Hello everyone, how are you all? I hope you all are doing good and i am too. Today we are going to see the procedure of FNAC for a case of lipoma.
Fine needle aspiration cytology( FNAC) for lipoma is quite different from regular one. Normally for lymph node, thyroid we will use narrow bore needles for procedure to avoid blood. But for Lipoma cases, we must go for large bore needle or needles with low gauge number. The most common use gauge is 18 gauge(green). The another most important thing that we have to keep in mind is syringe is must. You can perform FNAC procedure with needle itself for other swellings like thyroid, lymph nodes etc.. but for Lipoma you must use 18 gauge needle with syringe to give more negative pressure. Why we have to do like this because we are aspirating fat fragments which is very hard to aspirate and it needs more negative pressure to aspirate it but for thyroid lymph node etc.... small negative pressure is enough and we will get enough cells. After doing procedure, we have to transfer aspirate on to slides and make smears immediately and kept for fixation in alcohol for few seconds and then transfer slide to toluidine bule jar and make 3-4 dips in it and then wash with tap water by keeping in the jar.
Then clean the other side of slide with tissue paper and look under microscope for cellularity. You will see fat fragments and stromal fragments and then you can send the patient.

I have a youtube channel and i am going to share the video link here.
In the video the patient came with complaints of swelling over the back which is freely mobile, soft in consistency and slip sign is positive.
Watch the video carefully and observe everything in it.
https://youtube.com/shorts/QGIzab5-YNU?si=DxiLMXSgcZYErujv

References -

• Orell and Sterrett's Fine Needle Aspiration Cytology, 5e

Thanks for reading,
With regards,