Fine Needle Biopsy
(FNB)
Definition
A fine needle biopsy (FNB) uses a thin, hollow needle to remove a small tissue sample from an organ or tumor. Once the sample has been removed, a trained health professional will examine it for any abnormal cells, disease, cancer, or infection.
A common type of FNB is a fine needle aspiration (FNA), which removes fluid and cells through a syringe attached to the needle. The procedure for FNA and FNB is basically the same, and they are sometimes done together. Depending on the biopsy site, an ultrasound or a computed tomography (CT) scan may be used to help guide the needle to the exact biopsy location.
Needle Biopsy
© 2008 Nucleus Medical Art, Inc.
Parts of the Body Involved
Fine needle biopsies can be obtained from organs or tumors in many parts of the body. Common sites include:
- Breast
- Kidney
- Liver
- Lung
- Pancreas
- Prostate
- Thyroid
- Ovary
- Lymph Nodes
Reasons for Procedure
Fine needle biopsy is a diagnostic tool used to evaluate organ or tumor tissue. It is also sometimes used to evaluate how certain treatments are working.
Risk Factors for Complications During the Procedure
Complications from a fine needle biopsy/aspiration are uncommon. The type and severity of complication depends on the location of the biopsy. The most common complication is bleeding, which is monitored closely after the procedure. To minimize risk, all pre-procedure instructions should be followed.
What to Expect
Prior to Procedure
A fine needle biopsy or aspiration can be performed in a doctor’s office or in the hospital. The part of the body being sampled will determine where the procedure takes place. Surface biopsies close to the skin are simpler and are often performed in a physician’s office. Biopsies that are deeper in the body or require the guidance of ultrasound or CT are performed in a hospital.
Ask your doctor if there are any instructions you should follow before the procedure. Depending on the part of the body that the biopsy is being taken from, your doctor may order some or all of the following:
- Do not take aspirin or aspirin substitutes for three days to one week before the procedure.
- Do not eat for a specified time before the procedure.
- Drink contrast dye.
- Have routine blood work.
- Stop anticoagulants (blood thinning medication) for a specified time.
- Arrange for a ride home.
Anesthesia
A local anesthetic is used to numb the area where the needle will be inserted. Sedative medication may also be used.
Description of the Procedure
The doctor will position you for easiest access to the area for biopsy. The skin will be swabbed with a cleaning solution and may be draped with surgical towels. A local anesthetic will be applied to numb the area. You will be asked to stay still during the procedure. A thin, hollow needle will then be inserted through the skin to the biopsy site. The needle may be inserted more than once for positioning or to obtain multiple samples. Once the needle is in the proper position, tissue or fluid will be withdrawn for examination. You may feel a pinch, pressure, or nothing at all.
After the Procedure
Depending on where the biopsy was taken, you may be monitored for bleeding or other complications. The site will be bandaged, and you will be given follow-up instructions.
How Long Will It Take?
A simple in-office biopsy generally takes a few minutes. A deeper biopsy or one that is ultrasound- or CT scan-guided generally takes 30-90 minutes.
Will It Hurt?
The level of discomfort depends in large part on which part of the body is being examined. Local anesthesia and sedation are used to prevent discomfort. You may feel a pinch, pressure, or some discomfort. If the procedure proves painful, tell your doctor at once. There may be some tenderness at the insertion site after the procedure.
Possible Complications
Bleeding is the most common complication. You may see a small amount of blood in your sputum (secretions from the airways) after a lung needle biopsy or blood in your urine after a kidney biopsy. There is a risk for a pneumothorax , which is an air leak in lung biopsies. You may also develop a bruise at the site of needle insertion. In addition, you may experience some pain after the procedure, which is usually relieved by mild painkillers. Infection is rare, but if it occurs, antibiotics may be given.
Average Hospital Stay
Fine needle biopsies are performed on an outpatient basis (during a clinic visit).
Postoperative Care
Your doctor will provide you with specific instructions for care after the biopsy based on where it was performed. General instructions include monitoring the insertion site and keeping it clean.
RESOURCES:
American Family Physician
http://www.aafp.org
National Institutes of Health
http://www.nih.gov
CANADIAN RESOURCES:
Saskatoon Health Region
http://www.saskatoonhealthregion.ca/your_health/tp_angio_pi_fn_lung.htm
References:
Fine needle aspiration. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.aaohns.org . Accessed October 23, 2007.
Fine needle aspiration. American Family Physician website. Available at: http://www.aafp.org . Accessed October 23,2007.
Preparing for a needle aspiration biopsy. National Institutes of Health (NIH) website. Available at: www.cc.nih.gov/ccc/patient_education/pepubs/needle.html. Accessed October 23, 2007.
Zaret BL, Jatlow PI, and Katz LD. The Yale University School of Medicine Patient’s Guide to Medical Tests . New York: Houghton Mifflin Company; 1997.
Last reviewed October 2007 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.
