Contraindications and Complications of Thyroid FNA
The main contraindication to thyroid FNA is bleeding diathesis, as the formation of a large hematoma at the biopsy site may cause compression of the trachea and respiratory distress. Therefore, a bleeding time, PT and PTT should be ordered to screen this condition in all patients prior to thyroid FNA. This diagnostic procedure, if properly performed, is almost free of complications. Subcutaneous hematoma at the biopsy site, accidental puncture of the trachea and local infection are rare complications. Hematoma may be prevented by local pressure of the overlying skin at the biopsy site. Tracheal injury is manifested by minimal and transient hemoptysis. Seeding of thyroid cancer cells along the needle tract is also an exceedingly rare complication with FNA.