12. Soft Tissue Lesions & Biopsy Flashcards
Name examples of types of biopsy.
Blood test (aspiration biopsy).
Aspiration from lesion (abscess).
Fine needle aspiration biopsy (solid lesions).
Surgical biopsy - incisional or excisional.
What type of blood tests might you ask for ?
FBC, U&E, haematinics, glucose.
What is the benefit of aspiration of lesions such as abscesses ?
Avoids contamination by oral commensals.
Will also determine if lesions is solid or fluid filled.
When would fine needle aspiration biopsy be used ?
Aspiration of cells from solid lesions i.e. neck swellings, salivary gland lesions. Will be sent to cytology rather than histopathology.
Define excisional biopsy.
Removal of all clinically abnormal tissue.
When should an excisional biopsy be used ?
When fairly confident of provisional diagnosis.
Benign lesions or discrete lesions - fibrous overgrowths, denture hyperplasia, mucoceles.
Define discrete lesion.
Localised to one area of the mouth and can be entirely removed.
What is a incisional biopsy ?
Representative tissue sample.
When is an incisional biopsy taken ?
Larger lesions with uncertain diagnosis i.e. leukoplakia, lichen planus, squamous cell carcinoma.
What 3 sizes of punch biopsy can be used ?
4, 6, 8mm diameter.
What should be in the criteria for a adequate biopsy ?
Must be large enough.
Must be representative.
Maybe requires more than one biopsy.
Include perilesional tissue.
What is the transport medium for biopsy ?
10% formalin.
What can be used to help lab orientate sample ?
Suture.
Define a fibrous epulis.
Swelling arising from gingivae - hyperplastic response to irritation i.e. overhanging restoration or subgingival calculus.
Describe the appearance of a fibrous epulis.
Pedunculate - attached at one point.
Smooth surface, rounded swelling.
Pink.
How should a fibrous epulis be treated ?
Can be left untreated or excisional biopsy, coe pack dressing and removal of source of irritation.
Define a fibrous overgrowth (or fibroepithelial polyp).
Swelling caused by frictional irritation or trauma.
Describe the appearance of a fibroepithelial polyp (fibrous overgrowth).
Semi-pedunculate or sessile.
Smooth surface.
Buccal mucosa or inner surface of lower lip.
Define giant cell epulis.
Peripheral giant cell granuloma (multi-nucleated giant cells in vascular storm).
Who is most commonly affected by giant cell epulis ?
Teenagers.
Where do giant cell epuli most commonly form ?
Anterior regions of the mouth.
What treatment should be given for giant cell epulis ?
X-ray to ensure not centrally originating.
Surgical excision with curettage of base.
Coe pack dressing.
What is a Coe pack dressing ?
Eugenol-free, surgical dressing and periodontal pack that has no burning sensation, no unpleasant taste or odor, and offers proven protection to surgical sites.
