Ultrasound guided fine needle aspiration using 25G needle as a new technique for a wide range of pathological conditions

OBJECTIVE: This study is to report on the use of 25 gauge (G) needle in ultrasound (US) guided fine needle aspiration (FNA), as a new technique for a wide range of pathological conditions, and to assess the yield of positive tissue material and the complications compared to those reported in the literature using larger needles.

METHODS: One hundred and seventy-two patients presented consecutively at King Saud University Teaching Hospitals, Kingdom of Saudi Arabia, during the period 2000 to 2002, with various pathological conditions, underwent US guided FNA using 25G needle. The adequacy of the tissue obtained, and the pathological outcome were tabulated. The patients were discharged in the same day and followed for 4-6 weeks for complications.

RESULTS: Adequate tissue was obtained from 165 (96%) patients. Seven (4.1%) patients had to be examined twice, to obtain a sufficient sample. The 172 patients also included 14 patients (8.1%) who had repeated procedure on the request of the clinician, who needed confirmation of the pathological diagnosis. Adequate sampling was obtained in the first attempt in 89%, in liver problems, and in other regions, and 86.8% in lung problems. The percentages of diagnostic categories revealed by the cytological analysis are similar to those obtained by other larger fine needles.

CONCLUSION: No complications have been encountered. The technique can safely be repeated if the amount is inadequate or diagnosis is inconclusive, to reach 100% correct sampling. The results of positive findings are comparable to other studies using larger needles. The use of 25G needle is recommended for use under ultrasound guidance.