WordNet

thin in thickness or diameter; "a fine film of oil"; "fine hairs"; "read the fine print"
money extracted as a penalty (同)mulct, amercement
characterized by elegance or refinement or accomplishment; "fine wine"; "looking fine in her Easter suit"; "a fine gentleman"; "fine china and crystal"; "a fine violinist"; "the fine hand of a master"
free from impurities; having a high or specified degree of purity; "gold 21 carats fine"
minutely precise especially in differences in meaning; "a fine distinction"
of textures that are smooth to the touch or substances consisting of relatively small particles; "wood with a fine grain"; "fine powdery snow"; "fine rain"; "batiste is a cotton fabric with a fine weave"; "covered with a fine film of dust"
have or feel a need for; "always needing friends and money"
a condition requiring relief; "she satisfied his need for affection"; "God has no need of men to accomplish His work"; "there is a demand for jobs" (同)demand
anything that is necessary but lacking; "he had sufficient means to meet his simple needs"; "I tried to supply his wants" (同)want
prick with a needle
a sharp pointed implement (usually steel)
a slender pointer for indicating the reading on the scale of a measuring instrument
goad or provoke,as by constant criticism; "He needled her with his sarcastic remarks" (同)goad
propel oneself through the water in a finning motion
a stabilizer on a ship that resembles the fin of a fish
organ of locomotion and balance in fishes and some other aquatic animals
show the fins above the water while swimming; "The sharks were finning near the surface" (同)break water
equip (a car) with fins
a will to succeed
a manner of articulation involving an audible release of breath

PrepTutorEJDIC

罰金 / 〈人〉‘に'罰金を科する:
(物・事が)『りっぱな』,みごとな;けっこうな.満足できる / (人が)『優れた』,りっぱな / (天気が)『晴れた』,気持ちのよい / 《補語にのみ用いて》《話》『元気な』,健康な(well) / (人・衣服・態度などが)『洗練された』,いきな,上品な(refined) / (粒・きめなどの)細かい;細い(thin) / 《名詞の前にのみ用いて》微妙な(delicate) / 精巧な / (物が)混じりけのない,(金・銀などが)純度…の / (言葉が)華美な / 《名詞の前にのみ用いて》《皮肉に》けっこうな,ごりっぱな / 細かく / 《話》りっぱに,うまく
〈U〉《時にa~》『必要』,入用 / 〈C〉《しばしば複数形で》『必要なもの』,(…の)必要品《+『for』+『名』》 / 〈C〉(…に対する)欲求,切望《+『for』+『名』》 / 〈U〉(…の)『困窮』,欠乏,不足《+『of』(『for』)+『名』》 / 〈U〉『困った時』(『事態』),まさかの時 / …‘を'必要とする,要する / 《疑問文・否定文,また疑問・否定の内容を表す文で》…『する必要がある』,しなければならない / 《need not have doneの形で》…する必要はなかったのに
『針』,縫い針;(編物用の)かぎ針,編み棒 / (レコードプレーヤーの)針;(磁石・らしん盤など各種計器の)針 / 外科用の針(縫合針など);注射針 / 針状のもの;小尖塔(しょうせんとう);とがった山頂 / (マツ・モミなどの)針葉 / …‘を'針で縫う(編む);…‘に'針を通す / (…のことで)〈人〉‘をいじめる,脳ます《+『名』+『about』+『名』(do『ing』)》;〈人〉‘を'いじめて(…)させる《『名』+『into』do『ing』》 / 縫い物(編物)をする
(魚などの)ひれ / (形・働きが)ひれに似た物 / (飛行機の)垂直安定板 / 《話》手,腕
大望,熱望 / 呼気,呼吸 / 気音を伴って発音すること(例:penの[p],killの[k])

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/30 04:05:48」(JST)

wiki en

Fine-needle aspiration biopsy (FNAB, FNA or NAB), or fine-needle aspiration cytology (FNAC), is a diagnostic procedure used to investigate superficial (just under the skin) lumps or masses. In this technique, a thin, hollow needle is inserted into the mass for sampling of cells that, after being stained, will be examined under a microscope. There could be cytology exam of aspirate (cell specimen evaluation, FNAC) or histological (biopsy - tissue specimen evaluation, FNAB).^[1] Fine-needle aspiration biopsies are very safe, minor surgical procedures. Often, a major surgical (excisional or open) biopsy can be avoided by performing a needle aspiration biopsy instead. In 1981, the first fine-needle aspiration biopsy in the United States was done at Maimonides Medical Center, eliminating the need for surgery and hospitalization. Today, this procedure is widely used in the diagnosis of cancer and inflammatory conditions.^[2]

A needle aspiration biopsy is safer and less traumatic than an open surgical biopsy, and significant complications are usually rare, depending on the body site. Common complications include bruising and soreness. There is a risk, because the biopsy is very small (only a few cells), that the problematic cells will be missed, resulting in a false negative result. There is also a risk that the cells taken will not enable a definitive diagnosis.

Applications

This type of sampling is performed for one of two reasons:

A biopsy is performed on a lump or a tissue mass when its nature is in question.
For known tumors, this biopsy is performed to assess the effect of treatment or to obtain tissue for special studies.

When the lump can be felt, the biopsy is usually performed by a cytopathologist or a surgeon. In this case, the procedure is usually short and simple. Otherwise, it may be performed by an interventional radiologist, a doctor with training in performing such biopsies under x-ray or ultrasound guidance. In this case, the procedure may require more extensive preparation and take more time to perform.

Also, fine-needle aspiration is the main method used for chorionic villus sampling,^[3] as well as for many types of body fluid sampling.

It is also used for ultrasound-guided aspiration of breast abscess,^[4] of breast cysts, and of seromas.^[5]

Preparation

Several preparations may be necessary before this procedure.

No use of aspirin or non-steroidal anti-inflammatory medications (e.g. ibuprofen, naproxen) for one week before the procedure;
No food intake a few hours before the procedure;
Routine blood tests (including clotting profile) must be completed two weeks before the biopsy;
Suspension of blood anticoagulant medications;
Antibiotic prophylaxis may be instituted.

Before the procedure is started, vital signs (pulse, blood pressure, temperature, etc.) may be taken. Then, depending on the nature of the biopsy, an intravenous line may be placed. Very anxious patients may want to be given sedation through this line. For patients with less anxiety, oral medication (Valium) can be prescribed to be taken before the procedure.

Procedure

A physician's hands are seen performing a needle biopsy to determine nature of lump either fluid-filled cyst or solid tumor.

The skin above the area to be biopsied is swabbed with an antiseptic solution and draped with sterile surgical towels. The skin, underlying fat, and muscle may be numbed with a local anesthetic, although this is often not necessary with superficial masses. After locating the mass for biopsy, using x-rays or palpation, a special needle of very fine diameter is passed into the mass. The needle may be inserted and withdrawn several times. There are many reasons for this:

One needle may be used as a guide, with the other needles placed along it to achieve a more precise position.
Sometimes, several passes may be needed to obtain enough cells for the intricate tests which the cytopathologists perform.

After the needles are placed into the mass, cells are withdrawn by aspiration with a syringe and spread on a glass slide. The patient's vital signs are taken again, and the patient is removed to an observation area for about 3 to 5 hours.

For biopsies in the breast, ultrasound-guided fine needle biopsy is the most common.

Post-operative care and complications

As with any surgical procedure, complications are possible, but major complications due to thin needle aspiration biopsies are fairly uncommon, and when complications do occur, they are generally mild. The kind and severity of complications depend on the organs from which a biopsy is taken or the organs gone through to obtain cells.

After the procedure, mild analgesics are used to control post-operative pain. Aspirin or aspirin substitutes should not be taken for 48 hours after the procedure (unless aspirin is prescribed for a cardiac or neurological condition). Since sterility is maintained throughout the procedure, infection is rare. But should an infection occur, it will be treated with antibiotics. Bleeding is the most common complication of this procedure. A slight bruise may also appear. If a lung or kidney biopsy has been performed, it is very common to see a small amount of blood in sputum or urine after the procedure. Only a small amount of bleeding should occur. During the observation period after the procedure, bleeding should decrease over time. If more bleeding occurs, this will be monitored until it subsides. Rarely, major surgery will be necessary to stop the bleeding.

Other complications depend upon the body part on which the biopsy takes place:

Lung biopsies are frequently complicated by pneumothorax (collapsed lung). This complication can also accompany biopsies in the upper abdomen near the base of the lung. About one-quarter to one-half of patients having lung biopsies will develop pneumothorax. Usually, the degree of collapse is small and resolves on its own without treatment. A small percentage of patients will develop a pneumothorax serious enough to require hospitalization and placement of a chest tube for treatment. Although it is impossible to predict in whom this will occur, collapsed lungs are more frequent and more serious in patients with severe emphysema and in patients in whom the biopsy is difficult to perform.
For biopsies of the liver, bile leakages may occur, but these are quite rare.
Pancreatitis (inflammation of the pancreas) may occur after biopsies in the area around the pancreas.
In biopsies in the area of the breast, bleeding and bruising may occur, less frequently also infection (rarely) or (very rarely, and only if performed near the chest wall) pneumothorax.
Deaths have been reported from needle aspiration biopsies, but such outcomes are extremely rare.

Criticism

A recent study showed that in one case a needle biopsy of a liver tumor resulted in spread of the cancer along the path of the needle, and concluded that needle aspiration was dangerous and unnecessary. The conclusions drawn from this paper were strongly criticized subsequently.^[6]

Current findings

A recent study introduced a technology that allows analysis of hundreds of proteins from minimally invasive fine-needle aspirates. The method capitalizes on DNA-barcoded antibody sensing, where barcodes can be photocleaved and digitally detected without any amplification steps. The method showed high reproducibility and achieved single-cell sensitivity. Other than profiling cancer cells, the method could also be used as a clinical tool to identify pathway responses to molecularly targeted drugs and to predict drug response in patient samples. ^[7]

References

^ http://www.indepreviews.com/article/2011/vol-13-no-1/006-084-FINE-NEEDLE-ASPIRATION-CYTOLOGY-%28F-N-A-C%29.pdf
^ http://www.maimonidesmed.org/Main/CultureofInnovation.aspx, First US Procedure
^ Chorionic villus sampling and amniocentesis: information for you from Royal College of Obstetricians and Gynaecologists. Date published: 01/06/2006
^ Trop I, Dugas A, David J, El Khoury M, Boileau JF, Larouche N, Lalonde L (October 2011). "Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up". Radiographics : a Review Publication of the Radiological Society of North America, Inc (review) 31 (6): 1683–99. doi:10.1148/rg.316115521. PMID 21997989.
^ Department of Pathology University of Massachusetts Medical School (Emeritus) Guido Majno Professor; Department of Pathology University of Massachusetts Medical School (Emerita) Isabelle Joris Associate Professor (12 August 2004). Cells, Tissues, and Disease : Principles of General Pathology: Principles of General Pathology. Oxford University Press. p. 435. ISBN 978-0-19-974892-1.
^ "bmj.com". Retrieved 2010-03-14.
^ Ullal AV, Peterson V, Agasti SS, et al. (Jan 2014). "Cancer cell profiling by barcoding allows multiplexed protein analysis in fine-needle aspirates.". Sci Transl Med. 6 (219): 219. doi:10.1126/scitranslmed.3007361. PMC 4063286. PMID 24431113.

Originally adapted from Preparing for a needle aspiration biopsy (634 KB). Public domain text of the National Institutes of Health Warren Magnuson Grant Clinical Center.
Video showing ultrasound-guided fine needle biopsy

External links

Aspiration Biopsy, Fine-Needle at the US National Library of Medicine Medical Subject Headings (MeSH)

Breast

-462749619 at GPnotebook - "fine needle aspiration cytology (breast)"

Lung

MedlinePlus Encyclopedia 003860 - "Lung needle biopsy"

Neck

ent/561 at eMedicine - "Fine-Needle Aspiration of Neck Masses"
MedlinePlus Encyclopedia 003899 - "Thyroid nodule fine needle aspirate"

Bone

MedlinePlus Encyclopedia 003658 - "Bone marrow aspiration"
med/2971 at eMedicine - "Bone Marrow Aspiration and Biopsy"

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 甲状腺結節の診断的アプローチおよび治療 diagnostic approach to and treatment of thyroid nodules
2. 経皮的生検、穿刺吸引生検、および腹腔鏡下肝生検 percutaneous fine needle aspiration and laparoscopic liver biopsy
3. 乳房生検 breast biopsy
4. 消化管における超音波内視鏡ガイド下での穿刺吸引生検 endoscopic ultrasound guided fine needle aspiration biopsy in the gastrointestinal tract
5. 甲状腺細胞病理学のアトラス atlas of thyroid cytopathology

English Journal

Elevated blood β-2 microglobulin is associated with tumor monosomy-3 in patients with primary uveal melanoma.

Triozzi PL, Elson P, Aldrich W, Achberger S, Tubbs R, Biscotti CV, Singh AD.SourceaTaussig Cancer Institute bQuantitative Health Sciences cDepartment of Molecular Pathology dDepartment of Anatomic Pathology eCole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Melanoma research.Melanoma Res.2013 Feb;23(1):1-7. doi: 10.1097/CMR.0b013e32835b7154.
Prognostic blood biomarkers for patients with uveal melanoma have not been identified. Tumor monosomy-3 is strongly associated with the development of metastatic disease. Tumor expression of human leukocyte antigen class I molecules and insulin-like growth factor (IGF)-1 receptor has also been assoc
PMID 23196330

Management of Thyroid Nodules with Atypical Cytology on Fine-needle Aspiration Biopsy.

Nagarkatti SS, Faquin WC, Lubitz CC, Garcia DM, Barbesino G, Ross DS, Hodin RA, Daniels GH, Parangi S.SourceThyroid Cancer Laboratory, Endocrine Surgery Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Annals of surgical oncology.Ann Surg Oncol.2013 Jan;20(1):60-5. doi: 10.1245/s10434-012-2601-2. Epub 2012 Sep 1.
BACKGROUND: Fine-needle aspiration biopsy (FNAB) of the thyroid categorized as atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) is a newly defined category according to the recent Bethesda guidelines. We sought to assess the characteristics and treatment
PMID 22941160

Japanese Journal

頸部リンパ節結核29症例の臨床的検討 : 診断における低侵襲な穿刺吸引法の位置づけ

三橋拓之,千年俊一,前田明輝 [他]
日本耳鼻咽喉科学会会報 115(12), 1037-1042, 2012-12
NAID 40019538370

巨大な胃壁内転移をきたした食道表在癌の1例

岩谷修子,根引浩子,丸山紘嗣,平松慎介,末包剛久,山崎智朗,平良高一,佐野弘治,佐藤博之,福島裕子
日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 54(7), 2000-2005, 2012-07-20
症例は，76歳男性．主訴は心窩部つかえ感．腹部超音波検査とCT検査で，胃体部と膵体部の間に7cm大の腫瘍を認め，上部消化管内視鏡検査で，胃体上部後壁に大きな粘膜下腫瘍と，胸部下部食道に7mm大の0-IIa病変を認めた．胃粘膜下腫瘍の超音波内視鏡下穿刺吸引細胞診および生検にて，扁平上皮癌と診断された．食道病変は，超音波内視鏡所見より深達度smの表在癌と思われ，生検にて扁平上皮癌であった．以上より，食 …
NAID 10030961623

Related Pictures

★リンクテーブル★

リンク元	「穿刺吸引細胞診」「FNA」「aspiration biopsy cytology」
拡張検索	「endoscopic ultrasound-guided fine-needle aspiration biopsy」
関連記事	「need」「aspiration」「needle」「fine」「needling」

「穿刺吸引細胞診」

Fine-needle aspiration
	Diagnostics
	Micrograph of a needle aspiration biopsy specimen of a salivary gland showing adenoid cystic carcinoma. Pap stain.
MeSH	D044963

　　[★]

英: aspiration biopsy cytology ABC、fine-needle aspiration biopsy FNA
関: 剥離細胞診

「FNA」

　　[★]

穿刺吸引細胞診

関: ABC、aspiration biopsy cytology、fine-needle aspiration biopsy

「aspiration biopsy cytology」

　　[★] 穿刺吸引細胞診 ABC = fine-needle aspiration biopsy FNA

「endoscopic ultrasound-guided fine-needle aspiration biopsy」

　　[★] 超音波内視鏡下穿刺吸引生検

「need」

　　[★]

助詞(否定・疑問文で)

(英正式)～する必要がある
[need not have done](主に英)～する必要はなかったのに(実際にはした)
(英正式)[need not do]必ずしも～でない

furthermore, aneurysms need not always be present, and angiographic findings may be limited to stenotic segments and obliteration of vessels.(HIM.2125)(さらに、動脈瘤はいつも存在するわけでないし、血管造影所見は血管の狭窄や閉塞に限られるかもしれない。)