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25 N Winfield Rd Ste 505, Winfield, IL 60190-1295

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Call
(630) 938-6161
to Schedule a Consultation

25 N Winfield Rd Ste 505
Winfield IL 60190-1295

Thyroid Nodules

What is a Thyroid Biopsy?

Fine Needle Aspiration Thyroid

General Information

Commonly referred to as a fine needle aspiration (aka ‘FNA’).

Ultrasound is used to visually guide a needle through the skin overlying the thyroid, directly into the nodule.

  • The skin is typically numbed prior, requiring a pinch from a needle and stinging / burning sensation as the numbing medicine is injected.
    • The sensation is uncomfortable but brief, like a quick bee sting. This is typically the worst part of the biopsy.
  • Unfortunately, the numbing medicine cannot numb the tissues deeper in the neck or the thyroid itself.
    • As a result, you may feel pressure or discomfort when the needle goes deeper.
    • Whatever sensation you feel can travel to your jaw, ear, head, or chest because the sensation nerve fibers in the head and neck are all connected.
  • Once the needle is in the nodule, an in-and-out motion is used to core out samples of thyroid cells into the hollow of the needle.
    • This in-and-out motion can cause increasing pressure on the windpipe depending on the location and composition of the nodule.
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While the needle is in the neck, the patient should try to remain very still, avoiding turning their neck, swallowing, or talking.

  • If the patient moves, it will make it more difficult for the person performing the biopsy, and potentially more uncomfortable for the patient.

The needle is typically in the neck for about 5 seconds or less before it is removed.

The contents of the needle are then squirted onto a slide and prepared for a pathologist to look at under a microscope.

If the pathologist does not receive enough cells to look at, they will not be able to make a diagnosis and the procedure would need to be repeated.

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To lower the risk of a non-diagnostic result, typically 4 passes are made with different needles.

  • This makes for a total of 5 needle pokes: 1 for the numbing medicine and 4 for collecting the cells.
    • If multiple nodules require biopsy, depending on the location of the nodules additional numbing medicine needle pokes may be necessary, as well as 4 additional needle passes for each of the nodules being biopsied.
      • Example – if two nodules on opposite sides of the thyroid require biopsy, there will be a total of 10 needle pokes: 1 numbing shot on each side (2) and 4 needle passes for each nodule (8).

The entire process takes about 10-15 minutes.

  • An extra ~ 5 minutes for each additional nodule being biopsied.

Once completed, the neck is cleaned and a small band-aid is placed, which can be removed the next morning.

The numbing medication wears off in 1-2 hours.

  • There can be some mild discomfort for 1-2 days following.
  • This can feel like a deep bruise or soreness in the neck.
  • The skin may also bruise and become slightly swollen.
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Ice compresses, Tylenol, and/or NSAIDs such as Ibuprofen / Motrin / Advil / Aleve are helpful to control discomfort.

There are no activity restrictions following the FNA – you can drive, eat, drink, exercise, sleep and relax in any neck position, etc.

  • You do not require someone to drive you home from the procedure.

Results are typically finalized in 1-2 business days, and you will receive either a MyChart message or phone call notifying you of the results.

  • Follow up appointments for benign thyroid nodules will be arranged before you leave the office on the same day of the biopsy.
  • If the biopsy results are positive for cancer, Dr. Kay will call you to explain the results and arrange an appointment in the office to discuss surgical treatment options within 1-2 weeks.

When is the FNA performed?

Dr. Kay performs the FNA in his office on the same day of the initial consultation. The entire visit takes ~ 40 min.

Central Neck Dissection

What are the risks of an FNA?

Insufficient cells (aka non-diagnostic result) requiring repeat FNA; ~ 5% risk.

  • Multiple needle passes creating more slides for the pathologist to review can help diminish this risk.
  • If the biopsy does come back as non-diagnostic, the recommendation is made to repeat the FNA in 6 weeks, allowing adequate time for the inflammation and swelling from the first FNA to resolve.

Bleeding from the thyroid resulting in significant swelling and bruising (aka hematoma) is very rare; < 1%.

  • This will present as significant swelling and bruising in the neck.
    • Please call the office right away if you experience anything more than a small (quarter sized) amount of bruising and swelling.
    • Very rarely can bleeding persist requiring admission to the hospital.
  • More common when patients are on multiple blood thinning medications.
    • If taking a single blood thinner, it is ok to proceed with the FNA with an acceptable slight increased risk of bleeding to ~ 1%.
  • If taking multiple blood thinners, you may be asked to stop one or all prior to the procedure to limit this risk.

If cancer is present, there is no risk for spreading cancer cells elsewhere in the body when performing the FNA.

The results of an FNA are accurate and reliable ~ 98% of the time.

  • Contrary to previous beliefs, thyroid nodules larger than > 4.0 cm do not have increased risk for a false negative biopsy.

To read more about the Thyroid Nodule Biopsy (FNA) procedure including what to expect, as well as details regarding recovery and risks:

 

To learn more about thyroid nodules visit

 

To learn more about the Thyroid, head back to the Thyroid main page here.

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