiological saline or hang's balance solution. You need slides which are clean, dry and free of any disease. Situatives such as 70-90% ethanol, carnois fixative solution, 10% buffered pormalin and glucose aldehyde are commonly used. These are the commonly used fixative agents. You also require certain stains and a microscope. These are the basic equipments required for fine needle aspiration cytology. Basically there are two techniques of performing FNAC, FNAC with aspiration and FNAC without aspiration. In FNAC with aspiration, the needle is introduced into the swelling and is gently moved to and fro. Simultaneously, negative suction is also created by withdrawing the piston. So this aspiration is similar to that while performing a local anesthesia. So by withdrawing the piston behind, you can create a negative suction within this syringe. In FNAC without aspiration, you don't aspirate it, so you don't require a syringe for FNAC without aspiration. This is based on the observation that the capillary pressure in a fine needle itself is sufficient to keep the detached cell inside the lumen of the needle. So this is the basic difference between the two techniques. In the first technique, you perform aspiration similar to that you perform while administering local anesthesia. And in FNAC without aspiration, the capillary pressure within the fine needle itself will perform the action of aspiration. You don't need to do it yourself. Here are some of the names of stains used for FNAC. Papanikolaus stain, verminoski skin, Maidenvault, Giemsa stain, Paz and Zilnitsyn. These are the commonly used stains for FNAC. About the complications of FNAC, this technique is usually free of any complications. Rarely, bleeding and hematoma can occur and very rarely, even emphysema in lung can occur. Another rare reaction of this technique is an apylaxis. It is mainly due to accidental rupture of chiropractic system. So that's all about this topic. Hope you have got suction points to complete a short knot on FNAC. Thanks for watching.