Women's Health

What Is a Thyroid Biopsy?

What Is a Thyroid Biopsy?

In a thyroid biopsy, a small tissue sample of your thyroid gland is removed and then examined under a microscope to test for an infection, cancer cells, and other thyroid disorders. The thyroid is a small gland located in lower part of the neck, just below the larynx. The gland's main function is the production of thyroid hormones.

A thyroid gland tissue sample can be extracted through different procedures such as:

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  • Open biopsy - In this method, your doctor makes an incision through the skin of your neck to see the thyroid gland. This procedure is performed when other tests cannot determine the cause of your thyroid problems.
  • Core needle biopsy - In this procedure, a hollow needle is inserted through your neck to remove a thyroid tissue sample.
  • Fine-needle biopsy - A thin needle is used in this procedure to remove a tissue sample of your thyroid gland. The thin biopsy needle is inserted through your neck and into your thyroid gland.

Why do I need a thyroid biopsy?

A thyroid gland biopsy is done for the following reasons:

  • To find the cause of goiter - Goiter symptoms include weight loss, swallowing and breathing problems, and a tight feeling in one's throat.
  • To find what has caused a nodule or lump in your thyroid gland - These lumps can be detected by the use of a radioactive thyroid scan, ultrasound scan, or through a regular physical examination.
  • To locate the growth in your thyroid gland - To determine whether it is cancerous or not.

How do I prepare for a thyroid biopsy?

In preparation for this procedure, you should tell your doctor whether you:

  • are allergic to any drugs used during surgery such as anesthetics
  • are regularly taking certain types of medications
  • have any bleeding problems or if you are taking blood thinners such as warfarin, aspirin, and ibuprofen

A blood test is also another important step in preparing for a thyroid biopsy. Blood coagulation tests are important to identify whether you have a blood clotting disorder or bleeding complications.

To prepare for a thyroid biopsy, you will:

  • Need to sign a consent form to make sure that you understand the whole procedure and its risks.
  • In the case of a needle biopsy, you should not do anything since you will be awake during the whole procedure.
  • You will receive a general anesthesia that will put you into a deep sleep throughout the procedure.
  • You should not eat or drink anything on the day of the procedure. If your doctor tells you to take your medicine on the day of your thyroid biopsy, you should take them with a sip of water only.
  • You will have to remove all of your jewelry or any metallic objects on the upper part of your body, especially near your neck.

How It Is Done

A thyroid biopsy can be achieved through different methods as discussed below:

1. Fine-needle aspiration biopsy

  • You will be required to lie on your back with a pillow placed between your shoulder blades.
  • The skin, where the needle is to be inserted, is cleaned with a suitable antiseptic before a local anesthesia is applied to numb the tissue. The anesthesia application may sometimes cause a little discomfort.
  • The doctor then inserts a thin needle through your skin and into the thyroid gland. A thin column of cells is removed using the needle.
  • Additional samples can be obtained by inserting the needle many times.
  • To stop the bleeding, pressure is applied on the biopsy site using a small bandage.
  • The whole procedure may take 10 to 30 minutes.

2. Open biopsy

  • At first, you are going to lie on your back on the operation table.
  • This procedure may not require a general anesthesia. The skin on the area of biopsy is first cleaned with an antiseptic. Then a local anesthesia is injected to help numb the cells and reduce pain.
  • A small incision is then made in your neck.
  • A surgical instrument is inserted through the incision to remove a thyroid tissue mass.
  • A stitch is made to close the incision. 
  • The specimen is sent to the lab for microscopic analysis.
  • This procedure may take long depending on the type of anesthesia used.

Thyroid Biopsy Results

After a thyroid biopsy is performed, the tissue samples are sent to the laboratory for a closer examination. A specialist who deals with biopsy tests is called a pathologist. A pathologist then examines the sample tissue to check for any abnormalities. Possible abnormalities may include cancer, a benign tumor, or Hashimoto’s disease. Biopsy tests will always provide an accurate diagnosis and will help your doctor decide the best surgical or medical treatment for your thyroid problem.

Risks and Side Effects

The most common side effect that is associated with a thyroid biopsy, especially with the fine-needle biopsy is discoloration, as a result of blood collection under the skin and swelling at the biopsy site. After the procedure, you may feel uncomfortable, but there is nothing to worry about. You are also going to experience swallowing difficulties.

Some of the serious complications linked to a thyroid biopsy include inadvertent neck injuries and infections. An open biopsy of the thyroid may also carry risks linked to the administration of a general anesthesia.

You may call your doctor if you experience any of the following:

  • excessive bleeding and drainage through the bandage
  • have a difficulty in swallowing
  • have swollen lymph nodes in the neck
  • fever with chills
  • red streaks on the biopsy site
  • have pus draining from the site of biopsy
  • increased warmth, swelling, and redness on or around the site of biopsy

What may affect a biopsy procedure?

  • If you can’t lie still on the operation table during the procedure, your doctor may give you a general anesthesia.
  • If you are taking anticoagulants or have bleeding problems. People with such conditions may receive special instructions from their health care provider before undergoing the procedure.

Bottom Line

A thyroid biopsy is a medical procedure that involves taking a sample of the thyroid gland and examining it under a microscope to test for cancer, infections, and any other thyroid problems. To get accurate thyroid biopsy results, preparation for the procedure is very important.