Why You Shouldn't Be Afraid of a Thyroid Biopsy

Thyroid neoplasms are the second most common problem among all endocrinological pathologies. Patients are frightened by information about a node that suddenly appeared in the thyroid gland, since the terrible word "cancer" immediately appears in the head. But don't be afraid, an article about thyroid nodules said that only 10% of all thyroid tumors can be malignant, and for the most accurate differential diagnosis, it is necessary to use such a diagnostic method as a biopsy of the thyroid gland . This is the most effective method for the differential diagnosis of thyroid formations, which allows obtaining material for cytological examination with minimal risks.

What are the indications for a thyroid biopsy

Fine needle aspiration biopsy of the thyroid gland – it is a method that is used for both diagnostic and therapeutic purposes: with the help of a biopsy, fluid can be aspirated from the cystic formations of the thyroid gland. Indications for a biopsy of the thyroid gland are the size of palpable nodes more than 1 cm, radiation of the head and neck   in the patient's history or a aggravated family history: thyroid cancer in close relatives. In addition, indications for a thyroid biopsy are the following ultrasound signs of nodules of any size:

• fuzzy node contours;
• central hypervascularization formations;
• point hyperechoic inclusions – microcalcifications.

Signs of thyroid nodules highly suggestive of cancer

There are also certain physical, anamnestic and laboratory features of thyroid nodules that suggest possible thyroid cancer, and therefore only an aspiration biopsy can provide correct information about the final diagnosis. If you have two or more of the following physical signs, you are very likely to have thyroid cancer:

• dense thyroid nodule;
• rapid growth of a thyroid nodule;
• node fixed to adjacent anatomical structures;
• presence of vocal cord paralysis;
• dysphagia and/or dysphonia – signs of invasive tumor growth.

History signs that are highly likely to indicate thyroid cancer include a burdened family history, radiation exposure to the head and neck, as well as certain types of diseases: adenomatous polyposis of the gastrointestinal tract, hyperparathyroidism and pheochromocytoma, Cowden's disease, and others. An increase in the level of calcitonin in the blood is one of the laboratory signs of thyroid cancer.

Thyroid aspiration biopsy technique

Before starting a biopsy of the thyroid gland, it is necessary to calm the patient and explain the sequence of the procedure, answer all his questions. This is necessary in order for the patient to relax as much as possible and not complicate the biopsy of the thyroid gland. The patient is placed in a supine position, in order to relax the neck muscles, a roller is placed under his shoulders. The puncture site must be treated with an antiseptic solution. Local anesthesia is not required – thyroid biopsy is a completely painless procedure, provided the patient has the right attitude towards it. Fear and tightness can cause discomfort during any medical manipulation.  Under ultrasound control, a needle is inserted into the node through the tissues of the neck and its contents are aspirated.

Cytological findings after thyroid biopsy

The contents of the node obtained by biopsy are transferred to glass slides and processed depending on the staining method for cytological examination. Papanicolaou or Giemsa stains are most commonly used. On the basis of a cytological examination, the following cytological diagnoses can be made:

nodular colloid goiter;
papillary, follicular, medullary, or anaplastic thyroid cancer;
suspicious  in relation to malignancy, B-cell or indeterminate follicular neoplasia;
acute, subacute or chronic thyroiditis;
thyroid lymphoma;
metastases of tumors of other localization.

If the material obtained after the biopsy of the thyroid gland turned out to be unsuitable for cytological examination, a conclusion is made about the uninformativeness of the punctate and the need to repeat the procedure. Biopsy of the thyroid gland – is the most informative method for diagnosing thyroid neoplasms. After receiving the results of a cytological examination of the punctate, doctors draw up the most effective treatment regimen in each specific case.

   A thyroid biopsy should not be feared, if only because as early as possible this painless procedure can save the patient's life, even if the diagnosis of thyroid cancer is established. In the early stages, the probability of a complete cure of the patient is very, very high!