Korean J Radiol.  2017 Feb;18(1):217-237. 10.3348/kjr.2017.18.1.217.

Core Needle Biopsy of the Thyroid: 2016 Consensus Statement and Recommendations from Korean Society of Thyroid Radiology

• Na DG
• Baek JH
• Jung SL
• Kim JH
• Sung JY
• Kim KS
• Lee JH
• Shin JH
• Choi YJ
• Ha EJ
• Lim HK
• Kim SJ
• Hahn SY
• Lee KH
• Choi YJ
• Youn I
• Kim YJ
• Ahn HS
• Ryu JH
• Baek SM
• Sim JS
• Jung CK
• Lee JH
• Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology

• KMID: 2468135
• DOI: http://doi.org/10.3348/kjr.2017.18.1.217

Abstract

Core needle biopsy (CNB) has been suggested as a complementary diagnostic method to fine-needle aspiration in patients with thyroid nodules. Many recent CNB studies have suggested a more advanced role for CNB, but there are still no guidelines on its use. Therefore, the Task Force Committee of the Korean Society of Thyroid Radiology has developed the present consensus statement and recommendations for the role of CNB in the diagnosis of thyroid nodules. These recommendations are based on evidence from the current literature and expert consensus.

Keyword

Thyroid; Thyroid nodule; Thyroid neoplasms; FNA; CNB

MeSH Terms

Biopsy, Large-Core Needle/adverse effects/instrumentation/*methods
Hematoma/etiology
Hoarseness/etiology
Humans
Image-Guided Biopsy
Patient Care
Republic of Korea
Societies, Medical
Thyroid Neoplasms/diagnostic imaging/*pathology
Thyroid Nodule/diagnostic imaging/pathology
Ultrasonography, Doppler

Figure

• 

  Fig. 1 Core needle device. A. Stylet and specimen notch (arrows). B. Cutting cannula.

• 

  Fig. 2 CNB procedure on US. A. Insertion of core needle through isthmus. B. Measurement of distance of fire (arrows). C. Firing of stylet. Specimen notch includes nodule, nodule capsule, and small amount of normal thyroid parenchyma. D. Firing of cutting cannula. CNB = core needle biopsy, RLP = right lower pole US = ultrasound

• 

  Fig. 3 Nodule in deep posterior portion of thyroid gland. A. Nodule is located in posterior portion near thyroid capsule. B. Stylet is manually advanced into nodule. C. Then, nodule is elevated with inserted needle. Direction of firing would be changed after adjusting stylet to adopt safer direction. D. Finally, cutting cannula is fired. CNB = core needle biopsy

• 

  Fig. 4 Representative microscopic images of core needle biopsy specimens. A. Paucicellular fibrotic nodule with calcification shows few atypical follicular cells with nuclear atypia and can be diagnosed as papillary carcinoma. Shown at × 12.5 original magnification (left), × 100 original magnification (middle) and × 400 original magnification (right). Hematoxylin and eosin stain was used. B. Core needle biopsy specimen consists of microfollicular proliferative lesion, fibrous capsule, and surrounding normal parenchyma. In high-power view, follicular cells have no nuclear atypia. This case can be diagnosed as follicular neoplasm. Shown at × 40 original magnification (left) and × 400 original magnification (right). Hematoxylin and eosin stain was used. C. Case of classic papillary carcinoma. Specimen shows papillary proliferative lesion with typical nuclear features of papillary carcinoma. Shown at × 12.5 original magnification (left) and × 400 original magnification (right). Hematoxylin and eosin stain was used.

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