Bleeding Thyroid Nodules

I noticed in an earlier post you mentioned a common cause for rapidly growing thryroid nodules is bleeding within the nodules.  I just experienced this on Friday 2/8.  I saw the doctor today (2/12) and he attempted to do an impromtu needle biopsy.  The fluid was thick and black, but was too thick to obtain a substantial sample using two needles of different sizes (21 and 23 - not sure of the measurment unit).  The doctor reasoned that it was dried blood, which may take some time to soften in order to drain it.  Also, we determined that the nodule grew from 1.6cm to 1.93cm in less than two months.  The doctor maintains that there is nothing to be worried about since the nodule is full of fluid and not a solid mass.

What are the general causes of bleeding within a thyroid nodule?  Can anything be done to lessen this occurrance?  What will typically happen with a nodule that bleeds (i.e. will the body absorb the blood, will it drain itself, etc.).  Are there any complications that can develop from bleeding nodules?

I still need to get the results from the biopsy (hoping that they got enough cells to analyze).  If they cannot get an adequate sample because of thickness of the fluid, what is the next step?

[Mark Lupo, M.D.]

This happens when the small blood vessels in the nodule tear and bleed - it is common and not known to be preventable (of course, blood thinners may increase this risk).  The body will absorb the blood, no specific treatment is needed.  There are usually no complications.  

If the sample was not adequate for analysis, would re-check in 2-3 months and consider repeat biopsy.  21 and 23 gauge needles are large for thyroid biopsies....a smaller needle (27g is what I usually use) is less traumatic and should yield a good result.  Sometimes the larger needles are needed to drain cyst fluid, but in a nodule this small, there is not significant benefit of draining fluid.

[Dovel]

A related discussion, Bleeding Thyroid cyst was started.