Thyroid nodule biopsy pros and cons

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 28, 2024
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Currently, thyroid nodule puncture is performed under ultrasound guidance, so it is relatively safe. Fine needle aspiration causes minimal damage to the thyroid and almost no complications occur. Generally speaking, the following few adverse reactions may occur: One is bleeding, because the thyroid is a blood-rich organ, so bleeding may occur post-puncture. It can be controlled by applying local pressure immediately after the puncture. The second is pain, which is generally mild and can be relieved within 1-2 days. The third is skin infection, which is more likely in patients who are obese, have numerous skin folds, and sweat easily. In such cases, antibiotic treatment may be necessary. The fourth is injury to the trachea and nerves, although this is very unlikely and typically resolves on its own.

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Written by Gan Jun
Endocrinology
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Can thyroid nodules heal themselves?

Thyroid nodules cannot heal on their own, but with appropriate treatment, good recovery can be achieved. Thyroid nodules are a common clinical disease, with many causes. Nodules can be either solitary or multiple, and the incidence of multiple nodules is relatively higher. Regardless of the cause, thyroid nodules are more common in middle-aged women, with the most common symptoms including thyroid enlargement, neck discomfort, and localized thyroid pain. When people are diagnosed with thyroid nodules, there is no need to be overly worried. If the color ultrasound and thyroid function tests show no abnormalities, it is possible to observe the condition dynamically, with a follow-up check about once a year. If there is a high suspicion of malignant nodules, it is advisable to opt for early surgical removal, which typically yields very satisfactory results.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Are thyroid nodules serious?

The severity of thyroid nodules needs to be assessed based on their nature, size, function, and location. Generally, they can be classified into benign and malignant, with malignant nodules being thyroid cancer, which requires timely treatment. Surgical treatment is the main method for treating thyroid cancer, whereas most benign nodules do not require special handling. Regarding the size of the thyroid nodules, if the nodules are too large and compress surrounding tissues such as the trachea, esophagus, and nerves, surgical treatment is recommended. For common benign nodules, regular observation is sufficient. Functionally, some thyroid nodules may affect thyroid function, such as in Hashimoto's thyroiditis, which can present with diffuse multiple nodules, leading to either hyperthyroidism or hypothyroidism. In such cases, appropriate medication treatment is needed. From a positional perspective, ectopic growth of thyroid nodules, if located at areas like the base of the ear, pharynx, neck, esophagus, or thoracic cavity, is a rare congenital developmental anomaly. If such a nodule significantly enlarges and compresses surrounding tissues, surgical treatment is advised.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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What is a thyroid nodule?

The thyroid is an endocrine gland located in the neck of the human body. If some abnormal nodules appear in it, they are referred to as thyroid nodules. Based on histological classification, they can be divided into follicular type, papillary type, and mixed type. A common characteristic of these types is that they generally appear as solitary nodules with a relatively complete capsule; the tumor cells differ from the surrounding thyroid tissue; and the cellular structure inside the tumor is relatively consistent. Generally speaking, middle-aged women are the demographic most prone to developing thyroid nodules.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Probability of thyroid nodules becoming cancerous

The malignant manifestation of thyroid nodules is thyroid cancer. Thus, thyroid nodules are divided into two major categories: benign and malignant. Benign nodules generally make up the vast majority, with malignancies accounting for less than 5%. Malignant thyroid nodules are cancerous. Some benign thyroid nodules may also become malignant over time. Generally, small nodules do not show obvious clinical symptoms during the cancerous transformation, but their nature changes. When a nodule compresses surrounding tissues and causes certain symptoms, such as hoarseness, tracheal compression, and difficulty swallowing, it often indicates that the tumor is in the middle or late stage. Overall, the chances of benign nodules becoming cancerous are very small. The malignancy rate of benign nodular goiter is about 5%, and the possibility of adenomas turning malignant is around 10%. As the diameter increases, the possibility of adenomas becoming malignant gradually increases. There are several high-risk factors for the malignant transformation of thyroid nodules: for instance, having a history of radiation exposure to the head and neck area during childhood or adolescence, patients who are younger than 14 or older than 70; the rate of malignant transformation of thyroid nodules significantly increases; and the rate of malignant transformation in male nodules is significantly higher than in females. Also, patients whose nodules significantly increase in size in a short period during regular check-ups are also considered high-risk for malignancy.

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Written by Yuan Qing
Pulmonology
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Which is more serious, pulmonary nodules or thyroid nodules?

It is impossible to compare the severity between thyroid nodules and lung nodules. Firstly, thyroid nodules and lung nodules occur in different organs. Lung nodules are mostly caused by inhalation of dust, pollutants, or smoke. Thyroid nodules, on the other hand, often result from genetic factors, or issues with the patient’s own constitution leading to the formation of these nodules. Most lung nodules can be classified as benign or malignant through diagnostic tests, whereas it is often difficult to assess the nature of thyroid nodules with standard tests. Additional auxiliary examinations, such as PET-CT or SPECT, and biopsy pathology are needed to determine the nature of thyroid nodules. Therefore, the approaches to observing and handling these two types of nodules are entirely different, and they cannot be compared.