When Should Thyroid Nodule Undertake Fine Needle Puncture Biopsy

But at the same time, biopsy is also a kind of harm to the body, and there may be damage, so under what circumstances can fine needle biopsy be carried out? Clinical management of thyroid nodules should be based on ultrasound and FNA biopsy results. Thyroid ultrasound should be performed when patients are at risk for thyroid malignancy, have palpable nodules, polynodular goitres, or lymph node enlargement with suspected malignant lesions, the new guidelines state. According to the examination results, whether ultrasound-guided fine needle biopsy should be determined. During ultrasound examination, FNA biopsy is recommended for nodules that meet the following conditions: ① Solid hypoechoic nodules larger than 10 mm in diameter. ② Ultrasound examination of thyroid nodules of any size suspected of extracapsular growth or cervical lymph node metastasis. ③ Children or adolescents with a history of neck radiation exposure; First-degree relatives of patients with papillary thyroid carcinoma (PTC), medullary thyroid carcinoma (MTC), or multiple endocrine adenomatosis type 2 (MEN2); Patients with surgical history of thyroid cancer; Elevated calcitonin levels measured in the absence of any interference. (4) Although the diameter is less than 10 mm, ultrasonographic examination found nodules with low echo and/or irregular boundary, elongated shape, tiny calcification or disturbance of blood flow signal in nodules, which are associated with malignant lesions. For polynodular goitre: ① When the nodules conform to the above malignant signs of ultrasound examination, FNA biopsy rarely requires more than 2 nodules; ② FNA biopsy cannot be performed when the isotope scan shows "hot" nodules; ③ If there is suspected lymphadenopathy, FNA biopsy should be performed on both enlarged lymph nodes and suspected nodules. For mixed (cystic solid) thyroid nodule: ① UGFNA biopsy was performed on the solid part; ② At the same time, the FNA biopsy samples and the liquid samples were cytologically examined. For accidental thyroid tumor: ① Its management should be based on the diagnostic criteria of thyroid nodule; ② For unexpected tumors discovered by CT or MAGNETIC resonance imaging (MRI), ultrasound examination should be performed before UGFNA; ③ For accidental tumors detected by 18F-fluorodeoxyglucose - positron emission tomography (PET), ultrasound examination and UGFNA should be performed simultaneously because of the high risk of malignancy. The above not only introduces the need for biopsy, but also lets us know some requirements for thyroid nodule disease biopsy, so as to achieve the purpose of biopsy and achieve the accuracy of disease diagnosis.

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