Puncture biopsy of the thyroid gland node

Fine needle aspiration biopsy of the thyroid gland (TAB)It is a modern minimally invasive diagnostic method. The essence of the procedure is to collect cells from thyroid nodules for further cytological examination. The TAB has strict indications for its implementation, it is performed with a thin needle, which makes the manipulation painless. For maximum accuracy, all actions during sampling are performed under ultrasound control. A fine needle aspiration biopsy does not require hospitalization in a hospital, the procedure is performed on an outpatient basis.

Why is it important to monitor the condition of the thyroid gland?

The thyroid gland produces thyroid hormones, which are necessary for the normal functioning of all organs. In case of violations of her work, the following is possible:

• sudden weight gain or loss;

• dry skin and hair loss;

• menstrual cycle failure;

• constant fatigue or overexcitation;

• gastrointestinal disorders;

• severe drowsiness or insomnia and other symptoms.

All of Russia, except Sakhalin, belongs to the iodine-deficient zone. Iodine deficiency is one of the main causes of nodular formations in the thyroid gland. Nodules can be benign (colloidal) and cancerous, the latter can be malignant.

It is possible to accurately determine the nature of the formation only with the help of a fine needle puncture biopsy. But even colloidal nodes require monitoring. They may increase in size, and then the patient feels a lump in his throat, it is difficult for him to swallow, there may be dizziness, suffocation. A nodular goiter appears — one or more nodes that have grown so much that spherical protrusions appear on the neck. On the background of nodular formations, thyroid gland disorders are possible: an increase or decrease in hormone production.

Endocrinologists at the EMC Clinic recommend that all Russian citizens over the age of 25 have their thyroid checked annually. At our medical center in Moscow, you can make an appointment with specialists the highest category, doctors with at least 15 years of professional experience and more. The examination may include an analysis for thyroid-stimulating hormone, T4, ultrasound of the thyroid gland, and a biopsy may be performed if indicated.

Types of thyroid biopsy

There are two ways:

✔ fine-needle;

✔ Core biopsy.

A fine—needle procedure is the fastest and safest procedure. But in some cases, for example, if the TAB results are ambiguous or insufficient for an accurate diagnosis, the doctor may prescribe a Core biopsy. It is similar to an aspiration needle, but with a larger needle. In most cases, a fine needle biopsy is sufficient.

Indications for the study

Puncture biopsy of the thyroid gland node is indicated for:

• nodular formations, the size of which is equal to or exceeds 1 cm in diameter;

• nodular formations less than 1 cm in size, but with the presence of suspicious ultrasound signs of thyroid cancer;

• when the ultrasound structure of benign thyroid nodules changes (in the process of dynamic observation);

• when enlarged or altered cervical lymph nodes appear.

The decision about the puncture is made by the endocrinologist after consultation. The risk group for the development of malignant processes in the thyroid gland includes:

• women over 50 years old, men over 70 years old;

• workers of harmful industries;

• persons whose close relatives suffered from thyroid diseases;

• victims of the Chernobyl accident.

If indicated, such patients are immediately given a biopsy.

Contraindications to the TAB

There are no absolute contraindications for fine needle aspiration biopsy. Among the possible limitations to the study are:

• severe mental disorders;

• inability of the patient to remain motionless;

• inflammatory and purulent processes at the biopsy site.

The decision on the possibility of performing a TAB or replacing it with another examination is made by the endocrinologist, taking into account the complaints and condition of the patient, the results of other tests or examinations.

Research methodology

No special preparation is required before a thyroid node biopsy. If the procedure causes severe anxiety, ask your doctor if you can take sedatives.

Course of the procedure

Manipulations are carried out in 2 stages:

• sampling of the material;

• its microscopic analysis in the laboratory.

Before the procedure, you need to inform your doctor about allergies to medications and taking medications on an ongoing basis. The clothes are loose, without ties at the neck and collars. Jewelry must be removed from the neck. When taking blood thinning medications, you should discuss their cancellation with your doctor.

The patient lies on the couch on his back, and a special cushion is placed under his neck. This position facilitates access to the area of the upcoming puncture. Next, the skin at the injection site is treated with an antiseptic. The doctor determines the location of pathological formations in the thyroid gland with an ultrasound sensor. To perform a biopsy, a thin needle is used, which is inserted into the node, after which the biomaterial is taken using a syringe. All actions are performed under strict ultrasound control. Thus, doctors manage to increase the accuracy and safety of the study, as well as minimize the risks of any complications. The resulting biopsy is sent to a laboratory for examination. TAPB is completed with repeated antiseptic treatment and the application of a sterile dressing.

Further analysis of the material takes place in EMC's own pathology laboratory. We do not cooperate with third-party organizations, the entire process is controlled by our specialists. The laboratory is open around the clock, so you will receive the results as soon as possible. The data on the study is transmitted to the patient electronically and entered into the unified EMC database. In difficult cases, the endocrinologist requests a second opinion from foreign colleagues: leading specialists from France, Israel and the USA.

How long does a thyroid biopsy take?

On average, the procedure takes 15-25 minutes. Including preparation and follow-up after the TAB, the total time spent in the clinic will be approximately 30-60 minutes.

What does a positive biopsy result mean?

We do not recommend decoding the results yourself. Make an appointment with an endocrinologist. He will tell you what is written in the report and make a treatment plan or prescribe additional examinations.

What should I do after the procedure?

Immediately after the completion of the biopsy examination, the patient returns to his usual lifestyle, there is no rehabilitation. It is rare for a small hematoma to appear at the puncture site, and a slight increase in temperature is considered normal: 37-37.2 °C. The specialists of the EMC clinic have many years of experience in performing puncture biopsy of the thyroid node, so the risks of any complications are reduced to zero.

Contact your doctor if:

• after examination, the puncture site swells and hurts;

• there are problems with swallowing;

• the lymph nodes are enlarged;

• the temperature does not decrease to normal.

TAPB results

Thanks to a thyroid biopsy under ultrasound control, the following can be detected:

• adenoma (follicular tumor, usually benign);

• lymphoma (malignant lymphoproliferative tumor);

• thyroid cancer;

• colloidal nodules (a type of nodular goiter in which a large amount of colloid is formed, stretching the follicles);

• "undefined" signs of AUS (atypia) and FLUS (follicular change)- require a repeat biopsy.

You can get a report 3-7 days after the puncture. In cases where the study is uninformative and the results are questionable, the doctor may recommend repeating the procedure after some time.

To date, TAPB allows detecting the presence of thyroid cancer with an accuracy of more than 90%. This makes the study indispensable in the diagnosis of various malignancies.