Under What Circumstances Should Fine Needle Biopsy Be Performed?

Under what circumstances should fine needle biopsy be performed?

The clinical treatment of thyroid nodules should be based on the results of ultrasound and FNA biopsy.

When the patient is at risk of thyroid malignancy, palpable nodules, multinodular goiter, or lymphadenopathy with suspected malignant lesions, ultrasound examination of the thyroid should be performed. According to the results of the examination, determine whether a fine needle aspiration biopsy under ultrasound guidance is necessary.

During the ultrasound examination, FNA biopsy is recommended for nodules that meet the following conditions:

1. A solid hypoechoic nodule with a diameter greater than 10 mm.

2. Ultrasound examination of thyroid nodules of any size suspected of extracapsular growth or cervical lymph node metastasis.

3. Children or adolescent patients with a history of cervical radiation exposure; first-degree relatives of patients with papillary thyroid carcinoma (PTC), medullary thyroid carcinoma (MTC), or multiple endocrine neoplasia type 2 (MEN2); with thyroid cancer Those with a history of surgery; those with elevated calcitonin levels in the absence of any interfering factors.

4. Although the diameter is less than 10 mm, the ultrasound examination found nodules with signs related to malignant lesions [hypoechoic and/or irregular borders, elongated shapes, microcalcifications or disturbance of blood flow signals in the nodules].

For multinodular goiter:

1. When the nodules meet the above-mentioned malignant signs of ultrasound examination, there are rarely more than 2 nodules requiring FNA biopsy;

2. When the isotope scan shows "hot" nodules, FNA biopsy cannot be performed;

3. If there is suspicious lymphadenopathy, FNA biopsy should be performed on the enlarged lymph nodes and suspicious nodules at the same time.

For mixed (cystic-solid) thyroid nodules:

1. Perform UGFNA biopsy on the solid part;

2. At the same time, the FNA biopsy sample and the liquid sample drawn are subjected to cytological examination.

For accidental thyroid tumors:

1 The treatment should be based on the diagnostic criteria of thyroid nodules;

2. For unexpected tumors discovered by CT or magnetic resonance imaging (MRI), ultrasound examination should be performed before UGFNA;

3. For accidental tumors found by 18F-fluorodeoxyglucose-positron emission tomography (PET) examination, ultrasound examination and UGFNA should be performed at the same time because of the high risk of malignancy. The above not only introduced the need for biopsy, but also let us know some of the requirements for biopsy of thyroid nodules. Only in this way can we achieve the purpose of biopsy and achieve the accuracy of disease diagnosis.

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