穿刺吸引針生検で甲状腺がんが示されているのは、全切除か二次性か

But at the same time, biopsy is also a kind of harm to the body, and damage may also occur. So under what circumstances should a fine-needle biopsy be performed? Let me introduce: The clinical treatment of thyroid nodules should be based on the results of ultrasound and FNA biopsy . The new guidelines state that thyroid ultrasonography should be performed when patients are at risk for thyroid malignancy, have palpable nodules, multinodular goiter, or lymphadenopathy suspicious for malignancy. Based on the examination results, it is determined whether ultrasound-guided fine-needle aspiration biopsy is required. During ultrasonography, FNA biopsy is recommended for nodules that meet the following conditions: ① Solid hypoechoic nodules greater than 10 mm in diameter. ② Ultrasound examination of thyroid nodules of any size suspected of extracapsular growth or cervical lymph node metastasis. ③ Patients with a history of cervical radiation exposure in children or adolescence; first-degree relatives of patients with papillary thyroid cancer (PTC), medullary thyroid cancer (MTC) or multiple endocrine neoplasia type 2 (MEN2); thyroid cancer surgery Patients with history; patients with elevated calcitonin levels measured in the absence of any interfering factors. ④ Nodules with diameters less than 10 mm, but with signs associated with malignant lesions (hypoechoic and/or irregular borders, elongated, microcalcifications, or disordered blood flow signals in the nodules) detected by ultrasonography. For multinodular goiter: ① When the nodules meet the above ultrasound signs of malignancy, FNA biopsy is rarely required for more than 2 nodules; ② When the isotope scan shows "hot" nodules, FNA cannot be performed Biopsy; ③ If there is suspicious lymphadenopathy, FNA biopsy should be performed on the enlarged lymph nodes and suspicious nodules at the same time. For mixed (cystic-solid) thyroid nodules: ① UGFNA biopsy was performed on the solid part; ② FNA biopsy samples and aspirated liquid specimens were simultaneously examined for cytology. For thyroid accidental tumors: ① the treatment should be based on the diagnostic criteria of thyroid nodules; ② for accidental tumors detected by CT or magnetic resonance imaging (MRI), ultrasonography should be performed before UGFNA; ③ for 18F-fluorodeoxygenated tumors Unexpected neoplasms detected by glucose-positron emission tomography (PET) should be performed concurrently with ultrasonography and UGFNA due to their high risk of malignancy. The above not only introduces the need for biopsy, but also lets us know the requirements of some thyroid nodule disease biopsy, only in this way can we achieve the purpose of our biopsy and achieve the accuracy of disease diagnosis.

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