European thyroid journal · 2014
Simple core-needle biopsy for thyroid nodule, complicated tinnitus.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bergeron Mathieu, Beaudoin Danielle
Аннотация
BACKGROUND: Fine-needle aspiration is the procedure of choice for evaluating thyroid nodules. Core-needle biopsy (CNB) is not included in the American Thyroid Association recommendations for evaluating such nodules. CNB complications are classically bleeding and hematomas. To our knowledge, no case of arteriovenous fistula (AVF) secondary to a CNB has been reported, nor has any case of tinnitus secondary to a post-CNB AVF.
OBJECTIVES: To make the clinician aware of possible vascular complications caused by CNB and the possibility of difficult pathology reading caused by previous CNB.
METHODS: A 44-year-old female is described who was referred to our tertiary care center for left-sided pulsatile tinnitus. She did report having had a CNB right before the tinnitus appeared. Conventional angiography demonstrated a focal AVF originating from the left vertebral artery, with reflux to the left vertebral venous plexus. A 6-mm stent was placed over the site of the fistula via an endovascular approach, which solved both the radiological and clinical documented problems. Moreover, CNB greatly complicated pathology reading once total thyroidectomy was later performed. The suspected area of invasion was an artifact due to the previous biopsies.
CONCLUSION: Although many authors recommend a CNB as an alternative modality in cases of inconclusive cytology with fine-needle aspiration, it is not in the American Thyroid Association recommendations. In cases of iatrogenic AVFs caused by a CNB, angiography is recommended both as a diagnostic and therapeutic modality. Stenting the fistula with an endoprosthesis can correct the problem immediately.
OBJECTIVES: To make the clinician aware of possible vascular complications caused by CNB and the possibility of difficult pathology reading caused by previous CNB.
METHODS: A 44-year-old female is described who was referred to our tertiary care center for left-sided pulsatile tinnitus. She did report having had a CNB right before the tinnitus appeared. Conventional angiography demonstrated a focal AVF originating from the left vertebral artery, with reflux to the left vertebral venous plexus. A 6-mm stent was placed over the site of the fistula via an endovascular approach, which solved both the radiological and clinical documented problems. Moreover, CNB greatly complicated pathology reading once total thyroidectomy was later performed. The suspected area of invasion was an artifact due to the previous biopsies.
CONCLUSION: Although many authors recommend a CNB as an alternative modality in cases of inconclusive cytology with fine-needle aspiration, it is not in the American Thyroid Association recommendations. In cases of iatrogenic AVFs caused by a CNB, angiography is recommended both as a diagnostic and therapeutic modality. Stenting the fistula with an endoprosthesis can correct the problem immediately.