All About Thyroid Fine Needle Aspiration Biopsy

The Amer­i­can Thy­roid Asso­ci­a­tion reports that while thy­roid lumps (nod­ules) are com­mon, few­er than 1 in 10 is can­cer­ous. If a physi­cian feels a lump in your neck/​thyroid, a fine nee­dle aspi­ra­tion may be rec­om­mend­ed to diag­nose if it is cancer.

What is the Thy­roid Gland?

The thy­roid gland is a but­ter­fly-shaped endocrine gland that is nor­mal­ly locat­ed in the low­er front of the neck. The thy­roid’s job is to make thy­roid hor­mones, which are secret­ed into the blood and car­ried to every tis­sue in the body. Thy­roid hor­mones help the body use ener­gy, stay warm and keep the brain, heart, mus­cles, and oth­er organs, work­ing as they should.

What Is A Fine Nee­dle Aspi­ra­tion (FNA) Biop­sy of a Thy­roid Nodule?

A fine nee­dle aspi­ra­tion (FNA) biop­sy of a thy­roid nod­ule is a sim­ple and safe pro­ce­dure per­formed in an out­pa­tient set­ting. The biop­sy is guid­ed by ultra­sound to ensure accu­rate place­ment of the nee­dle with­in the thy­roid nod­ule (or nod­ules if you have more than one). A FNA is usu­al­ly done to iden­ti­fy the type of cells inside a lump or to eval­u­ate how well treat­ment of an exist­ing lump is work­ing. Fine nee­dle aspi­ra­tions are a safer and less trau­mat­ic alter­na­tive to biop­sies which require surgery.

How Can I Pre­pare for my FNA?

Most med­ica­tions can be con­tin­ued when hav­ing a FNA. How­ev­er, often, but not always, anti­co­ag­u­lants, also called blood thin­ners”, are stopped tem­porar­i­ly in antic­i­pa­tion of your thy­roid biop­sy. Blood thin­ner med­ica­tions can increase the risk of bleed­ing or bruis­ing. It is com­mon to receive spe­cif­ic instruc­tions regard­ing when to stop tak­ing med­ica­tions pri­or to the pro­ce­dure. If you have any ques­tions about tak­ing your med­ica­tions before the thy­roid biop­sy, be sure to talk to your doctor.

How is the Pro­ce­dure Performed?

You will be asked to lie down on your back with your head tipped upward, so that your neck is extend­ed. Some­times, a tow­el is placed under your neck to help you get in best posi­tion for the biopsy.

Dur­ing the thy­roid biop­sy, gel will be applied to your neck to obtain ultra­sound images and locate the nodule(s). This gel is water sol­u­ble and non-tox­ic, but may get on cloth­ing or jew­el­ry. You will be asked to change into a gown to pre­vent any ultra­sound gel or anti­sepet­ic solu­tion from get­ting on your clothes.

Your neck will first be cleaned with an anti­sep­tic solu­tion. A local anes­thet­ic called lido­caine will be giv­en to numb the area. Dur­ing the pro­ce­dure you may feel some neck pres­sure from the ultra­sound probe and from the nee­dle. You will be asked to remain as still as pos­si­ble and do your best to avoid cough­ing, talk­ing and swal­low­ing dur­ing the biop­sy.

For the biop­sy, the prac­ti­tion­er will insert a very thin nee­dle through the skin and into the thy­roid nod­ule. After the sam­pling, which only takes sev­er­al sec­onds, the nee­dle will be removed. New nee­dles are used for any addi­tion­al sam­ples. Sev­er­al sam­ples of cells will be obtained, by stick­ing a fine nee­dle in var­i­ous parts of the nod­ule to col­lect cells. This assures a bet­ter chance to find can­cer­ous cells if they are present. If there is flu­id in the nod­ule, a syringe may be used to drain it.

Once the biop­sy is com­plet­ed, pres­sure will be applied to the neck. The pro­ce­dure usu­al­ly lasts less than 30 minutes.

Home Care After Fine Nee­dle Aspiration

  • You will have a small adhe­sive ban­dage on your pro­ce­dure site. This ban­dage should be left in place for four to six hours. After this time, you will not need to keep it covered.
  • It is com­mon to have some pain, swelling and even a lit­tle bruis­ing where the nee­dle was insert­ed into your neck. Sim­ple over-the-counter pain med­ica­tion such as Tylenol (aceta­minophen) can be tak­en for this. Pain and swelling should be min­i­mal after 48 hours.
  • You can show­er the day after your biop­sy, how­ev­er you should refrain from bathing or swim­ming for at least three days fol­low­ing your procedure.
  • It is impor­tant to avoid stren­u­ous activ­i­ty for 24 hours fol­low­ing your pro­ce­dure, par­tic­u­lar­ly activ­i­ty that involves bend­ing over, strain­ing (like lift­ing weights) or work­ing over your head (like hang­ing pic­tures), as all of these activ­i­ties can increase the chance of inter­nal bleed­ing into the thy­roid gland.

When to Call Your Physician

  • It is uncom­mon to have increas­ing pain, red­ness, ten­der­ness, drainage at the pro­ce­dure site, or a fever of 100.4 F or high­er. If you expe­ri­ence any of these symp­toms, con­tact your physician.
  • It is uncom­mon to have any change in your voice, severe pain, gen­er­al neck swelling, or dif­fi­cul­ty breath­ing or swal­low­ing after a thy­roid FNA. If any of these things hap­pen, con­tact your physician.
  • If you are expe­ri­enc­ing dif­fi­cul­ty breath­ing after the pro­ce­dure, you should go imme­di­ate­ly to the near­est emer­gency department.


Get­ting Your Results

  • Most patients receive their results with­in two weeks fol­low­ing their procedure.
  • Your doc­tor will con­tact you with the results once they have reviewed them.

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