Fine Needle Biopsies

[fedor]

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Who does Fine Needle Biopsies? I know the samples are sent to path, but who actually cuts the specimen? Would you need a surgeon for that or could even a tech or internist take care of that? Would patholgists ever take their own samples because they know exactly what they want?

 

[LADoc00]

Who does Fine Needle Biopsies? I know the samples are sent to path, but who actually cuts the specimen? Would you need a surgeon for that or could even a tech or internist take care of that? Would patholgists ever take their own samples because they know exactly what they want?

breaks out baseball bat and evil grin.....

 

[Brian Pavlovitz]

Who does Fine Needle Biopsies? I know the samples are sent to path, but who actually cuts the specimen? Would you need a surgeon for that or could even a tech or internist take care of that? Would patholgists ever take their own samples because they know exactly what they want?

Fine needle aspirations don't need to be cut because they are aspirates of a mass, and can usually be spread out on slides or spun down to concentrate the cells. Occasionally, the material is spun down and if there's enough, a cell block can be made of that (which would go to histology).

Many pathology departments have their own FNA clinics, where they see patients and actually perform the aspirate. In the hospital I used to work at, FNA's were done by radiologists, surgeons, pulmonologists, er docs, and primary care doctors.

 

[f_w]

Typically surgeons, surgical subspecialists or often radiologists will do FNAs and forward the specimens to a pathologist for processing and interpretation. (sometimes you will have a cyto-tech from pathology present during the FNA to give you a 'sufficient specimen' or 'sorry, only blood' verdict on your passes)

There are however pathologists who do for example breast FNAs (typically on request of a surgeon). This has the advantage that they can look at their slides right there and decide whether they have a sufficient sample. (the tech is a tech, while most of them are well qualified to discern blood from tumor cells, a 'medical' decision which might require another procedure for the patient should not rest on their shoulders).

 

[LADoc00]

Typically surgeons, surgical subspecialists or often radiologists will do FNAs and forward the specimens to a pathologist for processing and interpretation. (sometimes you will have a cyto-tech from pathology present during the FNA to give you a 'sufficient specimen' or 'sorry, only blood' verdict on your passes)

Maybe in academics, but in the real world at small to med. hospitals, many a pathologist does ALL the FNAs that arent CT guided. Yours truly does 50-60 FNAs/week when Im on the clinic service and I had like all of 4 weeks (literally) of cyto rotation as a resident. They even want me to train to ultrasound guided FNAs and core breast biopsies (!), Im basically a procedure ***** now.

No joke, I showed up my first day with a huge stack of FNA needles, bone marrow kits, DQ stains etc on my desk and post it that said "Youre It."

One more reason why pathology residency training has very little to do with actual real world practice.

 

[f_w]

I think it is more a question of local practice patterns rather than the academics/pp dimension. Some of the aspirating (or aspiring ?) pathologists I have seen so far were actually in academia.

Lucky you that your surgeons are busy enough operating that they don't have to make a living on FNAs in the breast clinic.

 

[DasN]

I think it is more a question of local practice patterns rather than the academics/pp dimension. Some of the aspirating (or aspiring ?) pathologists I have seen so far were actually in academia.

Lucky you that your surgeons are busy enough operating that they don't have to make a living on FNAs in the breast clinic.

Again f_w thinks that he knows everything! 😴