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HomeFactsHow Do You Do A Thyroid Biopsy

How Do You Do A Thyroid Biopsy

How To Prepare For This Procedure

What to Expect if You Have a Thyroid Nodule

Before performing a thyroid biopsy, it is essential that the doctor know the patientâs medical history. You should know if you take any medication or if you have any other pathology. A previous examination is also necessary to locate the nodules.

The usual thing is that certain complementary tests are carried out before the biopsy. For example, a blood test and an ultrasound.

No specific preparation is required for needle biopsy. As it is an outpatient test and without general anesthesia, it is not necessary to do a previous fast.

If the thyroid biopsy is open, general anesthesia will be used. As it is a more complex intervention, specific indications will be given to the patient. In this case, you should not eat or drink before the procedure. In addition, it will be necessary to remain at rest during the following hours.

Thyroid Nodules And Thyroid Cancer

The biggest concern on most people’s mind is probably whether or not their thyroid nodule is actually cancer in disguise.;

As I mentioned previously, most thyroid nodules are benign.;

But that leaves another 5-10% which can be cancerous and should be evaluated.;

There are some factors which have been evaluated which can help you understand your risk of thyroid cancer.;

The risk of thyroid cancers increases with these risk factors:

Thyroid Nodule Biopsy: Cancer Of Thyroid Nodules Is Diagnosed By Fine Needle Aspiration Biopsy

  • FNA is an abbreviation for Fine Needle Aspiration Biopsy. This is a common test performed thousands of times per day on people with thyroid nodules.
  • FNA is a type of biopsy. A biopsy is the removal of some cells from the body so they can be looked at under a microscope to see if the cells are cancerous.
  • The only purpose of a FNA biopsy is to get cells from the thyroid to look at under a microscope. If not enough cells are removed, the test is worthless or not diagnostic .
  • Thus, FNA is used to diagnose thyroid cancer in a patient with a thyroid nodule that is suspicious for cancer .
  • FNA biopsy can also be done on lymph nodes in the neck which are around the thyroid to see if there are any thyroid cancer cells inside the lymph nodes.
  • Ultrasound allows the doctors to see the thyroid nodule or lymph node during the needle biopsy, which helps make sure they are getting the needle stuck into the right areas.
  • FNA biopsy is the same as: needle biopsy of thyroid, FNA needle biopsy, FNA of thyroid, etc. They are all the same thing so don’t be confused.
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    About Thyroid Fine Needle Aspiration Biopsy

    Your doctor may order a fine needle aspiration biopsy if he or she finds a nodule in the thyroid.

    Thyroid nodules are common and are present in about one-half of all people by ages 50 to 60. FNA is the best diagnostic procedure for determining which thyroid nodules are benign, and which have cancer.

    If You Need Another Biopsy

    Thyroid Biopsy by Alexander Shifrin, MD

    Occasionally the first needle biopsy sample does not contain enough cells to make a;diagnosis and you may need to have the test again.

    Sometimes a surgical biopsy is needed. You have a sample of tissue removed during a small operation, usually under a general anaesthetic. This could be because:

    • the needle biopsy could not be done for some reason
    • a second needle biopsy did not get enough cells to make a diagnosis, but your specialist still thinks that there is a problem
    • it was difficult for the pathologist to be sure about the results of your needle biopsy

    You may have 1 or 2 stitches, or steri strips, to close the wound;in your neck.

    • Annals of Oncology, 2019. 30, Pages 1856 -1883; ;

    • Cancer and its management;J;Tobias and D HochhauserWiley-Blackwell, 2015

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    How Can You Prepare For Your Thyroid Fna

    Most medications can be continued. However, anticoagulants, also called blood thinners, often need to be stopped temporarily in anticipation of your thyroid biopsy. These medications can increase the risk of bleeding. It is common to receive specific instructions regarding when to stop taking medications from your doctors office prior to the procedure. If you have any questions about taking your medications prior to the thyroid biopsy, be sure to talk to your doctor.

    Generally, you will not be required to be fasting on the day of your appointment. During the thyroid biopsy, ultrasound gel will be applied to the neck to obtain ultrasound images. This gel is water soluble and non-toxic, but may get on clothing or jewelry. You may wish to wear comfortable clothing and take off any jewelry from around the neck for the procedure.

    How Long Does A Needle Biopsy Take To Heal

    Pain and Recovery The recovery time is likewise usually quick, though there might be some bleeding and/or bruising. Core needle biopsies usually result in more bruising than a breast fine needle biopsy. This can take up to several weeks to fully heal, though it should feel much better a lot sooner than that.

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    What Is The Thyroid Gland

    The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroids job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.

    How Is A Thyroid Nodule Evaluated And Diagnosed

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    Once the nodule is discovered, your doctor will try to determine whether the rest of your thyroid is healthy or whether the entire thyroid gland has been affected by a more general condition such as hyperthyroidism or hypothyroidism. Your physician will feel the thyroid to see whether the entire gland is enlarged and whether a single or multiple nodules are present. The initial laboratory tests may include measurement of thyroid hormone and thyroid-stimulating hormone in your blood to determine whether your thyroid is functioning normally.

    Since its usually not possible to determine whether a thyroid nodule is cancerous by physical examination and blood tests alone, the evaluation of the thyroid nodules often includes specialized tests such as thyroid ultrasonography and fine needle biopsy.

    The report of a thyroid fine needle biopsy will usually indicate one of the following findings:

  • The nodule is benign .
    • This result is obtained in up to 80% of biopsies. The risk of overlooking a cancer when the biopsy is benign is generally less than 3 in 100 tests or 3%. This is even lower when the biopsy is reviewed by an experienced pathologist at a major medical center. Generally, benign thyroid nodules do not need to be removed unless they are causing symptoms like choking or difficulty swallowing. Follow up ultrasound exams are important. Occasionally, another biopsy may be required in the future, especially if the nodule grows over time.


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    Do Thyroid Nodules Cause Weight Gain

    Symptom: Weight Gain or Loss An unexplained change in weight is one of the most common signs of a thyroid disorder. Weight gain may signal low levels of thyroid hormones, a condition called hypothyroidism. In contrast, if the thyroid produces more hormones than the body needs, you may lose weight unexpectedly.

    Biopsy Is A Fundamental Test For Cancer

    What we must remember is that, at present, the thyroid biopsy is the basic test to be able to diagnose the cancer of the gland. In fact, it not only reveals the presence of malignancy, but also allows the specific type of tumor to be identified.

    In this way, it makes it possible to establish an adequate treatment protocol depending on the pathology. In addition, it is a test that is usually performed on an outpatient basis and has a low risk of complications.

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    Why Would My Doctor Refer Me To Have This Procedure

    The most common reason for people to have thyroid FNA is to find out the cause of a thyroid lump . The nodule might be something that you or your doctor have noticed because:

    • You can see or feel a lump in the front of the neck in the area of the thyroid.
    • You have general swelling in the thyroid area and your doctor sent you to have an ultrasound examination that showed one or more nodules in the gland.
    • You had a thyroid problem detected while having a scanning test for other reasons.

    The most common tests that show thyroid nodules are:

    • ultrasound of the neck;
    • computed tomography scanning that includes the neck or PET CT scanning of the whole body;
    • nuclear medicine scanning of the thyroid.

    In all of these cases, thyroid FNA is carried out to discover the cause for one or more nodules in the gland. Thyroid nodules are extremely common, being found on ultrasound in up to approximately 50% of adults. Palpable nodules are much less common, being present in approximately 5% of women and 1% of men.

    Nodules are generally nothing to worry about and are more common in people born and raised in areas a long way from the coast, where the soil tends to be deficient in iodine. People living in these areas may have an iodine deficient diet. Iodine deficiency can make the thyroid gland get bigger . In some cases, this enlargement is a result of growth of one or more nodules in the gland.

    How Do I Prepare For A Thyroid Fna

    The Center for Integrative & Functional Endocrinology ...

    A thyroid FNA is a day procedure for most people. It takes up to half an hour, followed by a short period afterwards when you will be watched until you have recovered and can leave the hospital or radiology practice. You are generally allowed to resume normal, but non-strenuous, activities for the rest of the day.

    You can eat and drink normally before and after the procedure. You will not require a general anaesthetic where you would be asleep, although you may be given local anaesthetic to numb the area of the skin where the FNA needle is inserted.

    When you make your appointment for the thyroid FNA, you need to let the hospital radiology clinic or department know if you are taking any blood thinning medication, such as warfarin, clopidogrel, dabigatran, prasugrel, dipyridamole or asantin .

    Blood thinning medications will need to be stopped for a period of days, or your normal dose reduced, before this procedure is carried out. It is very important that you do not stop any of these medications or change the dose without consulting both your own doctor and the hospital or radiology clinic where you will have the FNA. They will give you specific instructions about when to stop and restart the medication. These drugs are usually prescribed to prevent stroke or heart attack, so it is very important that you do not stop taking them without being instructed to do so by your doctor or the radiology practice, or both. Aspirin is usually not stopped.

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    What Happens During A Thyroid Fine Needle Aspiration Biopsy

    Some people, like children, might need a medicine to help them relax before the procedure. Most people will not need this, though.

    In some cases, your healthcare provider might inject a local anesthetic to the area before inserting the needle. Because the needle is so small, this is often not necessary.

    Your healthcare provider may perform the biopsy with the help of an ultrasound machine. This machine uses high-frequency sound waves to provide an ongoing image of the nodule. This enables your healthcare provider to guide the needle to exactly the right spot. It also prevents damage to other structures. A gel-like substance will be applied to your neck, where the ultrasound detector will be used.

    After cleaning the area, your provider will insert the thin, fine needle into your thyroid gland. This may hurt a little. He or she will slowly advance the needle into the nodule itself, moving it back and forth several times.

    The needle attaches to a syringe that can apply suction and remove some cells from the nodule. After the removal of the needle, these cells will be placed on a slide. Your healthcare provider might repeat this procedure a few times to obtain different samples from different parts of the nodule. Sometimes the lump will be all or mainly fluid. The fluid can be removed during the biopsy.

    After the procedure, the cells will be sent to a pathology lab and analyzed for signs of cancer. A small bandage will be placed over the needle insertion site.

    Are There Any After Effects Of A Thyroid Fna

    It is common to have some pain, swelling and even a little bruise where the needle was inserted into your neck. Simple pain medication available from the chemist, such as panadol or panadeine, can be taken for this. Pain and swelling should be minimal after 48 hours.

    It is important to avoid strenuous activity, particularly activity that involves bending over, straining or working over your head , as all of these activities can increase the chance of internal bleeding into the thyroid gland.

    It is uncommon to have any change in your voice, severe pain, general neck swelling, or difficulty breathing or swallowing after a thyroid FNA. If any of these things happens, you should phone the hospital or radiology practice where the procedure was carried out and let them know.

    If you are experiencing difficulty breathing after the procedure, you should go immediately to the nearest hospital emergency department.

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    How To Read Thyroid Test Results

    This article was medically reviewed by Shari Forschen, NP, MA. Shari Forschen is a Registered Nurse at Sanford Health in North Dakota. She received her Family Nurse Practitioner Master’s from the University of North Dakota and has been a nurse since 2003. This article has been viewed 69,845 times.

    The thyroid is a butterfly-shaped gland located in the neck that produces thyroid hormone. Thyroid disorders, in which the gland produces too much or too little of the hormone, can influence many functions in your body, from your heart rate to your metabolism. If your doctor thinks you are suffering from an overactive or under-active thyroid, she may order tests. Reading the results can seem like a complex task; however, if you have a systematic approach and understand what each test represents, you can determine whether or not you have a thyroid problem and, if so, what the problem is. Remember that only your doctor can diagnose thyroid disease, so make sure you talk with her about the results so you can begin treatment if necessary.

    How Are Thyroid Nodules Treated

    Thyroid Nodule Biopsy

    All thyroid nodules that are found to contain a thyroid cancer, or that are highly suspicious of containing a cancer, should be removed surgically by an experienced thyroid surgeon. Most thyroid cancers are curable and rarely cause life-threatening problems . Thyroid nodules that are benign by FNA or too small to biopsy should still be watched closely with ultrasound examination every 6 to 12 months and annual physical examination by your doctor. Surgery may still be recommended even for a nodule that is benign by FNA if it continues to grow, or develops worrisome features on ultrasound over the course of follow up.

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    What Happens During A Thyroid Fna

    An ultrasound machine will be used to locate the nodule or nodules to be sampled and show images or pictures of the nodule or nodules onto a screen.

    The ultrasound will be carried out by a technologist or a radiologist , or both.

    The FNA procedure will then be explained to you. Instructions about what you can and cannot do after the procedure will be given to you at this time as well. You will be asked to sign a form indicating that you understand what will happen, the small risks involved, and that you agree to have the procedure done. The explanation will generally be provided by the doctor carrying out the procedure. You will have the opportunity to ask any questions at this time.

    You will generally be lying on an examination couch for the procedure.

    Your neck will be washed with antiseptic.

    The procedure is then over. The needle puncture site in your neck will be compressed for a couple of minutes by the doctor who did the FNA or a nurse who assists the doctor. An ice pack may be put on your neck to help reduce swelling and bleeding. You may be taken from the ultrasound room into an observation area for a short time to ensure that you are well enough to go home.

    How Should I Prepare

    Please notify your physician if you are taking any blood thinning agents, such as aspirin, Lovenox®, Plavix® or Coumadin®.

    Usually, no special preparations are required for this procedure.

    For biopsies performed in children, sedation may be used. Specific instructions will be given at the time of scheduling.

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    What Messes Up Your Thyroid

    Causes. Both hypothyroidism and hyperthyroidism can be caused by autoimmune diseases that affect thyroid function. Hypothyroidism also can occur as a result of an iodine deficiency, radiation, viral infections or the surgical removal of the thyroid gland. These conditions also may occur without any identifiable cause.

    Interpretation Of The Results

    What To Do When You Get An Inconclusive Thyroid Biopsy?
  • Benign Nodule; This means that cancer has been ruled out. In this case it could be due to thyroiditis, hyperplasia, fluid accumulation in form of a cyst.
  • Malignant The nodule is cancer. There are four types of thyroid malignancies.Papillary carcinoma is the most common comprising the 80% of thyroid malignancies and it tends to spread in lymph nodes. It is the easiest to treat and has very good prognosis.Follicular carcinoma appears more frequently in people living in areas with low iodide. It is more likely to spread to lungs or bones.Hurthle cell carcinoma is a type of follicular carcinoma and accounts for 3% of all thyroid cancers.Medullary carcinoma;;comprises the 4% of all thyroid cancers and is more aggressive than follicular and papillary types because it can spread to organs and nearby lymph nodes.Anaplastic carcinoma is very rare as it accounts for the 1% of thyroid malignancies. It has an extremely malignant potential and does not respond to any kind of treatment.
  • Inconclusive Diagnosis ;;The type of nodule could not be identified. This means that either the FNA should be repeated or the thyroid should be surgically removed.
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