Guest Author - Jim Lowrance

When a patient with thyroid disease, is found to have suspicious nodules (small tumorous growths) on their thyroid, the treating doctor might want to order an FNA biopsy of the nodules in question. The full name for this procedure is “Fine Needle Aspiration” and it is a fairly non-evasive method of biopsy that is done as an out-patient procedure. It may also be, ordered to diagnose some cases of Hashimoto’s thyroiditis along with blood testing for thyroid antibodies that also help diagnose the disease.

In the case of thyroid nodules, an FNA of these may be necessary, when they are of a certain size that makes them suspicious of possibly containing malignancy or cancer cells. The same is true if nodules are found to be solid, meaning they are not typical nodules that are softer in texture (warm nodules) or cystic but are very firm, which are also sometimes referred to as “cold nodules”. Single nodules are also considered more suspicious than are multi-nodules, meaning several of them, rather than a single one and might also have FNA biopsies ordered to evaluate them. While an FNA can detect certain types of cancers that affect the thyroid gland, other types, such as carcinomas need surgical biopsies performed to detect them.

In the case of Hashimoto’s thyroiditis, some patients who are blood tested for “thyroid antibodies” (TPO and TG), may be negative for these and still have Hashimoto’s thyroiditis. With an FNA biopsy of the patient’s thyroid tissue, the sample can be analyzed for the presence of this autoimmune thyroid disease which is also called “chronic lymphocytic thyroiditis”. An FNA may be done alone or in addition to a thyroid ultrasound, to help diagnose the more elusive cases of Hashimoto’s that are not obvious on blood lab results but signs and symptoms of the disease indicate its presence.

An FNA is performed using a needle that is inserted into the patient’s thyroid gland and tissue from the gland or nodules being biopsied, is extracted and sent for laboratory analysis. While it is a fairly non-evasive procedure, patients should expect some soreness for a few days following the procedure. The fine needle that is used does not leave scarring and a local anesthesia is used to numb the area on the neck, before the needle is inserted.