Title:A First Report of Thyroid Pneumatosis as a Complication of Ultrasound-guided
Thyroid Biopsy
Volume: 20
Author(s): Honglu Li, Wei Chen, Hua Xu, Chuanhong Wang, Huachun Zou, Yang Chen, Pinggui Lei and Bing Fan*
Affiliation:
- Department of Radiology, Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College, Nanchang 330006,
China
Keywords:
Thyroid gland, Biopsy, Ultrasonography, Complication, Computed tomography, FNA.
Abstract:
Background:
Ultrasound-guided needle biopsies, including fine-needle aspirations (FNA) and core needle biopsies (CNB), have become an effective technique
in the evaluation of thyroid nodules. In this report, we discuss the first reported case, to our knowledge, of thyroid pneumatosis after ultrasoundguided
FNA.
Case Presentation:
A 44-year-old woman underwent ultrasound-guided FNA in other hospitals after thyroid ultrasound revealed a solid lesion in the left lobe
classified as TI-RADS 4. Two days later, this female presented to our hospital for an excision of a thyroid mass. Pre- and post-contrast CT scans of
the thyroid showed extensive accumulation of gas in the thyroid gland and the retropharyngeal and retrotracheal space. A CT scan of the thyroid
two days later revealed obvious absorption of thyroid gas and faint low-density nodules in the left lobe of the thyroid. The lesion was
histopathologically confirmed as papillary carcinoma of the thyroid.
Conclusion:
We thought the aforementioned issues originating from the limited imaging capacity of ultrasound in the context of thyroid biopsy. To avoid these
limitations, we highlight the need to thoroughly examine the location of a lesion prior to thyroid biopsy to understand in detail the relationship
between the lesion and the adjacent tissues, especially the proximity of the lesion to the trachea, the occurrence of coughing during a biopsy
(indicating puncture of the trachea) is what operators need to be aware of so that they can manage such cases. On the other hand, we recommend
that pre-operative use of CT before thyroid biopsy and especially if CT is needed anyway later for nodules evaluation before surgery to ensure the
CT image quality.
