Thyroid Nodule Biopsy

Developing nodules in the thyroid is a common condition, particularly as we age. Most nodules are benign (non-cancerous) growths of normal thyroid cells which overproduce protein filled fluid or hormones. It is much less common but some nodules in the thyroid develop from cancer cells. If you have nodules in your thyroid diagnosed by an ultrasound, your doctor may recommend undergoing a biopsy to ensure that the nodule is non-cancerous. 

A thyroid nodule fine needle aspiration (FNA) is type of biopsy performed by a radiology professional using ultrasound imaging. A skinny needle is guided into the nodule and used to extract cells. The pathologist can then determine if the nodule is benign or not.

When you have an ultrasound of your thyroid performed, the radiologist looks at the shape and composition of each nodule and will designate a risk category according to a classification system known as TI-RADS. The classification is a scale of 1 (least suspicious) to 5 (most suspicious).

The risk category is then used along with the size of the nodule to determine if the nodule should be biopsied. The higher the risk, the smaller the minimum size for biopsy recommendation.

When it is time for your biopsy, our nurse will bring you to the procedure room. The ultrasound tech will scan your thyroid to confirm the location of the nodule(s) which are to undergo biopsy.

After the interventional radiology specialist comes in and speaks to you, he or she will clean the skin over your thyroid to keep it sterile.  The skin is then numbed using lidocaine local anesthetic. The goal with this is to reduce sharp pain during the biopsy.

Then, using ultrasound for guidance, the biopsy is performed by advancing thin needles into the center of the nodule. The needles are very thin (about half the thickness of a paperclip) and have a hollow center, which allows the cells from the nodule to be collected.

Despite the small size of the needle and the use of local anesthetic, it’s not uncommon to feel some pressure in your neck during the biopsy. This is a very sensitive area of the body but we always do our best to limit your discomfort as much as possible.

After obtaining material from a few needle passes, glass slides are created so that the cells can be looked at through the microscopic. The pathologist physician will then come in to review the samples. He or she will determine if there are enough cells to make a diagnosis or if we will need to obtain a couple more needle passes. This whole process usually takes about 10-15 minutes.

Once it is confirmed that the samples are adequate, a bandage will be placed over the site and you will be able to go home shortly after. Expect some soreness for the first couple days, and you may develop some bruising but everyone is a little different.