What’s an ultrasound guided, fine needle aspiration?

It’s a mouthful, certainly. The doctors like to refer to this little procedure as a ‘FNA’, and it’s really simple. I’ve had a few in the past!

Sometimes, after a scan an abnormality can show up. For me, this has been where a lymph node looks slightly different to the picture they saw the last time. This can be perfectly normal, as lymph nodes are very busy and they change size and shape all the time. Or it can be down to cancer which had previously been dormant springing to life and starting to multiply.

As soon as any abnormalities are spotted, the medical boffins are keen to find out what’s going on – and this procedure gives them a really good idea.

There are three tools that are used to help them with the tests. But before we get to that, you’re going to have to take some of your clothes off. My tests are almost always in the groin area – so that means being naked from the waste down and wearing a gown over the top.

The procedure

First up, an ultrasound machine is used to locate the suspicious nodes. It’s a probe that is covered in a cold gel and pushed up against your skin to take pictures under the surface. The doctor (or radiologist) doing the work is watching the results on a screen as they work. Once they find what they’re looking for, they’ll take a couple of pictures. it’s completely painless, you’ll just be covered in a sticky gel.

Next up, the fine needle aspiration. Now typically, I have these without local anaesthetic – but it’s up to you. You’ll certainly be offered it.

Guided by the ultrasound, the radiologist will insert a needle through the skin and into the node in question. Then, using a syringe they will remove some of the fluid from the node and send it away for testing. Sometimes this will require a couple of passes, but it’s not a procedure that’s all that painful – it’s just uncomfortable.

If the radiologist spots something on the screen that looks a bit more suspicious, they’ll do a biopsy. This will definitely need anaesthetic. Someone gave me one without at St George’s last year and it was horrendous!

It’s a thicker needle/sharp thing, again inserted right into the node and designed to remove more matter to send away for testing.

Results take a few days to come back, and they’ll give the doctors leading your treatment the information needed to work out a treatment plan. It could be to do nothing, it could need monitoring or it could require surgery and further treatment.

Bottom line though, if you get an invite to have one – turn up. It’s important enough for them to be concerned about, so you should be too!