Possible use and role of molecular techniques in fine-needle aspiration cytology (FNAC) practice

Fine-needle aspiration cytology (FNAC) is a recognized ancillary tool in the diagnosis of tumours and infectious diseases. Throughout decades cytopathologists did tremendous marvels with pure morphologic criteria, diagnosing in shrinking amounts of material. The recent understanding of complex cancer biology reshapes the practice of FNAC. The scientific advance of image techniques gave cytopathologists the possibility to go to deep locations and collecting material from previous unlikely locations. This conjunction of knowledge’s and techniques has increased the role of FNAC in the diagnosis, prognosis and in the establishment of new therapeutic targets. Lately, core needle biopsy is gaining popularity and advantage regarding FNAC. The sample limitation of FNAC regarding immunocytochemical staining with proper controls, as well as the limitation in appreciating invasiveness has lead, in some fields, like soft tissue tumours, breast, lymph node, and prostate, to diminish the use of FNAC. However FNAC still is a less invasive, effective, and cost efficient technique. In this review we demonstrate the application of basic molecular techniques to FNAC as a crucial tool in the diagnosis, prognosis and planning of alternative molecular therapeutics of tumours.