Thyroid puncture (fine needle aspiration biopsy)
- What are the indications for a thyroid puncture?
Nodular formation in the thyroid gland is detected in two out of three patients during the examination Ultrasound of the thyroid gland. More than half of women over the age of 50 have nodules in the thyroid gland. When identifying a node, the main problem is to determine which nodes are to be feared, and which ones can simply be observed. According to the results of many years of research conducted by large endocrine clinics, about 90% of the identified "nodes" are benign and do not require special (surgical) tactics. In order to understand the nature of the cellular composition of the "node", in some cases, a fine-needle aspiration biopsy of the thyroid gland is indicated.
A properly performed fine needle aspiration biopsy of the thyroid gland with a clearly formulated expert opinion on the cell material is the standard in the diagnosis of the nature of thyroid nodules.
A fine-needle aspiration biopsy of a thyroid nodule and a study of the cellular composition of the drugs allows the doctor to determine the type of node and make recommendations for further tactics in relation to the patient. Adequate treatment of patients with thyroid nodules is impossible without professional performance of a fine-needle aspiration biopsy of the thyroid gland and an understandable standardized conclusion.
The Russian Association of Endocrinologists has formulated the following indications for thyroid cancer:
1. Nodular formations equal to or greater than 1 cm in diameter (detected by palpation and / or ultrasound);
2. Conducting TAB (under the control of ultrasound) with randomly detected formations of a smaller diameter is advisable only if a malignant tumor is suspected according to ultrasound data;
3. Clinically significant increase in previously identified thyroid nodule formation under dynamic observation;
- How is a thyroid puncture performed?
Aspiration biopsy is performed under the control of ultrasound using a conventional syringe. When performing the TAB, anesthesia is not required. During the TAB, the cells are taken directly from the identified nodular formation with a syringe. The injection is performed with an ordinary 5 or 10 ml syringe with a standard needle and practically does not cause pain, does not require special training and takes about 1-2 minutes. Minutes after the puncture biopsy, the patient can leave the clinic and return to their normal activity.
- What should I do after receiving the results of a thyroid puncture?
Most often, after the first attempt of a biopsy, it is possible to establish an accurate diagnosis and give the necessary recommendations for further treatment. However, in any, even the most experienced clinic, there is a possibility of receiving an uninformative answer, that is, a conclusion that does not contain a final judgment about the type (benign or malignant) of the node. According to modern statistics, this probability according to various data is up to 20-30%
If such a response is received, it is recommended to repeat the fine needle biopsy. And if you repeatedly receive an uninformative response, it is considered that the patient is shown surgical treatment, since it is impossible to accurately determine the structure of the node and exclude the diagnosis of a malignant formation.
In our clinic, the cytological response for fine needle biopsy is standardly formulated based on the internationally accepted classification of The Bethesda System for Reporting Thyroid Cytopathology, which makes it presentable and understandable for specialists around the world.
Only by studying the cellular composition can thyroid cancer be confirmed or rejected with a high degree of confidence.
Diagnosis and treatment of thyroid diseases should take place with the participation of an endocrinologist and an endocrinologist surgeon in a specialized department.