Fine Needle Aspiration (FNA) Thyroid Biopsy

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The doctor has seen or felt a nodule or bump on your child’s thyroid. An ultrasound of the thyroid was then done.  The ultrasound confirmed the presence of a nodule. Now it is time to take some fluid from inside the nodule and get it tested. This procedure is called a biopsy. A doctor who specializes in radiology will do the procedure.

Sometimes sedation (anesthesia) medicine will be offered to make your child stay asleep during the biopsy. Your child’s health care provider will talk to you about this option. Anesthesia will be given by a doctor called an anesthesiologist (an es thee see OL o gist).

The biopsy is done in Interventional Radiology (IR).

How to Prepare for the Test

  • Explain the test to your child at a time you feel is best and in a way he or she will understand. If your child is old enough, explain how the test is done.
  • Your child does not need to do anything special to get ready for this test unless he will be sedated. If your child will be sedated, you will receive special instructions on when he should stop eating and drinking before the test.
  • Be sure to tell the doctor if your child has any allergies.
  • At the time of the test, your child should be free of any illness. If your child is ill with a fever, “stuffy nose” or cough, you may need to reschedule the test.
  • You will receive a phone call from a nurse at the IR Procedure Center the day before the test. You will be told the time to arrive, where to go and reminded of any special instructions.

The Day of the FNA Biopsy

Please arrive on time. Come to the Crossroads Lobby and ask to go to the Procedure Center.

A parent or legal guardian must be present to sign consent forms to allow the biopsy and give sedation.

If You Have Requested Sedation for Your Child

  • Your child will have an “anesthesia work-up.” You will need to give information on your child’s health and sign a separate form giving consent for the sedation.
  • You and your child will meet with the anesthesiologist before going to the IR suite to have the biopsy done.

If Your Child Will Not be Sedated

  • Your child will have the option to receive numbing cream. This cream is applied to the skin to dull the feeling of pain on the surface of the skin.
  • Your child needs to arrive a half hour earlier than his scheduled appointment to have numbing cream applied.  A nurse in IR will apply the numbing cream.
  • After a half hour, the IR staff person will take your child to the IR suite to do the biopsy.

Please be aware that from time to time, the schedule runs behind or gets delayed. When this happens, the nurse or technologist will be sure to keep you informed of when the test will be done.

  • The test takes about one half hour to 1 hour to complete.
  • Parents may wait in the Crossroads Lobby in the hospital until the test is over.

How the Biopsy is Done

  • Once in the IR suite, your child will lie down on his back on a padded table. A rolled towel will be placed under the shoulders. Your child’s head will be tipped back in a relaxed way.  If your child cannot hold his head still, sometimes sedation may need  to be given.
  • The area of the neck where the test will be done is thoroughly cleaned using “sterile technique” to prevent infection.
  • A very small needle is used to inject the pain medicine (lidocaine) into the tissues (skin) around the thyroid. This medicine numbs the area beneath the skin. The area will stay numb for a little while after the procedure is over.
  • When the site is numb, another very small needle is used to probe the nodule(s). The radiologist will use ultrasound to help guide the needle.
  • A small amount of fluid from the thyroid nodule is pulled into the syringe. This process may be repeated until there is enough fluid for testing.
  • When the procedure is done, the site is cleaned, dried off and a bandage is applied.
  • The tissue sample will be sent to the pathology laboratory to be examined under a microscope.  A report will be sent to the doctor who ordered the biopsy.

Risks and Possible Complications

  • Medicine used for sedation can slow down breathing. Your child will be watched closely and treated if this happens.
  • There can be increased bleeding from the biopsy site. This is rarely severe unless your child has a bleeding problem such as hemophilia or a platelet disorder.
  • Your child may have bruising at the biopsy site.  This is normal.
  • Your child’s neck and throat may hurt for 1 to 2 days.  This is normal.
  • Your child may be unsteady on his feet and should be watched for several hours or until the sedation has worn off. He should not ride a bike, play sports or do things that require coordination and judgment for the rest of the day.
  • Infection can occur. This is rare unless your child has a problem with his immune system or a heart problem.  In these cases, antibiotics are usually given to prevent infection.

After the Test

  • If your child has been sedated, he will stay in the procedure room until fully awake.
  • When your child is awake, he may drink clear liquids like water or apple juice as soon as he can.
  • If your child is a patient in the hospital, he will be taken back to his room.
  • If your child is an outpatient, you will take him to your car in a wheelchair or carry him.
  • Your child may eat his usual foods and return to normal activities within a few hours.
  • The bandage should stay on for 24 hours after the test.
  • If your child has pain or discomfort, you may give acetaminophen (Tylenol). The amount depends on your child’s age and weight.

Give (amount) of (Tylenol) times a day.

  • It takes about 48 hours to 1 week for the test results to be completed. When the report is ready, your child’s doctor (the one who made the referral) will discuss the test results and the plan for medical care with you.

When to Call the Doctor

Complications are rare.  Call your child’s health care provider if there is:

  • Any redness, swelling or discharge from the biopsy site.
  • Fever of 101F or higher.
  • Pain or soreness lasting more than 72 hours. 

Fine Needle Aspiration (FNA) Thyroid Biopsy (PDF)

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