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What is fine needle aspiration of the thyroid?
Fine needle aspiration (FNA) is a common medical technique for evaluating thyroid nodules and suspicious masses in the thyroid gland. Fine-needle aspiration helps doctors determine whether a lump or nodule in the thyroid is cancerous. In the following article, we will learn more about how to perform thyroid sampling.
What is the purpose of fine needle aspiration?
The main purpose of FNA thyroid sampling is to detect the nature of thyroid masses or nodules. Thyroid nodules are usually discovered during physical examinations or through ultrasound imaging. If the doctor suspects malignancy or unusual features in the nodules, it is recommended to perform an FNA thyroid biopsy.
This method is especially effective in the quick and non-invasive diagnosis of thyroid cancer and prevents unnecessary surgeries. FNA sampling, if done correctly, can provide detailed information about the cells in a thyroid nodule or mass.
How to perform FNA thyroid sampling
Thyroid sampling by FNA (Fine Needle Aspiration) method is generally a simple and outpatient procedure that does not require hospitalization or general anesthesia. This method is usually performed under ultrasound guidance to be more accurate. In the following, the steps of how to perform this sampling are explained:
Patient preparation
• The patient lies on his back and a pillow is placed under the shoulders so that the stretched neck of the thyroid gland can be easily accessed.
• The skin doctor cleans the sampling area and, if necessary, a local anesthetic is used to reduce any discomfort. Of course, this method is usually performed without anesthesia or with minimal pain.
Using ultrasound
• Ultrasound is often used to precisely guide the needle to the nodule or thyroid mass.
• This method ensures that the needle is accurately placed in the target area and an appropriate sample of suspicious cells is taken.
Insert the needle
• The doctor gently inserts a thin needle into the nodule or thyroid mass. This needle is much thinner than conventional injection needles and is designed to minimize patient discomfort.
• Once the needle enters the nodule, the doctor moves the needle inside the nodule with gentle movements to collect the desired cells from its different parts.
Sample collection
• Using a syringe attached to a needle, the doctor collects the cells in the nodule.
• The samples taken are then placed in special tubes and sent to the laboratory for further analysis.
Repeat the process
Sometimes, this process may be repeated several times from different angles to ensure that enough samples are obtained. Usually, several small samples are taken from different areas of the nodule to increase the accuracy of diagnosis.
Termination and aftercare
• After sampling, the needle entry site is covered with a small bandage.
• The patient may feel a slight pressure or burning sensation in the neck area after sampling, but the pain and discomfort usually disappear quickly.
• After the sampling, the patient can return to their daily activities, although it is recommended to avoid vigorous activities on the same day.
Test results after thyroid sampling
The collected samples are sent to the laboratory for cellular analysis. The test results may take a few days to a week. The results may show one of the following:
• Benign (non-cancerous): Many thyroid nodules are benign and do not require aggressive treatment.
• Malignant (cancerous): If the sample is cancerous, the doctor may suggest thyroid surgery to remove the thyroid gland or part of it.
• Suspicious or indeterminate: Sometimes the results of FNA sampling do not clearly indicate whether the mass is benign or malignant. In these cases, the doctor may recommend re-sampling or performing an open (surgical) biopsy.
• Undiagnosable: In some cases, there are not enough cells to make an accurate diagnosis. In this case, re-sampling is recommended.
Necessary preparations before performing FNA
It is recommended that you tell your doctor if you are allergic to a medicine, have bleeding problems or are pregnant. Also, make sure your doctor has an up-to-date list of all medications you take, including herbal and over-the-counter medications.
A few days to a week before the biopsy, you will be asked to temporarily stop taking blood thinners. Medications that you may need to stop taking include:
• Aspirin
Clopidogrel (Plavix)
Ibuprofen (Advil, Motrin)
• Naproxen (Olio, Naprosyn)
Warfarin (Coumadin)
Advantages and disadvantages of thyroid FNA method
The FNA method is a minimally invasive, fast and safe diagnostic tool for the evaluation of thyroid nodules, which can avoid unnecessary surgeries in many cases. However, it also has advantages and disadvantages, which we will discuss below:
Non-invasive and simple
This method is less invasive than surgical methods and is performed as a simple outpatient procedure. It usually does not require hospitalization or general anesthesia.
High precision
FNA is one of the most accurate methods for diagnosing thyroid nodules. This method allows doctors to examine thyroid cells and determine whether or not they are cancerous.
No need for surgical incision
Unlike open biopsies, this procedure does not require an incision in the skin and is performed using a thin needle, so the patient avoids large wounds or bleeding.
Fast and inexpensive
The FNA method is fast and usually takes less than 30 minutes. It is also cost-effective for patients as there is no need for complex surgical facilities or hospital stays.
Minimal side effects
The FNA method has few complications, and patients can quickly return to their daily activities after performing it. Pain and discomfort are usually mild and transient.
Early detection of cancer
Using this method, it is possible to quickly determine whether a thyroid nodule is cancerous or benign, which allows doctors to start appropriate treatment programs in time.
Disadvantages of the FNA method
Inconclusive or questionable results
In some cases, the results of the biopsy do not clearly indicate whether the nodule is benign or malignant. These inconclusive results may require repeat biopsy or other diagnostic procedures.
Need to repeat sampling
If the sample obtained is not sufficient or appropriate, the doctor may need to perform the FNA again. This issue may be annoying for the patient.
Minor risks of complications
Although FNA is a safe procedure, as with any medical procedure, complications such as bleeding or infection at the sampling site may occur. These side effects are rare and usually not serious.
Limitations in complex diagnoses
In some special cases, FNA is not able to diagnose the exact type of thyroid cancer or other more complicated thyroid problems, and more diagnostic methods are needed.
mild discomfort
Some patients may experience temporary discomfort, swelling, or mild pain at the sampling site, which usually resolves within a few days.
final word
FNA thyroid biopsy is a very useful tool for diagnosing and evaluating thyroid nodules. This method, with the least side effects and the highest accuracy, helps doctors to make the necessary treatment decisions very quickly and avoid unnecessary surgeries. For this reason, this method is one of the most widely used diagnostic methods in cases of suspected thyroid cancer.
Using the best methods for rapid diagnosis of thyroid disease is very effective in its treatment. Dr. Ahmad Fanaei, a thyroid and parathyroid surgeon with a history of 5000 successful thyroid surgeries, performs his surgeries with the most advanced devices and technology in the world. Contact us to schedule an appointment.
References
https://www.mountsinai.org/health-library/tests/fine-needle-aspiration-of-the-thyroidhttps://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/thyroid-fine-needle-aspiration-biopsyhttps://www.mskcc.org/cancer-care/patient-education/fine-needle-aspiration-fna-thyroid-nodulehttps://www.ncbi.nlm.nih.gov/books/NBK557883/https://www.insideradiology.com.au/thyroid-fna/
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