In fine needle aspiration of a neck mass, a long, thin needle is inserted through the skin to withdraw (aspirate) a column of cells from a growth in the neck. This specimen is sent to a laboratory for microscopic examination.
Fine needle aspiration is typically performed to evaluate a neck mass that was detected on an imaging test, such as a CT scan or an MRI scan. Common sites include the thyroid gland, parotid salivary gland, or lymph nodes.
Purpose of the Fine Needle Aspiration of a Neck Mass
- To determine whether a neck mass is benign or malignant (cancerous)
- To assess lymph nodes and cysts in the neck, the parotid gland, thyroid gland, a mass inside the mouth or any lump that can be felt
Who Performs Fine Needle Aspiration of a Neck Mass
- The procedure is conducted by a surgeon, a pathologist, or another physician trained in fine needle aspiration.
- In some cases, a radiology technician may assist.
Special Concerns about Fine Needle Aspiration of a Neck Mass
- Fine needle aspiration may be performed in a doctor’s office, an outpatient surgery facility, or a hospital, depending on the exact procedure.
Before the Fine Needle Aspiration of a Neck Mass
- If you are anxious about undergoing this procedure, your doctor may administer a sedative to relax you.
- You will be instructed to empty your bladder just before the test.
- You will be asked to disrobe above the waist and put on a hospital gown.
What You Experience during Fine Needle Aspiration of a Neck Mass
- In most cases, a local anesthetic is injected to numb the site of needle insertion, but it is not always necessary. This injection may cause mild discomfort.
- The doctor inserts a thin needle through the skin into the neck mass and withdraws cells from the mass. Sometimes several samples are obtained.
- If you did not receive a local anesthetic, you may experience mild discomfort during needle insertion. However, it is important that you remain very still during the procedure.
- For a mass that is located deep in the neck, ultrasound imaging or CT scanning may be used to guide the placement of the needle.
- Pressure is placed on the needle insertion site until bleeding has stopped, and small bandage is applied.
- The procedure usually takes only about 5 minutes.
Risks and Complications of Fine Needle Aspiration of a Neck Mass
- The most common complication is swelling or bruising due to collection of blood under the skin (hematoma) at the needle insertion site. This is harmless and will resolve on its own, but may cause some discomfort and slight, temporary difficulty swallowing.
- Serious complications—such as bleeding (hemorrhage), infection, or inadvertent puncture of other structures in the neck—are extremely rare. Bleeding risk is higher in patients who take aspirin, ibuprofen (Advil), or blood thinners, such as warfarin (Coumadin, Jantoven, generics).
After the Fine Needle Aspiration of a Neck Mass
- You may be instructed to place pressure on the aspiration site for some minutes to minimize the chance of a hematoma. Otherwise, you are free to leave the testing facility.
- Your doctor may recommend that you avoid strenuous physical activity for 24 hours.
- For a large hematoma at the needle insertion site, you should apply ice initially. After 24 hours, use warm, moist compresses to help dissolve the clotted blood and relieve discomfort.
- Your doctor may recommend taking an over-the-counter pain reliever, such as aspirin, acetaminophen, or ibuprofen, to allay any postprocedure discomfort.
- Call your doctor if you develop excessive pain or bleeding or if you develop a fever.
Results of Fine Needle Aspiration of a Neck Mass
- The specimen is sent to a pathology laboratory and examined under a microscope for the presence of abnormal cells. Possible findings include inflammation due to bacterial or viral infection, benign tumors, and cancer.
- If a definitive diagnosis can be made, your doctor will recommend an appropriate course of medical or surgical treatment.
- On rare occasions, the cells obtained by fine needle aspiration are insufficient to make a diagnosis. In this case, the procedure may need to be repeated, or a surgical biopsy under general anesthesia may be necessary.
The Johns Hopkins Consumer Guide to Medical Tests
Simeon Margolis, M.D., Ph.D., Medical Editor
Updated by Remedy Health Media