Thyroid aspirant

What is it and when is it performed

Thyroid aspiration is a minimally invasive diagnostic procedure, used when it is necessary to confirm or exclude the malignant nature of a thyroid nodule .

Thyroid nodules - which are cellular clusters detectable on palpation and / or through diagnostic techniques such as ultrasonography and gland scintigraphy - are malignant in about 5% of cases . The risk is far greater if the nodule appears cold, therefore not functioning, ultrasonographically solid, of a size equal to or greater than 1 cm and / or with small calcifications or vessels inside it.

The diffusion of the thyroid aspirate has allowed to reduce the number of surgical removal of the gland and above all to limit them to well selected cases, where there is sufficient evidence about the malignancy of the thyroid nodules.

How is the Needle?

The needle aspiration of the thyroid is a rather simple and safe technique, which is used when a nodule shows suspicious echographic and scintigraphic characteristics.

It is performed on an outpatient basis, with the patient lying on his back and with his head extended backwards on a pillow. Normally anesthesia is not required, neither local (sometimes practiced) nor much less general; the examination can also be conducted during pregnancy and there are no particular contraindications.

On the other hand, the cytological reading of the aspirated material is more complex, which must be carried out by expert personnel (the diagnostic accuracy can thus exceed 90%).

After these preliminary operations, the doctor carefully disinfects the anterior region of the neck and, under ultrasound guidance, inserts a particularly thin needle into the thyroid nodule. In this way it is possible to aspirate a minimum quantity of cellular material, which is then crawled and fixed on slides to be colored and analyzed under a microscope (cytological examination).

The procedure of puncture and aspiration is rather rapid, it foresees a number of withdrawals in different points for single node and the pain connected to it is light and well tolerable. Furthermore, ultrasound guidance minimizes the risk of complications due to damage to vital neck structures, such as veins, arteries and nerves (lesion of the laryngeal nerve can cause hoarseness).

Possible complications

In a small percentage of cases (less than 5%), after a thyroid aspiration small hematomas can form inside the thyroid, painful but destined to spontaneously reabsorb in a few days. Rarely, after the examination, the pain can overcome the simple discomfort and in this case it can be effectively calmed with the common counter analgesics and anti-inflammatories.

Prepare for the exam

Fasting is not necessary before the thyroid needle aspiration; it is however important to suspend, in accordance with the prescriptions from the doctor, any anti-aggregation treatments (aspirin, ticlopidine etc.).