Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What are the complications of fine needle aspiration biopsy of the thyroid?
Most patients notice very little bleeding or swelling. There may be
some discomfort in the area for a few hours after the biopsy, which
is usually relieved with acetaminophen (Tylenol). Some patients like
to put an ice pack over the area when they get home, but most do well
without such measures. The risks of fine needle aspiration biopsy of the thyroid include
bleeding, infection, and cyst formation, but these complications are
exceedingly rare. Patients should contact their doctor if they notice
any excessive bruising or swelling in the area of the biopsy, if they
have persistent pain in the area, or if they develop a fever.
What happens to the thyroid tissue obtained at the fine needle aspiration biopsy?
After the procedure, the tissue obtained is prepared onto glass slides and sent to the pathologist for evaluation. First, the pathologist determines whether or not enough thyroid tissue has been obtained for analysis. (When there is an insufficient amount, a repeat fine needle aspiration biopsy is necessary.) After analysis, the tissue is classified. Although the classifications used by pathologists vary, the tissue is usually reported as (1) benign; (2) malignant; (3) suspicious; or (4) indeterminate. The chance of a false negative test (a test report that is negative when cancer is actually present) varies from 0-5%, depending on where the test is performed. The chance of a false positive (a test report showing cancer when there is no cancer present) is less than 5% and is usually due to the presence of degenerating cells or atypical cells. These results are reported back to the doctor's office, usually within one week. At this point, the doctor discusses the implications of the report and outlines further treatment, if needed based on the results.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the
rate of thyroid hormone production is controlled by the brain at the pituitary.
Hypothyroidism is a very common condition and the symptoms of hypothyroidism are
often subtle.
Hyperthyroidism is an excess of thyroid hormone resulting from an overactive thyroid gland. Symptoms can include increased heart rate, weight
loss, depression, and cognitive slowing. Treatment is by medication, the use of
radioactive iodine, thyroid surgery, or reducing the dose of thyroid hormone.
Cysts are saclike structures that can occur throughout the body and usually contain a semisolid, liquid, or gaseous substance. Infections, tumors, genetic conditions, chronic inflammatory conditions, and wear and tear can cause cysts. Though some cysts may be palpable, others may not produce any symptoms. Treatment depends upon the location and cause of the cyst.
There are four major types of thyroid cancer: papillary, follicular, medullary, and anaplastic thyroid cancer. Tumors on the thyroid are referred to as thyroid nodules. Symptoms of thyroid cancer include swollen lymph nodes, pain in the throat, difficulty swallowing, hoarseness, and a lump near the Adam's apple. Treatment usually involves chemotherapy, surgery, radioactive iodine, hormone treatment or external radiation and depends upon the type of thyroid cancer, the patient's age, the tumor size, and whether the cancer has metastasized.
Thyroid nodules are the most common endocrine problem in the United States. The term "thyroid nodule" refers to any abnormal growth that forms a lump in the thyroid gland. The vast majority of thyroid nodules are benign.
There are many types of thyroid disease. Some occur due to the function of the thyroid itself such as hypothyroidism, hyperthyroidism, Hashimoto's thyroiditis, etc. Some causes of thyroid disease occur due to problems with the structure of the thyroid gland such as goiters, thyroid nodules, and thyroid cancer. Treatment of thyroid disease depends on the cause of the disease.
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