Abstract :
Introduction: Fine needle aspiration cytology (FNAC) is a valuable diagnostic tool in evaluation of mass
lesions. One of the major limitations of FNAC is the need for repeat aspiration which imposes workload on
the laboratory and stress on the patient as well as on the aspirator. There are only few studies which have
focused on the issue of repeat aspiration especially the factors associated with repeat FNAC.
Aim: Present study was conducted with the aim to determine the factors associated with repeat FNAC.
Materials and Methods: This was a retrospective, analytical laboratory audit of 350 repeat FNAC over a
duration of two years. Age, sex, site of FNAC, reasons for repeat and outcome of repeats were recorded.
Reason for repeat and final outcome of repeat FNAC were considered as outcome measures.
Results: Repeat FNAC accounted to 20.94% (350/1671) of all FNAC performed. Maximum number of
repeat FNAC were from thyroid 96/351 (27.4%) followed by soft tissue 86 (24.6%) and breast 81(23.1%).
The outcome of repeat FNAC were diagnostic in 279 (79.7%), non-diagnostic 47 (13.4%) and loss of
patient follow-up in 24 (6.9%) cases. Reasons for repeat were inadequate aspirates in 223 (63.7%), nonrepresentative
material in 118 (33.7%) and suspicious cells to be repeated in 9 (2.6%). Logistic regression
analysis revealed that organ of FNAC, month of FNAC and reason for repeat FNAC were independent
variables linked with outcome of FNAC.
Conclusion: FNAC as an investigative modality has immense diagnostic utility and this potential is fettered
by inadequate aspirates and descriptive reporting in certain cases. The tricky cases were often encountered
in thyroid, soft tissue and breast lesions. Regular audit of repeat FNACs gives us an insight into conditions
where a diligent and meticulous approach is required.
Keyword :
Fine needle aspiration, Cytology cytology in low resource setting.