One of the main organs endocrine system– The thyroid gland performs an intrasecretory function. It is responsible for the storage of iodine and the synthesis of iodothyronines (iodine-containing hormones). With iodine deficiency, the gland begins to work in emergency mode, which leads to changes in the tissue structure and the formation of nodes.
Seals require detailed diagnosis, as they can be either benign or cancerous. The reasons for the transformation of thyroid tissue into malignant neoplasms may be unfavorable heredity in endocrinology or radiation exposure. Puncture thyroid gland under ultrasound control is the most informative procedure for differentiating the nature of the occurrence of nodes.
Not all thyroid nodules are cancerous. The doctor’s task: to determine which formations need to be eliminated urgently (malignant) and which do not require surgical intervention(benign) because they have no predisposition to degeneration. According to medical statistics, thyroid nodule cancer is diagnosed in 10–12% of the total number of neoplasms.
Indications and contraindications for thyroid puncture
Nodular neoplasms in the endocrine gland require detailed examination if they begin to rapidly grow and put pressure on adjacent organs. Symptoms of thyroid dysfunction include:
- labored breathing;
- swallowing disorder (dysphagia);
- decreased performance and tone;
- hyperhidrosis (sweating);
- Thyroid cancer was previously diagnosed in close relatives. This indicator is endogenous (characteristic of internal reasons), and denotes a predisposition to the disease, but not the fact of it mandatory manifestation.;
- the patient stayed for a long time in an area with increased radiation;
- unreasonable decrease or increase in body weight.
An endocrinologist, as a rule, prescribes laboratory blood microscopy for thyroid hormones and ultrasonography organ. Ultrasound clearly shows the number of nodules, their size and growth dynamics. A fine-needle puncture biopsy (FNA) is performed in the following cases: neoplasms are rapidly progressing, nodes are more than 10 mm in size, a blood test revealed a significant violation of the level of calcitonin, a tumor marker that makes it possible to establish rare view thyroid cancer – medullary cancer. This is a severe pathology in which tumor cells are crowding out connective tissues organ.
There are no absolute prohibitions on performing a puncture biopsy of the thyroid gland. Limitations may be unstable work heart and hypertension. In this case, prior consultation with the relevant medical specialist. Relative contraindications are: history of hemophilia (blood clotting disorder), respiratory viral infections, luteal phase of the menstrual cycle. TAB is performed on women during the perinatal period and young children.
Pros and cons of a biopsy
The prerogative aspects of the method of puncture examination of neoplasms in the thyroid gland are:
- efficiency of obtaining results. Evaluation of results does not require a long time;
- affordability. The procedure is not expensive;
- information content. Laboratory analysis can accurately determine the malignant or benign etiology of the nodules. This allows the doctor to prescribe the maximum the right tactics treatment.
Disadvantages include possible complications arising from violation of the rules of the procedure, and the doctor’s lack of the necessary qualifications. In rare cases, infection of the puncture site, with corresponding consequences.
Preparing for TAB
Special preparatory activities are not provided for thyroid biopsy. The recommendations boil down to limiting active physical activity and a ban on the consumption of alcoholic beverages. Training is focused on psychological condition patient, since inserting a needle into the throat area causes fear and anxiety in advance. In these cases, it will not be superfluous to take sedatives for 2-3 days before the study. plant based.
If it is decided to do the puncture under anesthesia, you should fast twelve hours before the procedure. Immediately before the study, the patient is obliged to notify the medical specialist about the presence allergic reactions on medical supplies. Before entering the diagnostic room, you should remove jewelry from your neck and ears and remove dentures from your teeth.
About the procedure
The collection of biomaterial for subsequent analysis is carried out by introducing into thyroid gland fine needle, which is not painful procedure. General or local anesthesia is not used because the patient reacts more painfully to the administration of analgesic drugs than to the biopsy procedure itself. In some medical institutions special creams with an anesthetic are used, but doctors are of the opinion that this is rather a psychological component of preparation for the procedure.
Today, blind biopsy is practically excluded. Puncture analysis is performed using an ultrasound machine. This helps to maintain continuous control over medical procedures. A clear image on the monitor allows the doctor to accurately insert the needle into the tumor and minimize the risk of damage to tissues and adjacent organs.
The time range of a puncture biopsy is about a quarter of an hour.
Schematic drawing of a fine-needle biopsy, which is performed only by a qualified specialist
The name fine-needle biopsy comes from the instruments used - thin needles, 23-21G in diameter. Such needles are used not only to make the procedure easier for the patient (reducing pain and fear), but also because little blood penetrates into the thin needle, which improves the quality of the biomaterial taken for analysis.
Biopsy process
Immediately before TAB, an ultrasound examination of the thyroid gland is performed to precise definition localization of nodes. The procedure is performed with the patient lying horizontally on the couch. The main condition is the correct fixation of the head and neck using a special roller. Support of the cervical spine on the bolster provides best access to the protruding thyroid gland.
The patient's neck area is treated with an alcohol-containing antiseptic. The instrument for collecting the biopath is an empty syringe equipped with a thin and long needle. The doctor uses an ultrasound sensor to find the tumor. The puncture can be performed in two ways:
- using a needle attachment. A specialized attachment for the ultrasound sensor helps to determine the location of the formation as accurately as possible. A thin needle passes directly through the nozzle, the doctor makes a puncture skin and enters the needle directly into the knot. In this case, sterility measures must be strictly observed, since the nozzle is a reusable instrument that comes into direct contact with the patient’s blood;
- without guide nozzle. Carrying out a biopsy without a special attachment requires a highly qualified doctor and experience in performing such manipulations. Because in this case, the doctor identifies the node with the help of a sensor with one hand and, holding it, inserts the puncture needle by touch with the other hand. This type of diagnosis is called “hands-free”.
In essence, puncture of the thyroid node is the drawing into a syringe of a substance that is located in the tissues and cells of neoplasms. The greatest information about the availability cancer cells have node walls, so it is preferable to obtain biomaterial from this part. During the biopsy, the patient must remain completely static and avoid swallowing movements.
After pumping out the required amount of biopath, the needle is removed, the puncture site is wiped with an antiseptic again, and a gauze napkin is fixed on it with a plaster. For getting complete information and in the presence of several space-occupying formations, the puncture is taken several times in different areas. To avoid bleeding, the bandages should be pressed and held for several minutes (as after intravenous injection).
The resulting biomaterial from the Spitz is squeezed onto a special laboratory glass and sent for further analysis. After a quarter of an hour, the patient can lead a normal life. On the first day after the puncture, doctors recommend avoiding sports and not washing or getting the puncture area wet.
The doctor will tell you before the procedure how to prepare and how the manipulation will take place.
Possible side effects
When using high-quality instruments and having the proper medical experience of the medical specialist responsible for performing the puncture, complications practically do not arise. In patients with osteochondrosis cervical spine spine, as well as in people suffering from unstable blood pressure, after TAB, short-term dizziness is possible.
If the nodes that were punctured are located near the trachea, a cough may appear on the first day. It doesn't need treatment. Post-procedure lethargy and loss of strength are associated with the patient’s neuropsychological stress during the study. This condition passes quite quickly.
In rare cases it is noted:
- violation of the swallowing reflex;
- elevated temperature bodies;
- hematoma in the injection area;
- bleeding.
If such symptoms appear, you should visit a doctor.
TAB results
The substance extracted from the thyroid nodule is sent for microscopic analysis to a cytologist. When assessing structural changes in tissue and cellular composition, the doctor uses color indicators. The reliability of the results is more than 96%. The results of the analysis of the contents of nodes are classified into four main groups:
- Colloidal node. A benign neoplasm that is not prone to transformation into cancer and does not require surgical intervention. With colloid nodes, it is necessary to balance the level of iodine in the body. This is easily achieved through diet correction and vitamin and mineral supplements.
- Inflammation of the thyroid gland autoimmune, syphilitic or tuberculous etiology (thyroiditis). Not related to malignant processes, but requires additional diagnostics for differentiation and special treatment.
- Compensated or decompensated follicular neoplasia. The disease can be malignant or benign. Determining the nature of the tumor is possible only through surgery, followed by studying the extracted biomaterial.
- Carcinoma or cancerous tumor. There are several types of thyroid cancer. Squamous cell and papillary carcinomas are considered less dangerous. The rapidly metastasizing and aggressive types include medullary and anaplastic. In any case, a cancerous tumor requires immediate surgical removal. At timely treatment and the absence of metastases in adjacent organs, the prognosis is 94–96% favorable.
The location of the node in the thyroid gland can be palpated in most cases
Benign formations in the thyroid gland do not have a tendency to degenerate into cancer. Oncologic nature is always inherent from the very beginning. If hyperplasia was determined ( benign tumor), and a few years later the patient is diagnosed with cancer, which means that during the first study the medical errors: the doctor passed the needle past the node and the puncture was taken from the gland tissue, the microscopy technology of the biopath was violated, when decoding the results, the doctor interpreted them incorrectly or the tests were mixed up.
Nodes of benign origin do not pose a serious danger, but require constant monitoring by an endocrinologist. Neoplasms tend to grow, which can significantly complicate the patient’s life.
Additionally
The results (results) of the analysis can sometimes be uninformative; in percentage terms, this figure is about 20% of all studies. This situation occurs when there is insufficient amount of biomaterial and requires a repeat puncture biopsy. In case of a secondary uninformative study, to determine the nature of the nodules, it is recommended surgery on opening the thyroid gland.
Only in this way can the condition of the gland be assessed and material removed for laboratory analysis. By decision of the doctor, auxiliary tests for hormones (calcitonin, thyroglobulin, patharhormone) may be prescribed. The biomaterial is obtained by flushing from a manipulation needle. The patient receives a protocol with the results of FNA in 10-15 days.
The choice of treatment tactics (conservative or surgical), as well as the prescription of medications and special nutrition, is the prerogative of the endocrinologist. The thyroid gland is part of a complex endocrine system, in order to avoid severe consequences Self-medication is prohibited.
Thyroid puncture is done after medical examination an endocrinologist and ultrasound diagnostics, during which a tumor larger than 1 cm was discovered. This minimally invasive surgery aims to obtain a tissue sample for cytological examination. The reason for this may be suspicion of malignancy.
Types of puncture and scheme of its implementation
There are several types of biopsies, but fine needle biopsies are usually performed. This procedure is characterized by the fact that the endocrinologist uses a needle with a minimum diameter. It does not bring any discomfort to the patient, so anesthesia is not used during the biopsy. All manipulations must be carried out under ultrasound control. The oncologist’s task is to obtain tumor cells from the patient, and not the thyroid gland itself.
Cells extracted from the tumor are sent to the laboratory. During the cytological analysis of the biopsy, specialists determine whether the resulting material is malignant or not. If the number of cells taken during a fine-needle biopsy for staging accurate diagnosis is not enough, the endocrinologist prescribes a histobiopsy to the patient.
During this procedure, the specialist acts on the affected area with a needle of a larger diameter and can obtain a larger area of tissue for cytology. This manipulation may be more painful, so it is performed under local anesthesia.
Indications for biopsy and preparation for it
A biopsy of any type is prescribed only after full examination. Suspicions may be raised by:
· seals;· cysts and other pathologies.
The highest risk groups include patients under 20 and over 60 years of age, people with a hereditary predisposition to cancer diseases, women who have been diagnosed with tumors of the breast or appendages. The puncture is not performed if the patient has:
· poor blood clotting;Acute vascular lesions (history);
· mental illness.
Complications after thyroid puncture
A puncture of the thyroid gland does not always occur without consequences for the patient. This procedure does not require any special preparation on the part of the patient, but the technology must be highly accurate. The patient lies on his back. A high cushion is placed under his head. You should not swallow throughout the entire procedure so that the thyroid gland does not move and the needle gets directly into the tumor.
With osteochondrosis of the cervical spine, the patient may experience slight dizziness after the puncture. Minor bruising may also occur at the puncture sites. They will pass quickly, and there is no need to worry about it. TO possible complications After thyroid puncture, wound infection can occur if the skin surface is not thoroughly treated.
In this case, acute thyroiditis, or inflammation of the gland, sometimes occurs. There are several types of this disease:
Diffuse and focal;· purulent and non-purulent thyroiditis.
Inflammation develops gradually, but it “makes itself known” abruptly, overnight. The patient suddenly begins to feel severe pain in the area of the thyroid gland and the entire throat. It can be projected onto the sides of the neck and even the spine.
In extreme cases, due to intense pain, a person cannot turn their head to the side. If this happens after a puncture, you need to know what manifests itself in this way infectious inflammation. The patient himself does not need to take any action. See a doctor immediately!
Thyroid puncture is both therapeutic and diagnostic medical appointment. It involves taking material from a neoplasm in an organ by piercing it with a syringe, which is why the method is otherwise called fine-needle biopsy. There is no need to be afraid of a puncture: this is an ordinary manipulation that does not require special preparation.
Why is a thyroid puncture performed?
The thyroid gland (TG) is “famous” for the fact that neoplasms of various types often form in it. These are cysts, nodes or tumors. Visually, you can only determine the approximate size of the formation and its location. An ultrasound or MRI can show the depth of the node, as well as determine the homogeneity and intensity of the blood supply to the thyroid gland.
A puncture or biopsy of the thyroid gland allows you to find out what is inside the tumor and, thus, determine its nature. Chemical and biological analysis of the contents shows whether it is a cyst, node or tumor - benign or malignant.
By the way! Sometimes puncture of the thyroid gland is done even in the absence of nodules. For example, if a goiter is suspected and to determine its nature (diffuse or toxic), or to diagnose thyroiditis (inflammation of the thyroid gland).
Indications for thyroid puncture are as follows:
- Availability cystic formations unknown nature;
- suspicion of a malignant tumor;
- detection of deep nodes after ultrasound of the thyroid gland;
- ambiguous ultrasound images;
Also, puncture of the thyroid gland is indicated in medicinal purposes. For example, to pull out the contents from a cyst, provided that you are 100% sure that it is not malignant tumor. Then you can literally pump out the pathological fluid with a syringe, reducing the size of the tumor. But even in this case, the contents will be sent for analysis.
There are no absolute contraindications to thyroid puncture, but there are relative ones - those that need to be eliminated or additional consultation other specialists. This is infancy psychical deviations The patient has problems with blood clotting. Pregnancy is not a contraindication to such manipulation.
Preparation and technique
A thyroid biopsy is rarely done suddenly during a routine examination by an endocrinologist or surgeon. Usually the procedure is scheduled for another day, because before the puncture it is necessary to take blood tests: general and hormonal. And if the patient also has problems with coagulation, then an additional coagulogram is done.
On the day of thyroid puncture, no preparatory actions are required. The only point is that the man is recommended to shave thoroughly so that the doctor can accurately determine the puncture site. If the patient wears a model beard, then the conditions for the puncture are discussed individually.
By the way! If the neoplasm is deep, then puncture of the thyroid gland is carried out under ultrasound control. This is necessary so that the doctor does not “miss” the node.
There is no pain during puncture of the node, because the doctor first performs an application (superficial) anesthesia, lubricating the skin with an anesthetic. In addition, the puncture needle is very thin. And the main fear is usually not pain, but that a biopsy may show oncology. But there is no need to worry in advance: it is better to hope for the best and calmly wait for the results.
How is a thyroid puncture taken? If the formation is large, then the doctor makes several punctures to take the contents from different areas. After the puncture, a patch is applied to the skin.
The contents of the thyroid tumor are sent to the laboratory, where a study will be carried out to determine the cellular composition. The patient will receive a conclusion after 1-5 days, depending on the workload of the laboratory and the urgency of the analysis. If suspicion of a malignant tumor is high, then the analysis will be carried out immediately.
What could be the results?
In the laboratory’s conclusion, the detailed composition of the contents taken for analysis from the thyroid gland will be prescribed. Thyroglobulin, parathyroid hormone, calcitonin are all important hormones that will allow you to assess the presence or risks of endocrine diseases, as well as determine the criticality of the patient’s condition.
Calcitonin, for example, is a marker of oncopathology that allows timely diagnosis of medullary cancer. This is a rare type of hormonal malignancy that does not cause symptoms. Information obtained in a timely manner, thanks to a biopsy, will allow the operation to be carried out in as soon as possible and save the patient's life.
If the analysis shows that this is not a malignant tumor, but, for example, a colloid nodule, then the patient will simply have to slightly adjust his lifestyle and change his diet, as well as be examined annually by an endocrinologist. If this is benign follicular neoplasia, then it is recommended to remove it (along with part of the thyroid gland), because such a formation can develop into cancer.
Possible consequences of puncture
Although the procedure is safe and painless, it can lead to some complications. Stress, nervousness and insomnia before waiting for results do not apply to them.
- Cough. It can be caused by irritation of the trachea during manipulation, because this organ is located very close to the thyroid gland. This cough does not need to be treated - it will go away within a day.
- Temperature increase. If it is insignificant - up to 37 - then this is also a temporary phenomenon as the body’s reaction to minimally invasive intervention. If the temperature is high, with fever, it is an infection. It is urgent to call an ambulance.
- Hematoma at the puncture site. A harmless consequence that can be smeared with troxevasin and masked with a high collar sweater.
- Pain at the puncture site may be felt after the anesthesia wears off (and it will go away almost immediately after the manipulations are completed). This is normal, you just need to wait a few minutes. If the pain is felt more deeply and does not go away for a long time, you should contact the doctor who performed the puncture.
- Dizziness. Present after puncture of the thyroid gland in people suffering from osteochondrosis.
Thyroid biopsy is one of the most informative methods for studying the contents of neoplasms. Only in 5% of cases is a repeat puncture necessary to confirm a rare tumor or when receiving incomplete or unclear results.
A thyroid biopsy involves taking a tissue sample for analysis to determine the nature of the tumor (benign or malignant). It is necessary to take a biopsy directly from the area that arouses suspicion among the doctor. Subsequently, histological and, if necessary, cytological examination is carried out. Based on the test results, it is possible to establish the nature of the origin of the neoplasm. This is the answer to a survey about why a thyroid biopsy is done.
Typically, suspicious nodes and seals are detected when ultrasound examination. In some cases, you can feel them yourself, or even notice them visually. It is especially important to undergo such diagnostics when large nodes form and grow rapidly.
Remember. Timely puncture of the thyroid gland allows you to avoid undesirable consequences, including fatal outcome due to late detected cancer.
Indications for testing
The following circumstances may be indications for a thyroid biopsy:
- large neoplasms (more than 10 mm);
- suspicious seals;
- detection of calcifications;
- intensive growth of the node;
- no effect from conservative treatment for several months;
- anomalies vascular structure organ;
- hereditary risks of cancer;
- specific location of the pathology, for example, on the isthmus;
- any suspicions indicating the likelihood of developing cancer.
The procedure itself is quite safe, so it is performed even on small children.
Important. A biopsy is not capable of triggering cancerous degeneration of cells, so such fears are completely unfounded.
However, it is worth considering that thyroid puncture may be contraindicated in a number of cases, for example, with cardiovascular pathologies, problems with nervous system, as well as when the organ is located incorrectly, which makes access to it difficult.
Execution method
In medicine, there are two methods of taking a biopsy sample.
- The first is open, that is, invasive. It is used extremely rarely, for example, when there are contraindications for performing a regular puncture. The thyroid gland is accessed through a small incision in the neck.
- The second method is Tab of the thyroid gland. What it is? A tissue sample of the node is taken by puncturing the neck and thyroid gland with a needle, into which biomaterial is sucked under the influence of a vacuum. The full name of the procedure is fine needle aspiration biopsy thyroid gland.
Preparation
On a note. To obtain reliable results, any research is preceded by preparation. In this case, no special measures not provided.
It is enough to comply with the following conditions:
- If a person is taking any medications, you should consult your doctor in advance about temporarily canceling them or changing the dosage.
- To clarify the situation with the tumor, you should first undergo all the necessary tests.
- Held ultrasound diagnostics, and based on the conclusion, a decision is made on the need to collect biomaterial from certain areas of the thyroid gland.
- Since a puncture of the thyroid gland is being performed, it is better to come to the clinic on an empty stomach so that the use of an ultrasound machine or the puncture itself does not provoke a gag reflex.
If there is severe stress and fear of the procedure, the patient may be injected with a sedative. The use of anesthesia is discussed on an individual basis. Pain relief is necessary for children with a low pain threshold, as well as for certain health problems. In other cases, anesthesia is not used, since the procedure is almost painless, and any medications can affect the result of the study.
How is a biopsy done?
The procedure is extremely simple and is characterized by minimizing risks, especially in comparison with open method. The patient is placed on the couch, the neck is treated with an antiseptic, and, if necessary, a gel is applied to enhance the transmission of the ultrasound signal.
In most cases, TNA of the thyroid gland is performed under ultrasound guidance.
Note. Ultrasound guidance is prerequisite when taking a biopsy from small nodes, as well as when the pathologically altered area of the organ is inconveniently located. If we are talking about a large-diameter goiter, you can do without hardware support.
Next, the doctor feels the optimal point for inserting the needle and makes a puncture. A tissue sample is taken using a needle. At this moment, the patient feels only slight pain discomfort, as with a standard injection. All manipulations take an average of 5-15 minutes.
Important. For a more accurate diagnosis, 2-3 tissue samples are taken, which saves the patient from the need to perform a repeat biopsy.
Since the thyroid gland is punctured with a thin needle, it is enough to treat the puncture site with an antiseptic. If there is bleeding, use a patch. The wound will heal within a few days. When using a thick needle, the puncture site is covered with a sterile bandage for 3-4 days.
Possible consequences
If the thyroid puncture is performed correctly under ultrasound guidance, the risk of complications is minimized. Since a small wound remains at the site where the needle was inserted, the following phenomena may occur:
- bruise;
- slight discharge of blood and ichor;
- skin redness;
Remember. It is important to follow the rules regarding treating the puncture site with antiseptics; it is recommended not to wet it for several days. Otherwise, inflammation may begin due to bacteria entering the wound.
In rare cases, the following consequences of thyroid puncture are observed:
- cough;
- pain when swallowing;
- dizziness;
- enlarged lymph nodes.
Difficulties arise if the doctor touches adjacent tissues (for example, in the absence of ultrasound guidance), or pierces the trachea or blood vessel. With increased body temperature, tachycardia and general deterioration condition, you must immediately seek help from a clinic.
Biomaterial analysis
The collected biomaterial is sent for microscopic examination. Basic is histological analysis. Thanks to him, they are determined structural changes in tissues. Additionally, a cytological study can be performed, which demonstrates a more detailed picture of the current situation through a thorough analysis of the biopsy at the level of cellular structure.
Important! Changes in cell structure indicate the presence pathological process malignant in nature.
A puncture biopsy of the thyroid gland allows us to examine the structure of such samples of biomaterial from the organ as:
- blood;
- colloid;
- follicle epithelium;
- knot tissue.
On a note. It is important to collect tissue from exactly the area that causes the greatest suspicion to the doctor. Even minor deviations from the pathological zone can lead to distortion of the final results. In this regard, a biopsy for small formations is prescribed in exceptional cases.
Decoding the results
The doctor can make an accurate diagnosis only after receiving the results of a thyroid biopsy, the interpretation of which indicates the nature of the tumor.
Fortunately, the vast majority of cases (more than 90%) are associated with the development of benign tumors. In this case further treatment mostly limited to observation and medication.
Much greater concern is caused by results of an uncertain nature or with suspected oncology (neoplasia). In this case, it is recommended to undergo a repeat examination in another laboratory with an existing biopsy specimen or take new tissue samples.
On a note. Malignant formations determined by distinctive features in the structure of altered tissues. Thus, adenoma, carcinoma, sarcoma or epidermoid cancer and metastases can be detected. Oncology is also classified into papillary, follicular, medullary and anaplastic types.
The more and faster the world of technology improves, the less people pay attention to their own health. Although the thyroid gland is a small organ in the body, it performs a very important function. The production of hormones is involved in metabolic processes, growth and development of the body. A puncture of the thyroid gland is prescribed if cancer or other neoplasms are suspected. There are indications and consequences here.
This procedure, a biopsy, is necessary in diagnosing the thyroid gland. It is usually painless. However, there are cases when puncture causes discomfort, moreover, complications that threaten a person with death.
A biopsy of the thyroid gland reveals the disease, and also understands the nature of its course. Thyroid nodules are considered the most common disease of the modern century. In 5-7% of cases their appearance is malignant, in the rest – benign. In any case, treatment is carried out, but it is prescribed depending on the disease. The nature of the disease helps to determine the puncture of the thyroid gland.
The endocrine cells that are removed during the biopsy are examined under a microscope. The procedure itself is performed by a surgeon using ultrasound.
When is a puncture necessary?
What situations may trigger a thyroid biopsy? Not every person needs a puncture. Moreover, it is prescribed after an ultrasound of the thyroid gland is performed, the data of which show the presence of nodes, possibly of a malignant nature.
Not every thyroid problem forces doctors to perform a puncture. A biopsy is performed if the size of the node in diameter exceeds 1 cm (10 mm). If a person has sick relatives or has already undergone thyroid radiation, then a puncture is prescribed if the diameter is less than 1 cm.
The essence of the study is to use ultrasound equipment and a special thin needle, which is inserted into the thyroid gland to partially remove the tissue. Next, it is examined under a microscope, revealing the nature of the disease.
Number of punctures:
- If the tumor diameter is up to 1 cm, one puncture is required.
- With a diameter of more than 1 cm - several punctures.
The procedure takes about 15 minutes, of which 3-4 minutes are the extraction of the tissue itself. The biopsy is usually painless, but discomfort may occur. Everything is carried out under ultrasound, since there are many blood vessels in the thyroid gland area. Any mistake can lead to bad consequences.
As the site already indicated, any appearance of a nodule in the thyroid gland forces a biopsy. A puncture is prescribed in the following cases:
- The node's diameter exceeds 5 mm.
- The presence of a single node that does not accumulate radioactive iodine.
- The appearance of metastatic nodes.
- Presence of multiple nodes.
- A cyst has appeared.
- There are signs of cancer.
- The patient complains of pain that occurs on palpation lymph nodes on the neck or thyroid gland.
Before performing a biopsy, a detailed blood test is performed. Other indications for puncture are:
- Active blood flow is observed inside the node.
- The neoplasm is located in the isthmus of the thyroid gland.
- The patient had a family history of thyroid cancer patients.
- On the side of the node, the lymph nodes are enlarged.
- The neoplasm does not have a clear capsule.
- The patient has cancer.
- The node exhibits heterogeneous contents and calcifications.
- The patient had previously been in areas of radioactive contamination.
Many doctors agree that nodes up to 1 cm in diameter do not require a biopsy. If the patient experiences rapid growth of nodes (up to 5 mm in 6 months), then puncture of the thyroid gland is sometimes prescribed several times.
It is not only the appearance of nodes that can force doctors to perform a puncture. Other reasons to order a biopsy include:
- Thyroiditis – subacute, painless or chronic autoimmune.
- Goiter is toxic, diffuse.
- Recurrence of adenoma, goiter or tumor.
Contraindications for thyroid puncture
Thyroid puncture has its own contraindications. They are as follows:
- Not performed on patients who have had multiple surgeries.
- Not suitable for persons with mental disorders.
- Not performed on patients with low blood clotting ability.
- It is not carried out if the size of the tumor is above 35 mm.
If there are no contraindications, then the patient is prescribed a biopsy. It is carried out by a surgeon under an ultrasound screen to clearly get to the puncture site. The procedure is not carried out blindly, since in this case it is possible irreversible consequences. The patient takes horizontal position, opening the collar area.
A 10-20 ml syringe with a thin needle is used to reduce painful sensations. Before inserting the needle, the neck is treated with an antiseptic. The needle is inserted precisely into the node from which the biomaterial is taken. The accuracy of the hit allows the procedure to be carried out without blood sampling. The needle is removed, and the biomaterial is transferred to a special glass to conduct laboratory tests.
The procedure can be performed 2-3 times if there are several nodes. Preparing and taking a puncture takes 3-5 minutes. Usually no pain medication is used. A cream containing lidocoine may be applied to the skin to reduce the severity of the sensation. If the results are uninformative, then an additional biopsy is performed. However, this does not happen often.
- 2 days before the puncture, you can take a sedative.
- After the procedure, the puncture is covered with an adhesive plaster, and after 5-10 minutes you can go about your business.
- A couple of hours after the biopsy, you can take a bath and play sports.
- If there is pain after a puncture, apply cotton wool soaked in an alcohol solution to the puncture.
- If it hurts to turn your head after the procedure, you should consult a doctor. Will need to borrow correct position under the manipulation of a doctor.
- To prevent dizziness, it is recommended to lie down.
All patients experience different sensations after thyroid puncture. Some people return home within a day and go about their business, while others experience pain for several more days.
What are the consequences of a thyroid puncture?
As with any therapeutic procedure, puncture of the thyroid gland may have consequences. This depends on the professionalism of the doctor and on the individual characteristics and health of the patient. Frequent consequences of such a procedure are:
- The appearance of hematomas varying degrees. As the needle gets past blood vessels into the thyroid gland, cases of their impact are not uncommon. Despite the fact that everything happens using ultrasound, it is sometimes impossible to avoid punctures due to the individual structure circulatory system. This leads to bruising. The pain can be reduced by applying a cotton swab.
- Temperature increase. The mark does not exceed 37 degrees. This temperature subsides after a day and does not threaten a person.
- Cough. It occurs after puncture if the node from which the material was taken is located close to the trachea. This can also cause pain when swallowing. Symptoms usually go away on their own within a few days.
- Dizziness, fainting. This happens in two cases: with osteochondrosis of the cervical spine and with high impressionability. In the first case, after 10-20 minutes after the procedure, you should smoothly take a vertical position. In the second case, it is permissible to accept sedatives before puncture of the thyroid gland.
- Thyrotoxicosis is a psychological phenomenon manifested in panic fear, sweaty palms, rapid heartbeat, anxiety. This is eliminated thanks to a clear explanation of how the procedure will be carried out, as well as answers to all questions that concern the patient.
More complex consequences may occur that threaten a person’s life. In this case, he should spend several days under the supervision of doctors. Such complications are:
- Heavy bleeding from the puncture area that does not stop.
- Tumor formation in the puncture area.
- It is painful or impossible to swallow.
- There are signs of infection.
- The temperature rises above 38 degrees, which is accompanied by fever and chills.
- Enlarged lymph nodes, which is noticeable to the naked eye.
- Inflammation of the puncture site.
- Hemorrhages under the skin, inside the node or under the capsule of the gland. Usually the blood resolves quickly and the pain goes away.
- Transient vocal cord paresis.
- Decreased heart rate.
- Laryngospasm.
- Phlebitis.
- Tracheal puncture.
- Damage to the laryngeal nerve.
Forecast
Thyroid puncture is a safe procedure, despite all the negative consequences that sometimes arise. However, they are rare, since only qualified doctors. The prognosis is satisfactory, since the results of research are achieved - identifying cancer, determining the nature of the disease, prescribing the right treatment.
If you follow all the doctor's recommendations, then you can avoid negative consequences. Hematomas and minor ailments are temporary and often go away on their own. The procedure takes little time and is mostly painless. Wherein important role played by the doctor's manipulations and individual characteristics the patient's body.
It should be understood that this procedure cannot guarantee the accuracy of the diagnosis, despite its technology and uniqueness. If the doctor has suspicions about the results, then it may be necessary to repeat the thyroid biopsy or order other tests.
A puncture of the thyroid gland does not affect life expectancy, but it helps to identify diseases that cause topical issue: How long do people live with this disease?
