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Needle Biopsy: Thyroid by Julie J. Martin, MS

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

A needle biopsy use 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

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 (eg, 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 (eg, 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: http://www.ebscohost.com/dynamed/what.php . Updated August 30, 2012. Accessed December 27, 2012.
Thyroid nodules. New York Thyroid Center website. Available at: http://cpmcnet.columbia.edu/dept/thyroid/NodulesHP.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.

Last reviewed November 2012 by Michael Woods, MD

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