Needle Biopsy: Thyroid
(Fine-Needle Aspiration; Skinny-Needle Biopsy; Coarse-Needle Biopsy)
Definition
With this type of biopsy, the doctor uses a needle to remove a small sample of tissue from the thyroid gland.
Thyroid Nodule
Reasons for Procedure
The test is usually done when a lump, called a nodule, is found in the thyroid. Thyroid nodules are fairly common. They usually do not require treatment. However, about 5% of nodules are cancerous . The needle biopsy is usually done to see if a nodule contains benign (noncancerous) or malignant (cancerous) cells. It may also be done if the thyroid is enlarged, even if there is no nodule present.
Possible Complications
Complications are rare, but no procedure is completely free of risk. If you are planning to have a needle biopsy, your doctor will review a list of possible complications, which may include:
- Bleeding
- Bruising where the needle was inserted
- Pain after the procedure
- Infection
What to Expect
Prior to Procedure
In the days leading up to your procedure, you will need to:
- Have blood tests
-
Talk to your doctor about your medical history, including:
- Any allergies
-
Any medicines that you take—You may be asked to stop taking some medicines up to one week before the procedure, like:
- Anti-inflammatory drugs (eg, aspirin )
- Blood thinners, like clopidogrel (Plavix) or warfarin (Coumadin)
- Arrange for a ride home from the care center.
Anesthesia
Local anesthesia is used—just the area that is being operated on is numbed. It is given as an injection. You may also be given a sedative.
Description of the Procedure
There are two types of biopsies:
- Fine-needle aspiration (FNA)—most common
- Coarse-needle biopsy (CNB)
You will be asked to lie on your back. A pillow will be placed under your shoulders. Your neck will be extended. The site of the biopsy will be cleaned with an antiseptic solution. For an FNA, your doctor will insert a tiny hollow needle into the nodule to collect a sample of tissue. For a CNB, your doctor will make a small cut in the skin. The needle will be inserted through the incision and into the thyroid to collect a sample. The process may need to be repeated several times. After the procedure, pressure will be applied to the biopsy site. A bandage will be applied.
How Long Will It Take?
About 10-30 minutes (plus 30 minutes in the recovery room)
Will It Hurt?
You may feel soreness at the biopsy site for 1-2 days.
Post-procedure Care
When you return home after the procedure, do the following to help ensure a smooth recovery:
- If you had FNA, remove the bandage within a few hours. If you had CNB, remove the bandage in a few days.
- Avoid vigorous physical activity for 24 hours.
- Return to normal activities.
- Take pain medicine (eg, Tylenol ) for any discomfort.
- Be sure to follow your doctor's instructions.
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
- Bleeding
- Signs of infection, including fever and chills
- Trouble breathing or swallowing
- Excessive neck swelling
- Unusual pain or discomfort
RESOURCES:
American Thyroid Association
http://www.thyroid.org/
Thyroid Foundation of America
http://www.allthyroid.org/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
Thyroid Foundation of Canada
http://www.thyroid.ca/
References:
Beers, MH, Fletcher AJ, Jones TV, et al. The Merck Manual of Medical Information: Second Home Edition. Whitehouse Station, NJ: Merck Research Laboratories; 2003.
Ross DS. Fine needle aspiration biopsy of thyroid nodules/instructions for patients undergoing core needle biopsy. Thyroid Foundation of Canada website. Available at: http://www.thyroid.ca/articles/EngE12B.html. Accessed August 24, 2005.
Suen KC. Fine needle aspiration biopsy of the thyroid. Canadian Med Assoc J. 2002; 167:491-95.
Thyroid biopsy. Dr. Joseph F. Smith Medical Library website. Available at: http://www.chclibrary.org/micromed/00067980.html. Accessed August 24, 2005.
Thyroid nodule. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated September 2009. Accessed September 22, 2009.
Thyroid nodule fine needle aspirate. National Library of Medicine, Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003899.htm. Updated May 2008. Accessed September 22, 2009.
Thyroid nodules. New York Thyroid Center website. Available at: http://cpmcnet.columbia.edu/dept/thyroid/NodulesHP.html. Accessed September 22, 2009.
Thyroid nodules: symptoms, causes, diagnosis, treatment. American Thyroid Foundation website. Available at: http://thyroid.org. Accessed August 24, 2005.
Last reviewed November 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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