Thyroid gland
Competency Assessment
2. Thyroid fine needle aspiration (FNA)

Author: Ricardo R. Lastra, M.D., Michelle R. Pramick, M.D., Zubair W. Baloch, M.D. (see Authors page)

Revised: 20 January 2017, last major update November 2013

Copyright: (c) 2013-2017,, Inc.

Table of Contents
Aspiration Apparatus | Technique
Cite this page: Fine needle aspiration (FNA). website. Accessed June 21st, 2018.
Aspiration Apparatus
Medical knowledge
  1. Understand that 25 - 27 gauge needles are preferred for initial biopsies
  2. Recognize the various types of syringe holders used for suction

Practice based learning
  1. Understand that additional devices for suction are usually not necessary when using smaller diameter needles
Medical knowledge
  1. Understand that ultrasound guidance is preferred for nonpalpable nodules
  2. Understand that when visualized with ultrasound, different areas of large masses should be sampled, while avoiding cystic areas
  3. Understand the general principles of how cellular material is obtained and retained in the needle core
  4. Understand aspiration technique
  5. Understand that 2 - 5 passes per nodule is considered reasonable to ensure an adequate sample
  6. Understand proper smearing technique

Practice based learning
  1. Understand the clinical indications for a fine needle aspiration biopsy of a thyroid lesion
  2. Understand the possible complications of a fine needle aspiration biopsy
  3. Understand that the principal reason for a false negative result is inadequate sampling
  4. Understand that to maximize cellular yield and reduce bloody artifact, a dwell time of 2 - 5 seconds within a nodule and 3 forward and back oscillations per second is ideal
  5. Understand the possible histologic alterations associated with a fine needle aspiration biopsy