Table of ContentsView AllTable of ContentsPurpose of TestRisks and ContraindicationsBefore the TestDuring the TestAfter the TestInterpreting Results
Table of ContentsView All
View All
Table of Contents
Purpose of Test
Risks and Contraindications
Before the Test
During the Test
After the Test
Interpreting Results
A fine-needle aspiration (FNA) is a procedure that’s used to sample cells from thethyroid glandfor microscopic examination.This test is used in the diagnostic evaluation of a thyroid mass (also known as anodule) or when there’s a suspicion of thyroid cancer.
During an FNA, a very fine, thin needle is inserted into the thyroid gland to aspirate (remove) cells and/or fluid from the thyroid mass into the needle.
You may need to have a thyroid FNA if you have an enlarged thyroid gland or a thyroid mass. A thyroid mass may also be referred to as a nodule, growth, or lump.
A thyroid mass may be solid or filled with fluid, and it generally differs in some way from the rest of the thyroid gland. It may be harder in texture, or it may have a distinct appearance on an imaging examination.
A sample of thyroid cells obtained with an FNA can help healthcare providers evaluate the type of cells in a thyroid nodule, primarily to determine whether it is cancerous and, if so, how it can be treated.
You may need to have a thyroid FNA with ultrasound guidance, particularly if you have a small thyroid mass or if its location is difficult to access.
Limitations
Because a tiny sample of tissue is collected using an FNA, it is a diagnostic procedure, not a therapeutic one. It cannot remove or eliminate cancer from the thyroid gland.
A thyroid FNA technique does not provide enough information for your healthcare providers to determine whether cancer has spread to other regions of the thyroid or the neck. There is also a risk of false-negative results, which is a report of no cancer cells even if there is cancer in the thyroid gland.
In some cases, a needle core biopsy is used instead of FNA. The sample is obtained using a thicker needle than that used for FNA. The larger sample collected with a needle core biopsy can provide a better idea of the size and invasiveness of a tumor than an FNA, but with a higher chance of pain, bleeding, complications, and a longer recovery period.
Going Into a Thyroid Biopsy: What to Expect
Miodrag Gajic/E+/Getty Images
FNA is considered a safe, minimally invasive procedure without serious risks.
Potential adverse effects include:
If you experience neck swelling orsymptoms of thyroid dysfunction, you should tell your healthcare provider immediately.
Before your thyroid FNA, you may need to have blood tests, which can includethyroid function tests. Your healthcare provider may tell you to adjust or stop taking some of your medications a few days before your procedure, including thyroid medications and blood thinners.
Timing
You can expect a thyroid FNA procedure to take approximately half an hour. Be sure to allow several hours for the test so that you can arrive in time to fill out paperwork and possibly stay after your procedure if your healthcare providers need to observe you.
Location
Thyroid FNAs can be performed in a doctor’s office, at an outpatient surgery center, or in a radiology procedural suite. The healthcare system where you are seen likely has its own process in place for thyroid FNA.
What to Wear
You can wear anything comfortable to your procedure, but avoid any clothing that covers your neck. You may be asked to change into a gown for your procedure.
Food and Drink
Before your procedure, you can eat and drink whatever you normally would.
Cost and Health Insurance
If you are paying for the test out-of-pocket, your cost can range between $400 and $1600. Ultrasound-guided FNA and the use of anesthetic medication are more likely to put the cost at the higher end.
What to Bring
When you go to have your test, you should bring a form of identification, your insurance information, and a means of payment for your portion of the cost. You should expect to be completely alert and able to drive and resume your regular activities after the procedure, so it is not required that you bring anyone with you.
Pre-Test
Before your test, you will need to sign paperwork, which generally includes a consent form and authorization for payment. Soon after, you will be called in to prepare for your procedure. A nurse or technician will check your vital signs and may ask you to change into a gown.
Throughout the Test
Steps of your procedure:
Once the needle is removed, you may need a small bandage over the puncture site on your neck.
Post-Test
Your healthcare provider or nurse will check on you and may want to observe you after your procedure to monitor for any side effects. If you have no side effects, you will be discharged and you can resume routine activities, including eating and drinking.
In the first few days after your thyroid FNA, you might experience slight pain, swelling, or bruising near the injection site, and possibly slight discomfort when you swallow. You should avoid vigorous physical activity and sports for approximately 24 hours after your thyroid FNA, primarily to avoid any injury to your thyroid gland as it is healing.
Managing Side Effects
Your healthcare provider may recommend using ice or taking Tylenol (acetaminophen) to minimize your discomfort. You should not use non-steroidal antiinflammatories (NSAIDs) like Motrin or aspirin, because they can increase the risk of bleeding.
If you experience severe pain, swelling, a growing lump, a fever, or symptoms ofhyperthyroidism, you should call your healthcare provider.
There are several features that the pathologist will consider when examining your biopsy sample, including the presence of inflammatory cells, evidence of an infection, or thyroid cancer cells.
It is possible for the cells to be completely normal, suggesting a benign (noncancerous) lesion.
If you are diagnosed with thyroid cancer, the biopsy sample can help your healthcare provider determine which type of thyroid cancer you have:
An Overview of Thyroid Cancer
If you have evidence of cancer, based on the results of your thyroid FNA, you will likely need to have surgery, radiation, and/or chemotherapy.
If your FNA does not show signs of cancer but you have a thyroid nodule, they will monitor it and perform a repeat ultrasound in six to 12 months.
However, they may continue to search for evidence of cancer if there is still a high suspicion that you could have thyroid cancer despite the negative FNA results. The next steps may include a more extensive biopsy or further diagnostic imaging tests.
A Word From Verywell
A biopsy is often considered the most definitive way to analyze thyroid tissue. If you are scheduled to have a thyroid FNA, you should know that this is a minimally invasive procedure with limited side effects. Be aware, however, that because it provides only a tiny sample of cells, the results of a thyroid FNA must be considered along with the results of all your other tests, including your thyroid hormone blood tests and diagnostic imaging examinations.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Vanderlaan PA.Fine-needle aspiration and core needle biopsy: An update on 2 common minimally invasive tissue sampling modalities.Cancer Cytopathol. 2016;124(12):862-870. doi:10.1002/cncy.21742Limaiem F, Rehman A, Mazzoni T.Cancer, Papillary Thyroid Carcinoma (PTC). In:StatPearls[Internet]. 2019 Jan-.Podda M, Saba A, Porru F, Reccia I, Pisanu A.Follicular thyroid carcinoma: differences in clinical relevance between minimally invasive and widely invasive tumors.World J Surg Oncol. 2015;13:193. doi:10.1186/s12957-015-0612-8Pacini F, Castagna MG, Cipri C, Schlumberger M.Medullary thyroid carcinoma.Clin Oncol (R Coll Radiol). 2010;22(6):475-85. doi:10.1016/j.clon.2010.05.002Additional ReadingMacerola E, Basolo F.Current methodologies for molecular screening of thyroid nodules. Gland Surg. 2018 Aug;7(Suppl 1):S1-S7. doi: 10.21037/gs.2017.08.04.Strachan MW, Dalvi M, Ainsworth R, Gibb FW, Horsfall H, Patel D.Fatal haemorrhage following fine needle aspiration of the thyroid.J R Coll Physicians Edinb. 2016 Sep;46(3):166-167. doi: 10.4997/JRCPE.2016.306.Trimboli P, Guidobaldi L, Bongiovanni M, Crescenzi A, Alevizaki M, Giovanella L.Use of fine-needle aspirate calcitonin to detect medullary thyroid carcinoma: A systematic review.Diagn Cytopathol. 2016 Jan;44(1):45-51. doi: 10.1002/dc.23375. Epub 2015 Oct 19.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Vanderlaan PA.Fine-needle aspiration and core needle biopsy: An update on 2 common minimally invasive tissue sampling modalities.Cancer Cytopathol. 2016;124(12):862-870. doi:10.1002/cncy.21742Limaiem F, Rehman A, Mazzoni T.Cancer, Papillary Thyroid Carcinoma (PTC). In:StatPearls[Internet]. 2019 Jan-.Podda M, Saba A, Porru F, Reccia I, Pisanu A.Follicular thyroid carcinoma: differences in clinical relevance between minimally invasive and widely invasive tumors.World J Surg Oncol. 2015;13:193. doi:10.1186/s12957-015-0612-8Pacini F, Castagna MG, Cipri C, Schlumberger M.Medullary thyroid carcinoma.Clin Oncol (R Coll Radiol). 2010;22(6):475-85. doi:10.1016/j.clon.2010.05.002Additional ReadingMacerola E, Basolo F.Current methodologies for molecular screening of thyroid nodules. Gland Surg. 2018 Aug;7(Suppl 1):S1-S7. doi: 10.21037/gs.2017.08.04.Strachan MW, Dalvi M, Ainsworth R, Gibb FW, Horsfall H, Patel D.Fatal haemorrhage following fine needle aspiration of the thyroid.J R Coll Physicians Edinb. 2016 Sep;46(3):166-167. doi: 10.4997/JRCPE.2016.306.Trimboli P, Guidobaldi L, Bongiovanni M, Crescenzi A, Alevizaki M, Giovanella L.Use of fine-needle aspirate calcitonin to detect medullary thyroid carcinoma: A systematic review.Diagn Cytopathol. 2016 Jan;44(1):45-51. doi: 10.1002/dc.23375. Epub 2015 Oct 19.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Vanderlaan PA.Fine-needle aspiration and core needle biopsy: An update on 2 common minimally invasive tissue sampling modalities.Cancer Cytopathol. 2016;124(12):862-870. doi:10.1002/cncy.21742Limaiem F, Rehman A, Mazzoni T.Cancer, Papillary Thyroid Carcinoma (PTC). In:StatPearls[Internet]. 2019 Jan-.Podda M, Saba A, Porru F, Reccia I, Pisanu A.Follicular thyroid carcinoma: differences in clinical relevance between minimally invasive and widely invasive tumors.World J Surg Oncol. 2015;13:193. doi:10.1186/s12957-015-0612-8Pacini F, Castagna MG, Cipri C, Schlumberger M.Medullary thyroid carcinoma.Clin Oncol (R Coll Radiol). 2010;22(6):475-85. doi:10.1016/j.clon.2010.05.002
Vanderlaan PA.Fine-needle aspiration and core needle biopsy: An update on 2 common minimally invasive tissue sampling modalities.Cancer Cytopathol. 2016;124(12):862-870. doi:10.1002/cncy.21742
Limaiem F, Rehman A, Mazzoni T.Cancer, Papillary Thyroid Carcinoma (PTC). In:StatPearls[Internet]. 2019 Jan-.
Podda M, Saba A, Porru F, Reccia I, Pisanu A.Follicular thyroid carcinoma: differences in clinical relevance between minimally invasive and widely invasive tumors.World J Surg Oncol. 2015;13:193. doi:10.1186/s12957-015-0612-8
Pacini F, Castagna MG, Cipri C, Schlumberger M.Medullary thyroid carcinoma.Clin Oncol (R Coll Radiol). 2010;22(6):475-85. doi:10.1016/j.clon.2010.05.002
Macerola E, Basolo F.Current methodologies for molecular screening of thyroid nodules. Gland Surg. 2018 Aug;7(Suppl 1):S1-S7. doi: 10.21037/gs.2017.08.04.Strachan MW, Dalvi M, Ainsworth R, Gibb FW, Horsfall H, Patel D.Fatal haemorrhage following fine needle aspiration of the thyroid.J R Coll Physicians Edinb. 2016 Sep;46(3):166-167. doi: 10.4997/JRCPE.2016.306.Trimboli P, Guidobaldi L, Bongiovanni M, Crescenzi A, Alevizaki M, Giovanella L.Use of fine-needle aspirate calcitonin to detect medullary thyroid carcinoma: A systematic review.Diagn Cytopathol. 2016 Jan;44(1):45-51. doi: 10.1002/dc.23375. Epub 2015 Oct 19.
Macerola E, Basolo F.Current methodologies for molecular screening of thyroid nodules. Gland Surg. 2018 Aug;7(Suppl 1):S1-S7. doi: 10.21037/gs.2017.08.04.
Strachan MW, Dalvi M, Ainsworth R, Gibb FW, Horsfall H, Patel D.Fatal haemorrhage following fine needle aspiration of the thyroid.J R Coll Physicians Edinb. 2016 Sep;46(3):166-167. doi: 10.4997/JRCPE.2016.306.
Trimboli P, Guidobaldi L, Bongiovanni M, Crescenzi A, Alevizaki M, Giovanella L.Use of fine-needle aspirate calcitonin to detect medullary thyroid carcinoma: A systematic review.Diagn Cytopathol. 2016 Jan;44(1):45-51. doi: 10.1002/dc.23375. Epub 2015 Oct 19.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
