Currently, at the appointment with the endocrinologist, seals localized on the thyroid gland are increasingly being diagnosed. In this case, the nodes can have both benign and malignant nature. In order to decide on the feasibility of surgery, the doctor prescribes a laboratory study of a small piece of tumor biomaterial. The procedure for collecting it is called a fine-needle aspiration biopsy (TAB) of the thyroid gland. Based on the results of the diagnosis, the doctor gets the opportunity to assess the nature of the neoplasm and decide on the feasibility of the operation.
The essence of the method
A fine-needle aspiration biopsy is a procedure that allows you to determine the nature of previously identified seals and determine the further management tactics of the patient. Under the supervision of an ultrasound, the doctor collects the biomaterial from the walls of the node, since it is in this zone that malignant cells are most often detected.
The procedure is not associated with the occurrence of pain, in connection with which it is carried out without prior anesthesia. At the request of the patient, the doctor can apply an anesthetic cream to the skin of the neck.
Only a syringe and a very thin needle (0.6 mm) are needed to collect biomaterial. During the implementation of the TAB of the thyroid gland node, the doctor makes 2-3 punctures. Then the syringe with the contents is sent to the laboratory, where a cytological examination is carried out. Based on its results, one can judge the type of tumor, and also choose the most effective treatment method.
Indications
TAB of the thyroid gland is prescribed to patients in whom one or more large seals were found during ultrasound examination or during palpation. The procedure is indicated in the presence of a tumor with a diameter of more than 1 cm.
An aspiration biopsy does not provide clinically relevant information in the presence of small nodes, and therefore its implementation in such situations is considered inappropriate. However, there are exceptions.
With small seals, TAB is prescribed in the following cases:
- The patient’s body was exposed to radiation at least once in his life.
- The closest relatives of the patient suffered from thyroid cancer.
- During the ultrasound, a small seal was revealed, but all the signs indicate that the tumor process is malignant.
At the discretion of the doctor, the list of indications may be expanded. Only a specialist has the right to correlate the benefits of research and possible risks.
Contraindications
Like any other diagnostic method, TAB of the thyroid gland node has a number of limitations for its implementation.
Contraindications are the following diseases and conditions:
- The size of the seal is less than 0.5 cm. In the presence of a small node, the degree of information content of the study is reduced to a minimum.
- Thyroiditis in a subacute or acute stage.
- Uncompensated tereotoxicosis.
- Violations of the permeability of the walls of blood vessels.
- Coagulation problems with fluid connective tissue.
- Mental disorders.
The doctor necessarily assesses the condition of the patient before conducting a TAB of the thyroid gland. If a person has heart rhythm disturbances or a very high or, conversely, low blood pressure, the procedure is transferred to another day.
Contraindication is also a state of intoxication and a hangover. In this case, the procedure is also not performed.
Training
Immediately before visiting a doctor, the patient does not need to carry out any specific activities. A few days before the biomaterial is taken, the specialist draws up a referral for examination, including:
- Clinical blood test.
- Coagulogram.
- The study of liquid connective tissue for hormones TSH and free T4.
- Ultrasound of the thyroid gland.
It is recommended to contact clinics that specialize in the treatment of pathologies of the organs of the endocrine system. On average, about 40 episodes of biopsy per week should be performed at the selected facility.
Methodology for taking biomaterial
TAB of the thyroid gland node (both the left lobe of the organ and the right) in almost all cases is carried out under the supervision of ultrasound. The use of ultrasound equipment significantly increases the accuracy of the study. The technique is recognized outdated, during which the puncture site is determined by palpation.
Algorithm for taking biomaterial:
- The patient is laid on the couch and frees the front of the neck from the clothes.
- The doctor (endocrinologist or surgeon) takes a syringe with a capacity of 10 ml (less often 20 ml), equipped with a very thin needle.
- If necessary, the specialist treats the skin of the neck of the patient with an anesthetic cream.
- In most cases, TAB of the thyroid gland node is performed under ultrasound control. Using equipment, the doctor determines the puncture site.
- The specialist inserts the needle into the selected location. The biomaterial is taken from the walls of the neoplasm. This is due to the fact that it is in this area that malignant cells are most often detected.
- In total, the doctor makes about 3 punctures. This is necessary in order to collect the amount of biological material necessary for the study.
- The final stage of a fine-needle aspiration biopsy is the application of a sterile wipe to the puncture site.
Within 10 minutes after the procedure, the patient is recommended to remain in a horizontal position. After that, he can begin to carry out his daily activities.
Interpretation of Results
The resulting biomaterial is examined in a laboratory under a microscope. If the available number of cells is insufficient for analysis, a repeat procedure is indicated. Otherwise, after the study, the results of the thyroid gland nodes are sent to the medical institution.
Currently, there is a single classification (Betezdovskaya) of cytological findings. It was developed in 2010. Deciphering the TAB of the thyroid gland node is carried out by the doctor according to this classification.
Interpretation of results:
- I group. In this case, the procedure must be repeated. In the conclusion, it is indicated that in the process of the study an uninformative result was obtained.
- II group. Indicates the presence of a colloidal node. This is a neoplasm of a benign nature, which is diagnosed in 80% of patients with thyroid tumors. As a rule, a colloidal node does not require surgical treatment.
- III group. It is indicated in the conclusion if the biomaterial has signs of a follicular lesion that does not have a specific value.
- IV group. Indicates the presence of a tumor of a follicular nature. In this case, surgical intervention is indicated.
- V group. Assigned if cancer is suspected. Upon receipt of such a result, it is recommended to pass the TAB again.
- VI group. In this case, it is customary to talk about thyroid cancer. The patient can be identified as follicular neoplasms, as well as carcinomas.
TAB is a diagnostic method that is not performed to monitor the effectiveness of treatment. It is necessary solely to identify the nature of the tumor.
Possible consequences
Fine needle aspiration biopsy is a safe procedure. However, in some cases, patients find:
- Bruising at the puncture site.
- Excessive sweating.
- Cardiopalmus.
- Psycho-emotional instability.
- Frequent episodes of dizziness.
The presence of these conditions is not an occasion to consult a doctor. They pass on their own in a few days.
Reviews
Fine needle aspiration biopsy is a modern diagnostic method designed to determine the nature of tumors. According to medical reviews, TAB of the thyroid gland is well tolerated by most patients. Just a few minutes after the completion of the procedure, they can begin to carry out their daily duties.
Judging by the feedback from patients, the procedure is really quick and painless. Many people claim that blood sampling from a vein gives a more pronounced discomfort.
Finally
TAB of the thyroid gland node is a modern diagnostic method that allows the doctor to timely identify the nature of the tumor and determine the further management tactics of the patient. The essence of the procedure is as follows: the specialist makes 2-3 punctures with the thinnest needle. After that, the syringe with the obtained biomaterial is sent to the laboratory for cytological examination.