A biopsy is a procedure in which cells or tissues are collected from the body for further analysis. The sample will be examined by a pathologist to determine whether it contains cancerous cells.
Ultrasound of the neck is a safe, painless procedure that produces pictures of the neck using sound waves. This procedure involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin of the neck. Pictures of the structures on the neck are displayed on the monitor and recorded.
Indications for this procedure are:
- To determine if a lump in the neck is arising from the thyroid or the adjacent structures
- Evaluation of the thyroid nodule, which helps determine whether a fine needle aspiration biopsy is needed to rule out cancer in the thyroid nodule. Benign (non-cancerous) thyroid nodules can be monitored using regular intervals (6-12 months) for growth or change in appearance that will determine if a thyroid nodule needs to be biopsied.
- Evaluation of the lymph nodes in the neck, especially before thyroid surgery, is critical to determine if there are any abnormal lymph nodes that are suspicious for cancer and require biopsy.
- Evaluation of enlargements in the parathyroid gland/glands, seen in conditions of increased calcium in the blood called hyperparathyroidism and in parathyroid cancer
Benign (non-cancerous) thyroid nodules can be monitored using a fine needle aspiration (FNA) of the thyroid nodule.
This procedure is done only if your endocrinologist, Dr. Thomas, evaluates your thyroid gland by an ultrasound of the soft tissues of your neck and decides that it is important to get a small sample of the thyroid nodule tissue to send it to pathology to find out if there are any cancer cells in it.
FNA of the thyroid nodule is done using ultrasound guidance in the office by Dr. Thomas. A small sample of tissue is removed from the thyroid nodule using a small, thin, fine-gauge needle that is smaller in diameter than the needle used in most blood draws. Medications (1% lidocaine and ethyl chloride spray) are used to numb the area prior to the biopsy.
Following the FNA, the sample is sent to the pathology lab for analysis. Once the results are available, Dr. Thomas will communicate the results to you personally and discuss further management.
Depending on the results, she will coordinate further management with the endocrine surgeon (if you need surgery) or nuclear medicine specialist (if you need radioiodine therapy following the surgery).
Continuous glucose monitoring (CGM) is a system that gives you the ability to measure your glucose level in real time throughout the day and night. It measures glucose levels in the tissue fluid.
CGM systems use a tiny sensor that is inserted under the skin to check the glucose levels in the tissue fluid. This sensor stays in place for 3-day or 7-day monitoring and then is taken out or replaced. The sensor is connected to a transmitter that sends information about your glucose levels via wireless frequency every 5 minutes to a monitoring and display device. You will need to check blood glucose levels with a glucose meter to calibrate the device at least twice a day during the period of monitoring.
CGM provides vital information such as trends of rising or falling of the tissue glucose, low glucose or high glucose levels, and information on the impact of food, physical activity, medication, and illness on your diabetes. This valuable information helps you and your diabetes care team in the optimal management of your diabetes.
Please remember that this procedure does not replace home blood glucose monitoring.
Dr. Thomas will perform this procedure in her office and will discuss this information with you and recommend treatment options that will improve your overall glycemic control and quality of life.
If you have diabetes mellitus and are interested in starting insulin pump therapy, you can discuss this with Dr. Thomas. The office offers intensive insulin pump training with certified diabetes educators who have extensive insulin pump training experience and will guide your insulin pump initiation and management.
