Fine Needle Aspirates-FYI!
Silver Sands Veterinary.com
DonDeForge, VMD Director
DoctorDeForge@yahoo.com
Cancer?
Why Veterinarians Perform Fine Needle Aspirates!
Fine Needle Aspirates –With Informed Consent
Average time for a Cytology report to be available: [1 week]
Histopathology/biopsy surgery occurs only after the completion of the FNA cytology procedure at the pathology laboratory. As with other types of biopsies, the sample collected can help make a diagnosis or rule out conditions such as cancer!
Histopathology: When It's Used
Histopathology is commonly
performed on swellings or lumps located just under the skin if
cytology is not confirmatory of a benign mass.
Not ALL FNA Cytology procedures are
definitive with a complete diagnosis; if a diagnosis is not definitive surgical biopsies or special stains may be needed for diagnosis.
|
|
Early
malignant tumors
can often appear quiet and benign and some can have very slow initial growth
rates. If benign disease is identified, then it does not require removal (other
than rare circumstances when a benign mass is causing discomfort for the
patient). If a malignant process is
diagnosed, oncologist consultation will be advised.
The surgery to remove a known malignant
process is more intensive than one to remove a benign or undiagnosed tumor.
If cancer is not identified using this
technique, have we eliminated the possibility of a cancerous condition? Dr.
DeForge will use his experience and judgment to match the pathology results to
the appearance of the nodule. He will always be available for consultation
concerning the need for further surgical intervention. Board Certified Veterinary Surgeons and
oncologists will round out the
All
dermal nodules
should be tested using FNA Cytology or Surgical Biopsy techniques! Dr. DeForge
generally recommends that all dermal nodules be evaluated by FNA cytology or
histopathology because a patient may have several benign nodules along with a
malignant/cancerous one. Once a nodule has been determined to be benign, it can
be documented on a “patient body map”, a diagram that indicates the location
and diagnosis of cutaneous nodules for future comparison in the event that a
new nodule has been identified.
Exceptions to the “aspirate everything!” rule
are syndromes of multifocal benign skin growths such as benign adenomas of
poodles and terriers or epidermal inclusion cysts of Norwegian Elkhounds. These
patients can develop dozens of papules or nodules that tend to be identical in
appearance and tend to be reliably the same disease. Once such a benign
representative nodule has been diagnosed, you may be asked to monitor for and
report changes in any of the similar lesions. This rule exception should be
used with caution as it does NOT apply to other multifocal benign syndromes. A
patient may have lipomas AND a malignant soft tissue sarcoma or a mast cell
tumor at the same time, in different locations in the skin, and the
visual/textural presentation can be identical between these benign and
cancerous diseases.
If Cytology indicates a cancerous process is present-Histopathological Examination-i.e. Surgical Biopsy evaluation is required to confirm a diagnosis and determine if adequate margins were achieved. Misdiagnosis with FNA cytology is a possible disadvantage (malignant tumors misdiagnosed as benign have been reported in approximately 1/3 of skin nodules that were diagnosed as benign via cytology in one study), but this is a less common event when Dr. DeForge works together with the clinical pathologist to provide the most accurate diagnosis possible. Histopathology biopsy is the gold standard in dermal mass diagnosis.
Cytology is
non-invasive and is frequently recommended as the initial testing procedure.
Comments
Post a Comment