by Martin JJ

Needle Biopsy: Thyroid

(Fine-Needle Aspiration: Thyroid; Skinny-Needle Biopsy: Thyroid; Coarse-Needle Biopsy: Thyroid; Core Needle Biopsy: Thyroid)

Definition

A needle biopsy uses a needle to removal of a small piece of tissue or fluid for testing. In this case, the tissue is removed from the thyroid gland.

Reasons for Procedure

A thyroid biopsy is usually done when a lump is found in the thyroid. The lump is often called a thyroid nodule. These nodules are fairly common and usually do not need treatment. Only about 5% of nodules are cancer .
The needle biopsy is usually done to see if a nodule is cancer. The biopsy may also be done if there is no nodule but the thyroid is enlarged.
Thyroid Nodule
Nucleus image
© 2011 Nucleus Medical Media, Inc.

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:
  • Have blood tests
  • Talk to your doctor about your medical history, including any allergies.
  • Talk to your doctor about any medications you are taking. You may be need to stop taking some medicines up to one week before the procedure, like:
    • Anti-inflammatory drugs (such as aspirin )
    • Blood thinners, like warfarin (Coumadin)
    • Clopidogrel (Plavix)
  • Arrange for a ride home from the care center.

Anesthesia

Local anesthesia is used. The area that is affected will be numb.
You may also be given a sedative to help you relax

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. 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.
In some cases, your doctor will use ultrasound to help locate the area that needs to be sampled. If ultrasound is used, the doctor will place a transducer on your neck. The transducer will send images to a screen for your doctor to view. These images will be used to locate the nodule and to guide the needle. This helps to make sure your doctor got a sample of the nodule and not the surrounding "normal" tissue.

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. Talk to your doctor about medications that may help.

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 (such as Tylenol) for any discomfort.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • 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
In case of an emergency, call for medical help right away.

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

Thyroid Foundation of Canada http://www.thyroid.ca

References

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/e12b.php . Accessed December 27, 2012.

Thyroid nodules. American Thyroid Association website. Available at: http://www.thyroid.org/what-are-thyroid-nodules . Accessed December 27, 2012.

Thyroid nodule. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated August 30, 2012. Accessed December 27, 2012.

Thyroid nodules. New York Thyroid Center website. Available at: http://columbiathyroidcenter.org/nodules.html . Accessed December 27, 2012.

Ultrasound-guided fine needle aspiration biopsy of the thyroid. RadiologyInfo.org website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=thyroidbiopsy . Updated July 25, 2012. Accessed December 27, 2012.

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