Are all thyroid biopsies done by FNA?

[kimmie3434]

My 20 year old son is scheduled for a biopsy on his left thyroid for a 4.3 cm cyst. That has irregular border and nodularity of the cystic wall. I have two questions. When they called to set up his appt they said that he can't eat or drink anything after midnight the day before the surgery. Is this not just going to be Fine needle biopsy. I have had one before and I was able to eat and drink. Second how common is it to have thyroid cancer when the nodule is cystic? All blood tests came back negative.

[Red_Star]

From the Mayo Clinic...

Common types of needle biopsy techniques include:

Fine-needle aspiration. This type of needle biopsy uses a thin, hollow needle to draw cells from your body.

Core needle biopsy. This type of needle biopsy uses a wider needle than does fine-needle aspiration. The needle used during a core needle biopsy is a hollow tube that allows the doctor to extract a core of tissue for testing."

As the core needle is larger...ouch!...it's usually done under local anesthesia. You cannot eat or drink prior to this procedure.

[kimmie3434]

Thank you! Sounds like that's why they don't want him to eat or drink.

[Sarahjogs]

Hi kimmie3434,

I'm pretty sure I had something drink minutes before I went in for my FNB, and had no problems.  I had two thyroid surgeries where I was under general anesthesia, and I wasn't allowed to eat or drink after midnight for those.

As for the odds that a cystic nodule is cancerous - I don't know.  I know 90% of thyroid nodules are benign.  The size (>4cm) and irregular borders put it into a more suspicious category.  Also, if it is a mix of cystic and solid components (which an irregular border with nodularity might suggest), that makes it more suspicious too.

Also - I've never had a cystic nodule so I don't know what they do during the biopsy, but maybe the no eating/drinking guidelines come in to play if they plan on draining the cyst?  My nodules were all solid, so I don't know what they do for cysts - if it is fluid filled I know they sometimes have problems getting enough cells to analyze and when that happens you can get an inconclusive result.

Good luck with your son's biopsy.

[kimmie3434]

Thank you!

[Gracevd70]

Sorry again, is he having Thyroidectomy or FN biopsy? I would not do surgery until after the FN Biospy ....that would be a crazy thing to do not having a thyroid is a nightmare hormone wise.

[kimmie3434]

He's having a biopsy but they said couldn't eat or drink after midnight. She said it was percutaneous biopsy is that the same as an FNA?

[Gracevd70]

Percutaneous core needle biopsy vs. fine needle aspiration in diagnosing benign lung lesions.
Greif J1, Marmor S, Schwarz Y, Staroselsky AN.
Author information
Abstract
OBJECTIVE:
To determine the diagnostic value of percutaneous core needle biopsy (PCNB) in comparison with fine needle aspiration (FNA) in patients with benign pulmonary lesions.

STUDY DESIGN:
A retrospective review was undertaken of computed tomography-guided PCNBs and FNAs performed between 1988 and 1997. Both FNA and PCNB biopsies were carried out sequentially at the same visit in every patient.

RESULTS:
A specific benign diagnosis was made in 10/60 cases (16.7%) by FNA and in 49/60 (81.7%) by PCNB. PCNB findings resulted in significant modification of the diagnosis established by FNA. The only significant complication encountered was pneumothorax, at a rate of 11.7%, which is compatible with that reported in the literature for complications induced by FNA alone.

CONCLUSION:
Radiologically guided PCNB is a safe procedure, can provide sufficient histologic material for a specific diagnosis of peripheral lung disease and can avoid more-invasive surgical procedures in many cases. Our experience demonstrated that the histologic analysis provided by PCNB can greatly increase the diagnostic accuracy in benign pulmonary diseases as compared with the yield of FNA.

PMID: 10518126 DOI: 10.1159/000331287
[Indexed for MEDLINE]

[Gracevd70]

Ignore my post.....I clicked on wrong info.. I'm not sure it seems they are the same.

[Gracevd70]

Maybe someone else will come along with the difference if their are any.

[Gracevd70]

I had FN Biopsy before I had my Thyroid removed and I ate and drank 3 hours before FN biopsy and I had no numbing agent not by choice....all places are different and maybe they are afraid of him vomiting during the FN biopsy.

[Gracevd70]

Oops...I had thyroid cancer and no blood test said I had cancer FN Biopsy and pathologist said I had cancer and they sent my results/slides to a  2nd pathologists to check the first one conclusion.

[kimmie3434]

Is a percutaneous  biopsy the same as FN biopsy?

[Gracevd70]

I just googled it and they are the same by the description.