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🧪 What is FNAC (Fine Needle Aspiration Cytology)?

FNAC is a minimally invasive diagnostic procedure used to extract a small sample of cells from a lump, mass, or organ using a thin, hollow needle (usually 22–25 gauge) for cytological analysis.

The goal is to examine individual cells and cell clusters, not tissue architecture.
FNAC is often guided by palpation, ultrasound, or CT for accuracy.

❓ Why is FNAC Done?

To:

Diagnose the nature of a lump or swelling (e.g., thyroid nodule, breast lump, lymph node)
Differentiate between benign and malignant conditions
Evaluate infections (e.g., tubercular lymphadenitis, abscesses)
Guide further biopsy or treatment decisions
Monitor recurrence or response to treatment in known cancers

📍 Common Sites for FNAC

Site	Common Indications
Thyroid	Nodules, goiter, suspected carcinoma
Breast	Lump, fibroadenoma, carcinoma
Lymph nodes	Tuberculosis, lymphoma, metastasis
Salivary glands	Parotid swelling, pleomorphic adenoma
Liver / Lung / Abdomen	Guided FNAC for masses or suspected metastases
Soft tissue or skin nodules	Lipoma, cyst, sarcoma, abscess

📊 Normal Range

There is no "normal value" for FNAC — it is a qualitative test. The report provides cytological diagnosis, which may include:

Benign
Suspicious for malignancy
Malignant
Inconclusive / inadequate sample
Inflammatory / Infective

📈 Interpretation of FNAC Results

Report Category	Meaning
Adequate, benign cytology	Suggests non-cancerous lesion (e.g., fibroadenoma, colloid goiter, lipoma)
Atypical / Suspicious	Needs follow-up with biopsy or repeat FNAC
Malignant cells present	Suggests cancer (e.g., carcinoma, lymphoma, metastasis)
Granulomatous inflammation	May indicate tuberculosis or sarcoidosis
Purulent / Abscess	Indicates infection
Inadequate sample	Repeat procedure may be needed

🧠 Associated Organs and Conditions

Organ/System	Conditions Diagnosed via FNAC
Thyroid	Colloid goiter, thyroiditis, papillary carcinoma
Breast	Fibroadenoma, carcinoma
Lymph nodes	Reactive hyperplasia, tuberculosis, lymphoma, metastasis
Liver	Hepatocellular carcinoma, metastasis
Lung	Primary lung carcinoma, TB
Skin/Subcutis	Lipoma, sebaceous cyst, soft tissue sarcoma

🔄 Related / Follow-Up Tests

Histopathology / Biopsy – To confirm FNAC findings or if result is suspicious
Ultrasound / CT guidance – For deep or non-palpable lesions
AFB stain / PCR – For suspected TB (esp. in granulomatous lymphadenitis)
Immunocytochemistry – To subtype cancers (e.g., lymphoma, carcinoma)
Molecular tests / FISH / Genetic panels – In advanced oncological workup

✅ Fasting Required?

Requirement	Answer
Fasting Required?	❌ Not required for most FNAC procedures. ✅ May be advised if FNAC is done under anesthesia or sedation or involves viscera (liver, pancreas) where bleeding risk is evaluated.

📝 Summary

Parameter	Summary
What	Minimally invasive aspiration of cells using a thin needle for cytological diagnosis
Why	To evaluate lumps/masses, differentiate benign from malignant, guide treatment
Common Sites	Thyroid, breast, lymph nodes, liver, salivary glands
Results Categories	Benign, malignant, suspicious, inflammatory, inadequate
Associated Conditions	Cancer, TB, benign nodules, reactive lymphadenitis
Follow-up	Biopsy, imaging, AFB stain, IHC, molecular testing
Fasting Required	❌ No (except for some deep organ FNACs or procedures under sedation)

FNAC

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