Page 1 of 1: thyroid FNAB

asd · Credits: 831 My Scrapbook

What are the indications for thyroid FNAB? is there any contraindications?

whiteguardian · Credits: 9523 My Scrapbook

The main indication of FNAB is the preoperative selection of thyroid nodules.

others are:

Non-nodular thyroid enlargement or enlarged cervical lymph nodes may also harbor cancer and require FNAB for diagnosis as in...

1.Solitary thyroid nodule: when a solitary thyroid nodule is evidenced by palpation, it is important to rule out the presence of a cancer and of an autonomously functioning thyroid nodule (AFTN), which may lead to hyperthyroidism.

2.Multinodular goiter: multinodular goiters are especially common in endemic goiter areas with deficient iodine intake. They may also harbor AFTNs and/or malignant nodules.

3.Subclinical thyroid nodular disease: Non-palpable thyroid nodules are found in 25-50% of the population by using ultrasound screening. However, such a screening is not recommended at present and, therefore, these nodules may come to the clinician's attention following a neck echography carried out either for a single palpable nodule or an apparently diffuse goiter or a non-thyroid disease.

4.Graves' and Hashimoto's disease: In Graves' patients the occurrence of thyroid nodules and cancer was considered rare. However, different lines of evidence now indicate that palpable thyroid nodules are approximately 3-fold more frequent than in the general population and carry an increased cancer risk.

5. Enlarged cervical lymph-nodes: FNAB is a powerful tool to diagnose thyroid cancer metastases in patients with a thyroid nodule and enlarged cervical lymph nodes.

There are only few relative contraindications to performing a FNAB. Some patients undergoing thyroid FNAB may not be able to suppress a cough and therefore are at a risk of laceration and bleeding form the needle tip. Suspected advanced carotid body tumor may be an absolute contraindication. For deep-seated FNAB, history of bleeding diathesis or use of anti-coagulant therapy are relative contraindications.

asd · Credits: 831 My Scrapbook

does that mean all the nodules observed during US scan should be biopsied?

whiteguardian · Credits: 9523 My Scrapbook

Yes... Biopsy is the standard for diagnosis of any thyroid nodule.

asd · Credits: 831 My Scrapbook

why should we biopsy all the nodules if the malignancy risk is 1% ? thyroid malignancies have a good prognosis. why should we act so agressive?

I perform FNAB under US guidance .

In my opinion the nodules that should be biopsied are:

hypoekoik nodules
nodules that do not disappear when the TSH is suppressed.
nodules that appear after subtotal thyroidectomy

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