Biopsy of a thyroid gland
For definition of a condition of cells of a thyroid gland and the nodes formed in it carry out gland biopsy: by means of a needle from it select cellular material for the analysis. The procedure is called a fine-needle biopsy of a thyroid gland or a puncture biopsy of a thyroid gland and it is considered the main method of diagnosing of formations of a thyroid gland. The biopsy gives the chance to make the final diagnosis – after that as the doctor will conduct tactile inspection and ultrasonography, will collect the anamnesis, will study the available risk factors which perhaps influenced emergence of new growths.
The biopsy is shown not to all patients. Only nodes with indirect symptoms of a zlokachestvennost, nodes which by the size more than 1 cm, at the same time pay special attention to single nodes are subject to a research.
As the biopsy of a thyroid gland is carried out
The procedure does not demand special preparation, carry out it without anesthesia. To carry out anesthesia it is considered inexpedient as medicine can mix up with cellular material, and respectively, to affect a net result of a biopsy of a thyroid gland. Besides, for anesthesia it will be necessary to give an injection which on pain does not differ from a puncture and therefore it does not make sense. To patients for whom it will be psychologically difficult to postpone a similar procedure, recommend to accept the day before soothing.
The patient during a biopsy of a thyroid gland has to be in lying situation and throw back the head back. For receiving enough cellular material the doctor does usually 2-3 punctures of one node. The place of a puncture is previously processed alcohol. The received material which got to a needle gleam is placed on glass and transferred to histology.
During a prick it is impossible to swallow since the needle can move and for the analysis not that material will be taken.
Carry out a fine-needle biopsy of a thyroid gland under control the device ultrasonography, it increases probability of an intake of material from the struck node. As the procedure simple, it is possible to hold it in out-patient conditions, it lasts no more than half an hour.
After carrying out a puncture biopsy of a thyroid gland on an extent of two, three days morbidity in the place of a puncture can be felt. Small hemorrhage can be formed if the needle gets to a vessel.
Also cases when during a puncture in the field of an isthmus the doctor pierced a trachea are known. In this case at the patient the severe cough therefore the needle should be taken immediately begins, and for a while to postpone the procedure. Patients with osteochondrosis of cervical department can feel short dizziness after carrying out a biopsy, they cannot insert sharply after the procedure.
Assessment of results of a biopsy of a thyroid gland
The cytologic research of the received material lasts 3-7 days. The general accuracy at nodal pathology makes about 95%. The deviation from 100% is connected in many respects with qualification of the personnel making the procedure and directly with feature of the method: the greatest percent of not informative and wrong diagnoses is the share of nodes of the small sizes – to 1 cm.
High-quality result of a biopsy of a thyroid gland the formulation "a nodal craw" and its various variations is considered. High quality at such result of a biopsy makes 98%.
As high-quality it is possible to consider also such conclusions (with probability of 95%) as "colloid", "blood", "groups of cells/cell of a follicular epithelium".
The probability of a zlokachestvennost makes 50% at such conclusions: "difficulties with differentiation of a carcinoma and adenoma", "node with symptoms of atypia and proliferation of a follicular epithelium". Similar formulations are treated as "a follicular neoplasia".
At formulations: "a carcinoma medullary / carcinoma carcinomas/elements / a papillary carcinoma of a thyroid gland", "suspicion on a carcinoma", "a zlokachestvennost it is impossible to exclude" – the probability of a zlokachestvennost makes 100%, 90% and 70% respectively.
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