Unusual Findings With Imaging-Guided Fine Needle Aspiration

TL;DR

This paper discusses two cases where unusual materials found during imaging-guided biopsies caused confusion in diagnosis.

Contribution

The paper highlights the diagnostic challenges posed by refractile foreign materials and emphasizes the importance of polarized microscopy.

Findings

Refractile foreign materials were found in two biopsy cases, leading to diagnostic confusion.

One case involved barium crystals from a prior imaging procedure, and the other likely involved starch-based material.

The cases underscore the need for attention to detail and proper use of polarized microscopy in such scenarios.

Abstract

For deep-seated lesions, fine needle aspiration (FNA) under imaging guidance may be crucial to secure material for definitive diagnosis and further management. Rarely, components other than cells and tissue fragments may be visualized upon microscopic scrutiny following biopsy. These findings may lead to confusion in diagnosis. We describe two cases in which refractile foreign materials caused diagnostic challenges. The material in the first case turned out to be barium crystals left at a prior procedure for imagining study. The material in the second case was most likely starch-based material the patient aspirated or inhaled. These two cases highlight the importance of attention to details and judicious use of polarized microscopy.

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