Polyzos S A, Anastasilakis A D
Hippokratia. 2011 Apr;15(2):116-9.
Thyroid fine needle biopsy (FNB) is the procedure of choice for the management of thyroid nodules. Serious complications after FNB are rare, but there is also an underestimation of complication risk because of record, selection and publication biases.
Apart from the well-documented post-FNB complications, we hypothesized that there are potential complications following FNB, albeit supported by limited evidence in the literature. According to our hypothesis, there may be five distinct expected rare complications: 1) cyst fluid leakage; 2) anaphylactic reaction; 3) pneumothorax; 4) thromboembolism and 5) needle tract seeding of medullary thyroid carcinoma (MTC) or thyroid lymphoma.
Cyst fluid leakage and pneumothorax may be of minimal clinical significance. Needle tract seeding of MTC or thyroid lymphoma may not have significant clinical consequences, if someone considers the easiness and effectiveness of surgical removal of needle tract seeding in cases of differentiated thyroid carcinoma. On the contrary, anaphylactic reaction or thromboembolism may be life-threatening. The performers of thyroid FNB are hereby encouraged to publish these complications, if they ever occur, because awareness of them could render FNB even safer.
甲状腺细针穿刺活检(FNB)是甲状腺结节管理的首选方法。FNB后严重并发症罕见,但由于记录、选择和发表偏倚,并发症风险也被低估。
除了FNB后有充分记录的并发症外,我们假设FNB后存在潜在并发症,尽管文献中的证据有限。根据我们的假设,可能有五种不同的罕见预期并发症:1)囊液渗漏;2)过敏反应;3)气胸;4)血栓栓塞;5)甲状腺髓样癌(MTC)或甲状腺淋巴瘤针道种植。
囊液渗漏和气胸可能临床意义极小。如果有人考虑到分化型甲状腺癌针道种植手术切除的简便性和有效性,MTC或甲状腺淋巴瘤针道种植可能不会产生重大临床后果。相反,过敏反应或血栓栓塞可能危及生命。因此鼓励进行甲状腺FNB的人员,如果这些并发症确实发生,应予以公布,因为对它们的认识可使FNB更加安全。