Do I need a biopsy for a nodular mass at my thyroid?
Hi doc, I had a thyroid ultrasound last week. They found a solid mass lesion in the inferior left lobe with hypervascularity and calcifications. Doc prescribed me a levothyroxine. Do I need to go for biopsy to check for the mass? Thank you.
Thank you for your question. I agree with Dr Ethan that the thyroid hormone tablets you were given is likely for treatment of low thyroid level and not for treatment of the thyroid mass.
Thyroid nodules (or mass) are very common and most of the time they are benign (non cancerous).
The need to have a sample of cells from your thyroid nodule taken and sent for analysis in the lab (a procedure called fine needle aspiration and cytology – FNAC as explained by Dr Ethan) depends on:
- The size of the nodule
- The appearance of the nodule on ultrasound of the thyroid gland
If your thyroid nodule is larger than 1.5 cm or have features on ultrasound that may be suspicious for cancer (e.g. irregular border, hypoechoicity, microcalcifications, internal vascularity etc) your doctor will need to perform an FNAC of the nodule to exclude cancer.
A FNAC is a relatively quick and simple procedure done in the clinic. The analysis of the cells by the pathologist in a lab can take up to a week, and sometimes longer if special staining of the cells is required.
It is best that you discuss with the doctor who ordered the ultrasound of the thyroid for you if your mass needs an FNAC. A thyroid biopsy (a piece of thyroid tissue removed for analysis) is rarely done as a first line investigation.
Hope this helps.