A pictorial review of thyroid biopsy complications

Congress:

ECR 2019

Poster Number:

C-0095

Type:

Educational Exhibit

Keywords:

Haemorrhage, Biopsy, Ultrasound, Thyroid / Parathyroids, Interventional non-vascular, Inflammation

Authors:

S. Pasetto¹, O. Pozuelo², A. ANGUERA³, A. Tanasa⁴; ¹El Vendrell, Tarragona/ES, ²El Vendrell/ES, ³HOSPITALET/ES, ⁴TARRAGONA/ES

DOI:

10.26044/ecr2019/C-0095

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-0095

Fig. 2: A large thyroid gland is seen with low-density areas in both lobes. Marked...

Fig. 3: Subendothelial Carotid Hematoma After Core‐Needle Biopsy of a Solitary...

Fig. 4: ACUTE OEDEMA AFTER CNB (A) Ultrasound before core-needle biopsy, transverse...

Fig. 7: On the left: a mixed cystic and solid tumor in the right thyroid gland. On the...

Learning objectives

Core needle biopsy (CNB) has been suggested as a complementary diagnostic method to fine-needle aspiration in patients with thyroid nodules. US-guided CNB of thyroid lesions was found in a large population to be a safe procedure with a low complication ratio. In this review we tried to collect and summarize all reported adverse events following diagnostic thyroid CNB.

Background

The current thyroid guidelines suggest that CNB is a safe and well-tolerable procedure, associatedwith a low incidence of complications whenperformed by experienced operators.Thereported complication rate ranges from 0 to 4.1%, withthe major complication rate ranging from 0 to 1.9% Nonetheless, various complications may occur, including hematoma, infection, hemoptysis, edema, vasovagal reactionand dysphagia. We assessed the number and types of major and minor complications, and evaluated the factors associated with complications.

Findings and procedure details

US examinations were performed using high-resolution ultrasonography equipment (IU22® Philips–Advanced Technology Laboratories, Bothell, WA), with 5–12-MHz linear array transducers.US-guided CNBs were performed using a disposable, 18-gauge, double-action spring-activated needle (1.1-cmexcursion, TSK Ace-cut; Create Medic, Yokohama, Japan) under local anaesthesia with 1 % lidocaine. According to our experience, there may be all these potential complications: PAIN and DISCONFORTduring or after CNB are a common problem.Although they are regarded as minor, transient and well-tolerated by the patient, pain and discomfort are undesirable consequences of CNB and may...

Conclusion

Various complications occurred after CNB of thyroid lesions, but the pooled complication rate was low (1.11%). The guidelines suggest that CNB is safe, well-tolerated and associated with a low incidence of complications when performed by experienced operators.

Personal information

References

Ha EJ, et al. Complications following US-guided core-needle biopsy for thyroid lesions: a retrospective study of 6,169 consecutive patients with 6,687 thyroid nodules.Eur Radiol. 2017. D. Anastasilakis MD. Subendothelial Carotid Hematoma After Fine‐Needle Aspiration Biopsy of a Solitary Thyroid Nodule. Volume 27, Issue 10.October 2008 Pages1517-1520 A. Van den Bruel et al.A Thyroid Thriller: Acute Transient and Symmetric Goiter after Fine-Needle Aspiration of a Solitary Thyroid Nodule.THYROID Volume 18, Number 1, 2008 SA. Polyzos. Rare potential complications of thyroid fine needle biopsy. Hippokratia. 2011 Apr-Jun;...