2023-05-02 19:40:32
Otorhinolaryngologist, specialist in AEG diseases and head and neck surgery
The thyroid gland is also known by its names “shield gland” or “thyroid gland”. It is an endocrine gland that secretes hormones that affect the rate of metabolism in the body.
Although a node (focus) in the thyroid gland is very common, only about 3%-7% of the nodes are detected by palpation and most of them are detected randomly. Most of the connections are benign and only 5%-7% of the lesions are malignant. An ultrasound examination is the best examination for locating the foci, but the examination is not able to distinguish with certainty between a benign or malignant lesion. However, in many studies that have been carried out, certain characteristics have been found in the foci whose presence in the lesion raises the suspicion or the likelihood that the lesion is malignant.
“When there is a suspicion of a problem with the thyroid gland, the first thing to do is send for an ultrasound,” says Dr. Anat Blank, director of the diagnostic and invasive radiology unit at ARM – the Center for Otolaryngology. “This is one of the most sensitive methods available and it is an available and relatively cheap”.
According to her, “At least once a week, a patient comes to me at the ER who turns out to have already undergone an ultrasound in the community, but by someone who is not fully skilled in the specific field of neck ultrasound, and therefore the parathyroid was missed. These patients usually come to us for another and more accurate examination.”
If further diagnosis of the lesion is necessary, image-guided biopsies are currently performed, under CT or ultrasound. A skilled doctor can perform the biopsy in a matter of seconds.
“The test is usually performed while lying on the back with the head tilted back,” explains Dr. Blank and adds: “The puncture is performed by inserting a fine, thin needle through the skin of the neck to a maximum depth of about 3 cm. The needle is inserted while the ultrasound is being performed – This is how you make sure that the needle is in exactly the right place. When the puncture is done under sonographic (ultrasound) guidance, the doctor can see the blood vessels in real time and be careful not to pass through them, thus avoiding bleeding.”
The number of punctures ranges from 1 to 4. The first puncture is often the most diagnostic and in 90% of cases no further puncture is necessary. The cytologist – a laboratory diagnostician of diseases at the cellular level – receives the material from the doctor and looks under a microscope at the quantity and quality of the sampled material to make sure that it is indeed sufficient for a biopsy.
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