[Sonographically controlled fine punch biopsy of the thyroid gland]

Under local anaesthesia and under ultrasound guidance punch biopsy with a cutting biopsy needle was performed in 50 patients, providing 65 biopsy specimens. In 57 instances the indications for biopsy were nodular goitre, in 8 diffuse parenchymal involvement. Focal alterations were reliably hit if they were larger than 1 cm in diameter. The punch biopsy was performed without clinical complications. In 60 of 65 instances (92%) a sufficiently large tissue specimen was obtained for adequate histological assessment. In 13 patients with clinical indications for operation, surgical intervention was avoided because the biopsy proved the tissue to be benign. In 7 patients the accuracy of the punch biopsy was demonstrated, agreeing with the findings of biopsy obtained at operation or post-mortem. A close positive correlation existed between echogenicity of thyroid lesions and their histologically demonstrated colloid content. Although punch biopsy under ultrasound guidance is technically more complex than fine-needle aspiration cytology, it has the advantage that structural histological changes can also be assessed. This increases the diagnostic accuracy of the morphological diagnosis.