What is the thyroid?
The thyroid is a small organ, shaped like a butterfly, in the front of the neck. It makes hormones that help the body burn energy and produce proteins.
What is a thyroid biopsy?
A thyroid fine needle aspiration (FNA) is a type of biopsy where a thin needle and syringe are used to remove (aspirate) a small amount of fluid or cells from the thyroid. The cells or fluid is examined under a microscope in the laboratory. The procedure may also be called fine needle aspiration biopsy.
The thyroid FNA is done using image guidance by an interventional radiologist.
Why is a thyroid biopsy done?
A thyroid biopsy may be done if results from blood tests or imaging show that your child may have an abnormality in their thyroid.
Risks of a thyroid biopsy
Thyroid biopsies are considered low-risk procedures. The risk may increase depending on your child’s condition, age and health.
The risks of a thyroid biopsy can include:
- pain or discomfort
- bleeding
- infection
- blood vessel injury
- nerve injury
Visiting the clinic before the procedure
Your child will have a clinic visit with the interventional radiologist before the procedure. During the visit, you should expect:
- A health assessment to make sure your child is healthy and that it is safe to have sedation or general anaesthesia and to go ahead with the procedure.
- An overview of the procedure, and a review of the consent form with an interventional radiologist.
- A quick ultrasound of your child’s thyroid; your child’s neck will be marked with a semi-permanent marker in the area where the biopsy will be taken.
- Blood work if needed.
Giving consent before the procedure
Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks and will help you weigh any benefits against the risks. It is important that you understand all of the potential risks and benefits of the thyroid biopsy and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.
How to prepare your child for the procedure
Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.
Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.
If your child becomes ill within two days before the procedure
It is important that your child is healthy on the day of the procedure. If your child starts to feel unwell or has a fever within two days before the biopsy, let you doctor know. Your child’s procedure may need to be rebooked.
Food, drink, and medicines before the procedure
- Your child’s stomach must be empty before sedation or general anaesthetic.
- If your child has special needs during fasting, talk to your doctor to make a plan.
- Your child can take their regular morning medicine with a sip of water two hours before the procedure.
- Medicines such as acetylsalicylic acid (ASA), naproxen or ibuprofen, warfarin, or enoxaparin may increase the risk of bleeding. Do not give these to your child before the procedure unless they have been cleared first by their doctor and the interventional radiologist.
On the day of the procedure
Arrive at the hospital two hours before the planned time of your child’s procedure. Once you are checked in, your child will be dressed in a hospital gown, weighed and assessed by a nurse. Some freezing cream may be put on your child’s neck. You will be able to speak to the interventional radiologist who will be doing the thyroid biopsy and the nurse or anaesthetist who will be giving your child medication to make them comfortable for the procedure.
During the thyroid biopsy, you will be asked to wait in the surgical waiting area.
Your child will have medicine for pain
It is important that your child is as comfortable as possible for the procedure. They may be given local anaesthesia, sedation or general anaesthesia. The type of medicine that your child will have for the procedure will depend on your child’s condition.
How a thyroid biopsy is done
For the biopsy, your child will lie on their back and a towel roll will be placed under their shoulders to help extend their neck. The interventional radiologist uses ultrasound to see where the thyroid is and to direct the needle into the area for the biopsy. The interventional radiologist guides the needle into the thyroid, and takes a small amount of fluid or cells from one or both sides of the thyroid. These samples are then sent to the laboratory for examination.
Your child will usually not need any stitches. A small bandage is placed over the biopsy site if needed.
The procedure usually takes about forty-five minutes.
After the thyroid biopsy
Once the thyroid biopsy is complete, your child will be moved to the recovery area and will need to lie on their back for two hours. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up, a nurse will come and get you.
Going home
Most children who have a thyroid biopsy go home the same day. If your child’s doctor has arranged this, your child will be ready to go home when they are wide awake and stable. This often is about two hours after the biopsy.
For more details on how to care for your child after a thyroid biopsy/FNA, see Thyroid biopsy/FNA: Caring for your child at home after the procedure.
Results
Your referring doctor will receive the results of your child’s thyroid biopsy. You will need to make an appointment with them to discuss the results.
At SickKids
At SickKids, the interventional radiologists work in the Department of Diagnostic Imaging — Division of Image Guided Therapy (IGT). You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.
For more information on fasting see Eating and drinking before surgery.
For more information on preparing your child for their procedure see Coming for surgery.