FNAC &AUTOPSY

BY Dr. SUMANJALI & SUNIL

 FNAC

F
Introduction

Preparation

Procedure

Result

Benefits

Risk

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 INTRODUCTION
• FNAC : Full form ( Fine Needle Aspiration Cytology )
• This technique is an in expensive , simple and quick way to sample extraneous
lumps and masses that could be found in the neck ( thyroid gland , salivary gland ,
breasts etc ……)
• The sample is collected by inserting a fine gauge needle into the suspected mass
i.e, later studied under microscope.
• The mainly test primarily helps diagnose the presence of inflammatory condition
and also cancer.
• Unlike the open surgical biopsy is much more similar , quicker and safer.

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 PREPARATION
 Use of aspirin or other anti-inflammatories (ibuprofen , naproxen) should be stopped at
least one week prior to the latest one week prior to the test.
 Fasting for a few hours before the test is to be conducted.
 Anti-coagulants must be used .
 Routine blood tests must be in place at least two weeks before biopsy.
 Other things that would be checked before the test start are : a) pulse rate
b) blood pressure
c) Temperature
In case patient feels anxious she may be given sedation through an intra-venous line , for
normal case oral medication is suggested.

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 PROCEDURE
• Determine the gross characteristics or the mass to be aspirated including location relative to other
structures , estimated depth consistency and any evidence of pulsation or bruit.
• Assemble the syringe and syringe pistol with attached needle (23-25 gauge )
• Label slide ( using pencil), fixative and rinsing solution containers with patients name .
• Clean the skin over the puncture site with an alcohol skin preparation pad.
• Grasp the mass firmly with the free hand and insert the needle one swift motion.
• Apply full vaccum pressure to the syringe with the pistol finger.
• Conclude the aspiration if the hub of a needle is filled with a material or after about dozen passes by
releasing the trigger of the syringe pistol.
• Withdraw the needle from the mass and place pressure on the puncture site with a sterile gauze pad.
• Detach the needle from the syringe, fill the syringe with air reattach the needle.
• Express a small drop of aspirated material on one slide and gently spread the material by using a
second slide.
• Immediately fix one slide by dropping it into 95% alcohol , air dry the second slide
• Stain air dried slide with different quick
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 RESULT

 If the fluid is clear, the lump is most likely a cyst .

 Bloody or cloudy fluid can mean either a cyst that’s not cancer or,
very rarely cancer.

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 BENEFITS

• Minimally invasive , produce a speedy result and is inexpensive .

• Regraded as an essential component of the pre-operative/pre-treatment , investigation
of pathological processes , in combination with clinical , radiological and other
laboratory data.

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 RISKS

R
 Bleeding at the site of biopsy
 Infection
 Injury to structure adjacent to the
affected site ( mainly in thyroid
region )

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 AUTOPSY

A
Introduction

Purpose

Rules for medico-legal

Autopsy Types

Procedure

Benefits & Risks 10

 Introduction
AUTOPSY : It means to see for oneself (Auto = Self 0psis = View/Examination )

An autopsy is also called as post- mortem examination /Necropsy /Thana topsy

It may be defined as, the detailed scrutiny of both external surfaces and internal contents of dead
body after opening its cavities including further examination , such as histology, biochemistry and
toxicology of collected material. It is usually performed by a specialized medical
doctor called a “PATHOLOGIST”.

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 PURPOSES
Autopsies are performed for either legal or medical purposes.
Autopsies can be performed when any of the following information is desired.
To determine –If the death was natural or un-natural.
Manner of death must be determined.
Time since death
Establish identity of de-ceased
Retain relevant organs
Injury source and extent of the corpse
If infant, determine live birth and viability

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It is performed in certain cases such as:
 Committed suicide
 Unknown cause of ‘DEATH’
 Unknown dead bodies
 Homicide ( killing of one human being by another)
 The organs and tissues of the body are examined to establish the exact cause of
death to
learn more about a disease.

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 Rules for Medico-legal Autopsy
i. Authorization
ii. Identification
iii. Visit of scene of crime
iv. History of the case
v. Verification of the injuries noted by the police
vi. Examination
vii. Notes
viii. Preservation of viscera and other tissue
 Types of Autopsy

• Post-mortem examination
• Medical/clinical/pathological- carried on a patient who dies in hospital during course of treatment.
• Anatomical autopsy – 1.It is performed to study normal structure of human body.
- 2.Mostly on unclaimed dead bodies .
• Medico-legal autopsy – 1.Essential examination of dead body.
- 2.To rule out (or) establish foul play in death
Psychological autopsy – It is undertaken on alleged cases of suicide to know about the mental
status of deceased at the time of death.
Virtual Autopsy – It is a post-mortem examination without compromising the integrity of the
body , even without collection of sample.
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 Images (Types of autopsy)

Virtual autopsy Psychological autopsy​ Post-mortem autopsy

Anatomical autopsy Medico-legal autopsy Medical &clinical

autopsy

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 Classification

FORENSIC CLINICAL/ACADEMIC CORONER’S

• This is done for medical legal • This is usually performed in • This type of autopsy involves
purposes hospitals for research & study cases where no medical cause of
purpose death is readily available.
• No family permission is required
to complete this type of autopsy • For a clinical autopsy to take • Cause , manner & mechanism of
place, cause of death-certificate death are in question
• This is carried out when the cause completed.
of death may be a criminal matter • Eventually, the prospectors will
such as accident or burns identify whether the cases deserve
comprehensive, forensic autopsy
or a routine post- morterm.

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 PROCEDURE
1.External examination
2.Internal examination

P
External examination :
1. Clothes
2. Blood, Urine, Stools
3. Body orifices
4. Finger , Toe & Nails
5. Injuries/surgical intervention
6. Rigor mortis
7. Post -mortem staining
8. Decomposition/other changes
Internal examination :

 Skull
 Thorax
 Abdomen

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 PRE-AUTOPSY FORMALITIES

 VISIT OF SCENCE OF CRIME

 TRANSPOSITION OF CORPS
 REGISTRATION OF DEAD BODIES
 STORAGE OF DEAD BODIES
 LEGAL FORMALITIES
 OTHER FORMALITIES
 PLACE OF PEFORMING AUTOPSY

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 BENEFITS
 Discover cause of death for :

1. Criminal cases
2.Family peace of mind
3.Genetic disease (or) deformity
4.Insurance claim
5.Medical advancement
6. Providing information about preventable cause for disease , accident and other public health hazards.

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 INSTRUMENTS COMMONLY USED IN AUTOPSY

• Surgical blade/ knife • Bone forceps

• Scissors • Skull elevator
• Probe/surgical gloves • Brain knife
• Dissecting forceps • Scalpel
• Cartilage knife • Knife
• Rib shears/ sewing material • Measuring jug
• Chisel/preservatives • Weighing machine
• Hammer/labelling/sealing material • Magnifying lens
• Saw • Trays ( steel )

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 HIGH RISKS AUTOPSIES – GOALS

case selection/procedure

R
permissions/tissue handling
local approvals/equipment

LIMIT
LIMIT EXPOSURE
CONTAMINATION

• Respirator • Disposables
• Vacuum • Shroud
• Limited personnel • Coverings
• Dissection container
• Dedicated tool set

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 Summary
So, Autopsy is a medical examination of a dead body to determine the
exact cause of death.

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Thank you