|ECR 2019 / C-2152|
|Fine Needle Aspiration Biopsy with Menghini tip: A brand-new technique for obtaining histological samples of small lesions with difficult anatomical approach|
Aims and objectives
Fine Needle Aspiration Biopsy (FNAB) technique uses 20-25G needles without local anesthesia to obtain samples.
FNAB can be performed with manual or automatic aspiration without differences in the quality of the samples Automatic techniques are easier and more precise (1)
Cells obtained with FNAB are often enough to determine the malignancy of the tumour, the histological grade and its origin.
However, there are organs and pathologies in which is necessary to preserve the architecture of the tissue and to perform immunohistochemical and genetic analysis. In these cases, a core needle biopsy (CNB) is mandatory and it can be performed with two types of needles: Tru-cut”® (Fig. 1) and Biopince® (Fig. 2)
Automatic mechanism by Tru-cut® and Biopince® makes CNB especially traumatic. Tru-cut® in particular has a dead zone at the tip that has to exceed the diameter of the lesion to obtain the sample.
Despite these characteristics, CNB by Tru-cut® and Biopince® are easy, effective and safe techniques in most cases, but the risk is higher in small lesions located in some regions with important structures near the lesion, especially in head and neck with large vessels and the airway, but also in some patients with prior surgery or radiotherapy (2)
FNAB with Menghini tip obtains histological samples by increasing negative pressure inside the lesion without bleeding.
Menghini® (Fig. 3) and Hepashot® (Fig. 4) needles are the main options available. Menghini® uses a sharp cannula and a purged of saline solution to create negative pressure, so the sample length is always the same. Hepashot® uses a trocar style mandrel that retracts and creates a vacuum space that contains the sample, so the sample length depends on the number of passes of the needle through the lesion in different angles (Fig. 5, Fig. 6).
Several studies concluded that there are no differences in the quality of samples obtained by CNB or FNAB with Menghini tip. Quality of samples obtained with FNAB with Menghini tip is similar to CNB’s, specially in small sized lesions located near important structures, such as cervical spaces (3). They concluded that semi-automatic needles with Menghini tip (4) and 20G (5) calibre were the best options available.
Main objectives of our study were:
To review FNAB with Menghini tip, highlighting interventional clues for improving tissue sampling.
To describe efficacy of the technique in our population.
To explain the future application areas of this technique.
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