Ultrasound (U/S) -Guided Fine Needle Aspirate (FNA) of Thyroid or Soft Tissue Neck Structures

Fine needle aspiration (FNA) is a reliable, proven technique for sampling soft tissue pathology without an open incision. The tissue sample is obtained by making several passes using a very thin needle (22 or 25 gauge) through the target tissue, usually an abnormal nodule, cyst, or mass in the thyroid or nearby lymph nodes. Although this has been done in the past without the use of image guidance, studies have proven that ultrasound guidance dramatically improves the yield of the biopsies. This translates into obtaining diagnostic samples the first time around avoiding second procedures 97% of the time.

Technique: The patient lies on his/her back with the neck extended back to gain access to the lower part of the front of the neck. The ultrasound probe is glided along the front of the neck in order to identify the target tissue. Once the target is visualized and documented, the thin needle is introduced into the tissue, and the sample (solid and/or fluid) is aspirated. The needle is removed, and the sample is processed by a cytopathologist for diagnosis. Local anesthesia may or may not be used depending on the location of the target tissue. Many patients report mild to moderate discomfort initially when the needle is first introduced. But many others report similar discomfort with the injection of local anesthesia.

Dr. Speyer will discuss the risks, benefits, and alternatives to this procedure with you in detail. Listed below are some of the disclosed risks of undergoing ultrasound-guided fine needle aspirate of the thyroid and/or soft tissue neck structures. By reading and signing below, you are stating that you indeed understand the nature of the procedure, the risks as listed, and alternatives to undergoing the procedure.

Risks of ultrasound-guided fine needle aspirate of the thyroid and/or soft tissue neck structures include, but are not limited to, bleeding, hematoma, seroma, infection, failure to obtain diagnostic samples requiring additional needle aspirates and/or open biopsy techniques, false negative and false positive sample results, damage to surrounding tissues including arteries, veins, and nerves, among others including unforeseeable events. If the procedure is being performed for cystic (fluid-filled) lesions, recurrent formation of the cyst is very common and may need additional treatment including excision. By signing below, I also am aware that this procedure carries an increased risk of bleeding in patients with bleeding disorders, platelet diseases, and those taking any prescribed or over-the-counter blood thinners, including warfarin (Coumadin), aspirin, Plavix, and others not excluding herbal products and supplements.

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