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prostate fine needle aspiration

Wednesday 8 February 2012

Fine needle aspiration cytology, prostate FNA

Before the era of transrectal core biopsies, prostate cancer was traditionally diagnosed by fine needle aspiration (FNA).

FNA is still used in some countries and has some advantages. The technique is cheap, quick, usually relatively painless and has low risk of complications.

In early studies comparing FNA and limited core biopsy protocols, the
sensitivity of FNA was usually found to be comparable with that of core biopsies.

However, the use of FNA for diagnosing prostate cancer has disadvantages.

Potential sources of false positive diagnosis with FNA are inflammatory atypia, prostatic intraepithelial neoplasia and contamination of seminal vesicle epithelium.

Gleason grading, which is essential for the clinician, is based on the histological architecture of glands and cannot be applied on cytology.

Core biopsies, unlike FNA, provide information about tumour extent and occasionally about extra-prostatic extension and seminal vesicle invasion.

Before treatment of localized prostate cancer, the diagnosis should, therefore, be confirmed by core biopsies.

See also

- prostate cancer