Fine-needle aspiration biopsy (FNAB or FAB) is currently considered as the primary method for diagnostics of nodular lesions in thyroid, mammary glands, lymph nodes, masses in soft tissues etc.
Thyroid USI is the first stage of examination which allows to detect nodes, to assess their sizes, structure, shapes. An experienced diagnostician can assess the aggregation of ultrasonography criteria in order to identify benign or malignant character of the changes. Aspiration biopsy enables establishment of a final diagnosis based on the visual assessment of the changed organ cells. Certainly, depending on the findings, a decision is made concerning further treatment tactics – surgical or therapeutic.
No special preparation for this procedure is required, however, it is necessary to follow strictly all the instructions given by the doctor, who makes the biopsy. For example, when the needle is inside of the gland tissue, swallowing should be avoided, as the needle may slip out of the node tissue and the investigation will be ineffective. During the investigation, a patient is lying with his/her head slightly thrown back. Usually, 2-3 punctures in one focus are required to obtain the sufficient amount of the biomaterial.
For better accuracy of the biomaterial aspiration, manipulation is conducted with USI control which ensures aspiration of the cell material only from the lesion.
The procedure entails aspiration of the thyroid cells through a fine needle in the amount which is sufficient for cytological examination. The procedure is simple, safe and may be carried out outpatiently. The aspirated material is placed to the slides and examined by a cytologist. Based on the aspiration biopsy findings, a doctor will determine what should be done further with the node.
Though thyroid biopsy, just like any other injection, is not a pleasant procedure, the importance of the information which it delivers to the doctor may hardly be overestimated.
As a rule, biopsy is carried out without additional anesthesia, as the injection, which will have to be done to induce the anaesthetic, will cause as much pain as the biopsy itself, therefore there is no point in it.
However, not all patients require fine-needle aspiration biopsy of thyroid for correct diagnosis and effective treatment. In particular, cytological examination which may be conducted only with aspiration biopsy is carried out only for the thyroid nodes sized over 1 cm, especially single ones, and the masses of any size with indirect signs of malignization.
It should be noted that the size and palpability of the nodes are not the indications for biopsy. Currently, there is a tendency of adverse processes being detected in small nodes (less than 1 cm). Some nodes may not be generally palpated even by an experienced doctor due to their unfavorable location. The basic criteria for aspiration biopsy is the ultrasound findings and the medical history data (presence of thyroid cancer risk factors).
‘FLORIS’ medical center performs fine-needle aspiration biopsy of thyroid nodes with USI control on a daily basis. During the procedure, a cytologist assesses the amount and the quality of cellular material. Depending on the number of the nodes punctured, the aspiration biopsy may last for 15-30 minutes.
The slide plates are further processed at cytological laboratory, where they are subject to special dying and final cytological examination, the findings of which (depending on the pathology degree) may be obtained in 3-7 days.