In modern conditions, the treatment of oncology of the thyroid gland has risen to a fairly high level. At the same time, there is still a need for intervention in the internal structure of the body, that is, a thyroid biopsy is performed. What it is? - you ask. The answer will not be long in coming if the nodes of your thyroid gland exceed 1 cm in size or if there are several such formations. The fact is that an ultrasound scan is not always enough. To find out the nature of the formation, you need to take a sample of the material and consider its condition.
Recognition of the necessary procedure
Most scientists, as well as the World Health Organization, recognized the need for such a procedure. Scientists point out that formations, even of the smallest sizes, if there are several, have the most adverse effect on the human body, therefore it is the responsibility of every doctor who has encountered such a problem in a patient to determine their nature. People who seek help with such a problem are under the supervision of a doctor. The latter appoints to take tests for hormones such as thyroid stimulating hormone, triiodothyronine, thyroxine and so on. Periodic ultrasound examinations are also prescribed, usually such procedures are performed 3-6 times a month, in addition, patients themselves need to monitor their condition.
Preliminary consultation
During a consultation with a doctor, they will tell you all the nuances that accompany a thyroid biopsy: what it is, what it is done for, what preparatory steps you need to go through to complete it, and so on.
Do anesthesia do?
A completely natural question that arises in each patient: how is a thyroid biopsy done? Although the name sounds scary, the procedure itself is not so terrible. In fact, this is a puncture of cellular material from a node using a special very thin needle.
Preparation for the procedure
A thyroid biopsy is performed, preparation for which, by the way, is not required in a matter of minutes. Anesthesia before the doctor starts is not performed for two reasons:
The patient practically does not experience pain, only a needle prick is felt.
An injected preparation may fall into a sample of molecular weight, which will certainly affect its quality, and the procedure will have to be repeated several times.
The main method for performing a biopsy is fine-needle puncture.
Biopsy Procedure
To determine the state of the biological material from the nodes, the biopsy procedure begins. It involves drawing, using a special needle, biological material from the formation, which is transferred to the study. All patients diagnosed with such formations should undergo a similar procedure. Large single formations are subject to the most thorough examination during biopsy.
On the eve of the procedure, if the patient is very worried, they can give him a sedative. The procedure itself begins with the patient lying on a couch with his head bowed. The injection site is treated with alcohol, followed by several injections into the area of the nodes with the extension of the biological material. It is necessary to make several injections, since a single puncture cannot give the amount of material necessary for testing. Next, the selected material is placed on glass and sent for histological examination.
Patient restrictions
A restriction is made for the patient: he should not be swallowed during the procedure. This is due to the fact that the needle is very thin, and the formations are small, so the slightest push can direct the needle in the wrong direction and the wrong material will be taken. The whole procedure is performed using an ultrasound machine. It is needed in order to control the direction of the needle under the skin, this increases the likelihood of it getting into the affected node. The whole procedure takes a maximum of half an hour, it can be performed both on an outpatient basis and while in the hospital.
Assessment of the results of the procedure
Cytological examination of the obtained samples takes an average of one week. The accuracy of the results is very high - 95%, not 100, because there is a human factor, that is, the staff doing the puncture does not always have a sufficient level of qualification, and the procedure itself is quite specific. The largest percentage of erroneous or non-informative diagnoses occurs in cases of sampling from nodes whose size does not reach one centimeter.
A benign formulation in the case of such a procedure is nodular goiter, as well as all its variations. Benignity in obtaining the result is 98% of all cases. In the form of benign, such formulations of diagnoses as: colloids, a group of follicular epithelial cells are also considered - the probability of benignity with such diagnoses is 95%.
Malignant in 50% percent of cases are nodes with diagnoses:
- difficulties with differentiation of adenoma;
- a node with atypical symptoms;
- proliferation of follicular epithelium.
In such cases, the wording is follicular neoplasia.
The most dangerous and most often malignant diagnoses:
- mention in the diagnosis of carcinoma is almost one hundred percent malignancy of the node;
- suspected carcinoma - approximately 80-90 percent chance;
- in 70% of cases, the diagnosis of malignancy cannot be ruled out, the node is malignant.
Additional sample analysis
In some cases, the results of a thyroid biopsy need additional research. For example, quite often, needle wash tests for thyroglobulin or calcitonin are performed. These tests can improve the accuracy of the study, if the results of conventional studies were inaccurate, thus, sometimes adenomas of the parathyroid glands that are located inside the thyroid gland tissue are detected.
When the thyroid biopsy is completed, the results of the tests are given to the patient on special forms. It reflects all the most important information obtained after checking the samples: the condition of the unit, location, size and so on. Usually, the maximum waiting period for results is 7 days, sometimes longer, in some centers, on the contrary, the term for evaluating analyzes is 1-2 days.
Another way to check for malignancy
Radioisotope scanning is another way to check the status of nodes. He does not exclude a biopsy, but is a preliminary step in front of her. In medical terminology, there are 2 concepts: hot and cold nodes. Thyroid cells absorb iodine, which is part of the gland. With the introduction of radioactive iodine into the patient, 2 images can be obtained on the thyroid gland. If the glandular node consists of cellular material, which for some reason does not absorb iodine, then a bluish image will appear, and this will be a cold node. If iodine is actively absorbed, a bright orange image appears in the picture, it will be a hot knot.
Determining the benignity of nodes from these images is rather difficult, but if we talk about the probabilities, then if the node is hot, the probability that it is malignant is much lower than if the picture is the opposite. Since radioisotope scanning does not give an unambiguous answer, doctors still ultimately resort to the final type of diagnosis in the form of a thyroid biopsy.
Thyroid Biopsy: Implications
Thyroid puncture, in fact, is an absolutely harmless procedure. After it, almost no complications develop, and if they are, they are very minor. So, the worst that can happen is a hemorrhage in a knot or inflammation at the puncture site, these complications are treated elementarily.
Some little-informed or generally ignorant people believe that the cervical lymph node after taking a sample from benign can turn into malignant, but this is an absolute mistake, it does not happen. A benign formation cannot become malignant by definition, the only option is if the doctor misses something when examining the samples, but this is extremely rare. In general, do not listen to the tales of the terrible properties that biopsy of the thyroid gland is famous for, its consequences are absolutely insignificant.
Can cancer develop if it was not there
If the node is malignant, then it is malignant and the disease initially developed there. If, at the beginning of growth, such properties were not laid in these nodes, then cancer cannot appear there in any way. The fact is that when the node begins to grow, it already has oncology. Until the node has begun to grow, there is even nothing to check there, so WHO recommends checking only those nodes that are larger than 1 cm, or if the education is smaller, but according to the results of ultrasound, signs of oncology are clearly present in it.
Yes, of course, there are situations when, after a puncture, after a couple of years, the node begins to grow, and after a second procedure it becomes clear that there is still cancer. Then there are such mournful speeches like "My girlfriend underwent a biopsy of the thyroid gland, the reviews are good, and after the procedure six months later the node began to grow, what is the problem here?" The point here is not that the cancer appeared there just now, the problem is usually hidden in three nuances:
The first puncture was performed with extremely small node sizes. Most likely, the doctor, when the procedure was performed, simply took the wrong material, in other words, did not get into the site.
Wrong sampling technique. Some specialists, especially those working in small cities, when a thyroid biopsy is performed, what they are, are little aware, and how they should be performed, all the more they don’t know, that’s the wrong result.
The cytologist, when the biopsy of the thyroid gland was decrypted, could not notice the pathology. The procedure itself can be performed perfectly and the samples can also turn out to be good, but the knowledge of the cytologist is also very important, because the correct diagnosis depends on his attentiveness.
That's all you need to know about how a thyroid biopsy is done, what it is, and why it is needed.