A biopsy of the thyroid: what is it, how is it done? Thyroid biopsy: preparation, interpretation of test results, consequences
In modern conditions, the treatment of thyroid cancer has risen to a fairly high level. However, there is still a need for intervention in the internal structure of the body, that is, a biopsy of the thyroid gland is performed. What it is?- you ask. The answer will not keep you waiting if the nodes of your thyroid gland exceed in size 1 cm or if there are several such formations. The fact is that carrying out ultrasound is not always enough. To learn the nature of education, you need to take a sample of the material and consider its state.
Recognition of the procedure required by
Most scientists, as well as the World Health Organization, have recognized the need for such a procedure. Scientists point out that education, even the smallest size, if several, have the most unfavorable effect on the human body, so clarifying their nature is the responsibility of every physician who has encountered such a problem with the patient. People who seek help with such a problem are under the supervision of a doctor. The latter appoints to pass tests for the content of hormones, such as thyroid-stimulating hormone, triiodothyronine, thyroxine and so on. Periodic ultrasound is also prescribed, usually such procedures are performed 3-6 times a month, in addition, patients independently need to monitor their condition.
In consultation with a doctor, you will be told all the nuances that accompany a biopsy of the thyroid gland: what it is, what it is doing, what preparatory steps need to be taken to fulfill it, and so on. Do anesthesia?
Quite a natural question that arises in every patient: how do thyroid biopsies? Although the name sounds scary, the procedure itself is not so terrible. In fact, it is a puncture of the cellular material from the node with the aid of a special very thin needle.
procedure A biopsy of the thyroid gland is performed, which, by the way, is not required for preparation, in a matter of minutes. Anesthesia before the beginning of the doctor's work is not performed for two reasons:
The patient practically does not experience painful sensations, only a needle prick is felt.
A sample of the molecular mass can be injected, which will certainly affect its quality, and the procedure will have to be repeated many times.
The main method of performing a biopsy is thin-needle puncture.
To determine the state of biological material from the nodes, the biopsy procedure begins. It involves drawing a biological material from a formation with a special needle, which is passed on to the study. All patients who are diagnosed with such formations should undergo a similar procedure. The most thorough research in the biopsy should be large single formations.
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 the couch with his head thrown back. The site of the injection is treated with alcohol, followed by several injections into the area of the nodes with the extraction of biological material. Doing several pricks is necessary, since a single puncture can not give the amount of material necessary to check. Next, the selected material is placed on the glass and sent for histological examination.
The patient is restricted: he can 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 probability of its falling into the affected node. The whole procedure takes a maximum of half an hour, it can be performed both on an outpatient basis and in a hospital.
Evaluation of the results of the
Cytological examination of the samples taken 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 personnel doing the puncture does not always have sufficient skill level, and the procedure itself is quite specific. The greatest percentage of erroneous or non-informative diagnoses falls on the cases of sampling of the nodes, the size of which does not reach one centimeter.
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, also such formulations of diagnoses as: colloids, group of cells of follicular epithelium are considered - the probability of good quality with such diagnoses is 95%.
Malignant in 50% of cases are nodes with diagnoses:
- difficulties with differentiation of adenoma;
- node with symptoms of atypia;
- proliferation of follicular epithelium.
In such cases, the formulation is follicular neoplasia.
The most dangerous and most often malignant diagnoses:
- , the mention in the diagnosis of carcinoma is almost one hundred percent malignant node;
- suspected carcinoma - approximately 80-90 percent probability;
- in 70% of cases of diagnosis malignant can not be ruled out, malignant node.
Additional analysis of
samples In some cases, the results of a thyroid biopsy require additional study. For example, flushing from the needle is often performed for the presence of thyroglobulin or calcitonin. These tests can improve the accuracy of the study if the results of routine studies have been inaccurate, thus sometimes detecting adenomas of the parathyroid glands that are located inside the thyroid tissue.
When the biopsy of the thyroid gland is completed, the results of the tests are given out to the patient on special forms. Here all the most important information received after the testing of the samples are reflected: the state of the node, the location, size and so on. Usually the maximum waiting period of results is 7 days, sometimes more, in some centers on the contrary, the evaluation period of the analyzes is 1-2 days.
Another way to check the malignancy of
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 it. In medical terminology, there are 2 concepts: hot and cold nodes. Thyroid cells absorb iodine, which is part of the gland. When the patient is administered radioactive iodine in the pictures of the thyroid gland, two images can be obtained. If the gland node consists of a cellular material that for some reason does not absorb iodine, then a bluish image will appear, and it will be a cold knot. If iodine is actively absorbed, the image produces a bright orange image, this will be a hot knot.
It is difficult to determine the goodness of the nodes from these images, but if we talk about 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 resort to the final diagnosis in the form of a biopsy of the thyroid gland.
Thyroid biopsy: consequences of
Thyroid gland puncture, in fact, is an absolutely harmless procedure. After it, almost never develop any complications, and if they are, they are very minor. So, the worst thing that can happen is a hemorrhage to the knot or inflammation in the puncture site, these complications are treated simply.
Some little-informed or, in general, ignorant people believe that the cervical lymph node after taking a sample from a benign can turn into a malignant, but this is an absolute fallacy, it does not happen. Good-quality education can not become malignant by definition, the only option is if the doctor at the examination of the samples misses something, but this happens very rarely. In general, do not listen to the story about the terrible properties with which the biopsy of the thyroid gland is famous, the consequences of it are absolutely insignificant.
Can cancer develop if it was not
If the node is malignant, then it is malignant and there the disease initially developed. If, at the beginning of growth, these properties were not incorporated into these nodes, then cancer can not appear there. The point is that when the node begins to grow, there is already oncology in it. Until the node began to grow, there is nothing to check, so WHO recommends checking only those nodes that exceed 1 cm in size, or if the formation is smaller, but ultrasound evidence clearly shows signs of oncology.
Yes, of course, there are situations when after a puncture in a couple of years the node starts to grow, and after the repeated procedure it turns out that there is still cancer. Then there are such plaintive speeches like "My friend had 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 only now, the problem usually hides in three nuances:
The first puncture was performed at an extremely small site size. Most likely, the doctor, when the procedure was performed, just took the wrong material, in other words, did not get into the knot.
Wrong technique of sampling. Some specialists, especially those working in small towns, when there is a biopsy of the thyroid gland, what it is, are little aware of, and how it needs to be performed, the more they do not know, and the wrong results are obtained.
A cytologist, when deciphering a biopsy of the thyroid gland, 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 correctness of the diagnosis depends on its care.
That's all you need to know about how a thyroid biopsy is done, what it is and what it's for.