Infarction after fine needle aspiration. A report of four cases.

BACKGROUND

Fine needle aspiration (FNA) is a well-established and safe method for the rapid diagnosis of palpable and deep-seated masses. A few clinically important complications, including bleeding, pneumothorax, infection and inflammatory reactions, result from FNA. Little attention has been focused on tissue changes resulting from FNA. In a small number of cases FNA has been followed by varying degrees of necrosis. This has occurred in thyroid nodules, salivary glands, breast fibroadenomas, lymph nodes and renal cell carcinoma.

CASES

Four cases of infarction followed FNA biopsy. All 4 (1 papillary carcinoma of the thyroid, 1 pleomorphic adenoma of the parotid gland and 2 fibroadenomas of the breast) were diagnosed by FNA. Subsequent histologic study of the surgical specimens revealed massive necrosis of the neoplasms.

CONCLUSION

Necrosis associated with infarction may cause diagnostic problems in two settings. FNA yielding necrotic debris may result in a false negative diagnosis in repeat aspiration. Alternatively, post-FNA infarction may obscure the nature of a neoplasm diagnosed by FNA, making histologic confirmation difficult.