FNAC Test in Gomti Nagar, Lucknow

FNAC stands for fine needle aspiration cytology. A needle about as thin as an injection needle is passed into the lump, and a syringe draws out a few cells. Cytology is the study of cells, so a pathologist spreads them on glass slides, stains them and looks at them under a microscope.

The test can tell a fluid-filled cyst from a solid mass. It can show whether a swollen gland is reacting to an infection, and whether a nodule in the thyroid looks harmless or needs more tests. Many lumps turn out to be harmless, but a sample is often needed to be sure. FNAC is most often used for:

• Thyroid nodules: lumps in the thyroid gland at the front of the neck.
• Lymph nodes: swollen glands in the neck, armpit or groin.
• Soft-tissue lumps: swellings under the skin, such as a lump on the scalp, arm or back.
• Salivary gland swellings and other lumps in the neck.

For lumps in the breast, see breast FNAC. The breast care team handles them together with the scans that go with them.

FNAC suits lumps that lie close to the skin and are big enough to feel. It is quick, needs no stitches and carries a low risk of bleeding.

It is less suitable in some situations. A lump that is deep, very small or hard to feel is better sampled with ultrasound guidance, so the needle can be watched on a screen. Some conditions need the pathologist to see how the tissue is arranged, not only the cells, and your doctor then asks for a biopsy instead.

Not every lump needs sampling. The team reads your referral and scans, confirms that FNAC is the right test and says whether it can be done at the centre. The team will tell you when you book.

The report describes the cells that were seen. It is not a final verdict until your doctor reads it with your examination and scans. Most reports fall into one of four groups.

• Benign: the cells look harmless, for example a cyst or a simple enlarged gland. Your doctor may advise watching it or repeating a scan later.
• Inflammatory or infective: the cells point to inflammation or infection. Extra tests may be needed to find the cause, and treatment depends on it.
• Suspicious or malignant: abnormal cells that suggest cancer are seen. Your doctor usually advises further tests, such as a core biopsy, to confirm the type before any treatment.
• Not enough cells: the sample did not contain enough cells to decide. This is not a bad result. The test is usually repeated, sometimes with ultrasound guidance.

Thyroid reports often use a graded scale called the Bethesda system. Some nodules fall into an in-between group where the cells can be called neither clearly harmless nor clearly abnormal. Your doctor explains what that means for you.

A benign result is reassuring but not always the last word. FNAC can miss a small abnormal area, so a lump that keeps growing may still need a second look.

Both tests use a needle, but they collect different material and answer different questions. Your doctor chooses between them.