Biopsy Principles - 1

Question 1

What is a papule?

Answer 1

Circumscribed, solid elevation of skin with no visible fluid smaller than 1 cm

Question 2

What is a macule?

Answer 2

Circumscribed change in the color of skin that is neither raised nor depressed, and less than 1 cm

Ex: Oral melanotic macule

Question 3

What is a patch?

Answer 3

Circumscribed change in the color of skin that is neither raised nor depressed, and greater than 1 cm

Question 4

What is a nodule?

Answer 4

Raised, solid lesion more than 1 cm that may be int he epidermis, dermis of subcutaneous tissue

Question 5

What is a plaque?

Answer 5

A solid, raised, flat topped lesion greated than 1 cm

like a plateau

Question 6

What is a vesicle?

Answer 6

Raised lesions that are less than 1 cm and filled with fluid.

Question 7

What is a bullae?

Answer 7

Fluid filled lesions that are greater than 1 cm

Question 8

What does sessile mean?

Answer 8

Attached directly by its base without a stalk or peduncle

Question 9

What does pedunculated mean?

Answer 9

Attached with a stalk or peduncle

Question 10

What are the different options for biopsy of a lesion?

Answer 10

Watch it, cytology, brush biopsy, fine needle aspiration, scalpel biopsy, laser biopsy

Question 11

What are the indications for a brush biopsy?

Answer 11

Epithelial lesions that are not suspicious enough to warrant biopsy

Question 12

What are the contraindications for brush biopsy?

Answer 12

Lesions with intact normal epithelium, highly suspicious lesions, and lesions with obvious etiology

Question 13

What are the indications for scalpel biopsy?

Answer 13

Whenever a clinical examination fails to lead to a diagnosis “when in doubt, cut it out”, whenever a recognized premalignant lesion is encountered, whenever clinical signs and symptoms suggest a malignancy, whenever there is a lesion that fails to respond to recognized therapy

Question 14

What are the principles of biopsy?

Answer 14

Do not delay
Obtain representative specimen of the tissue
Avoid distortion or destruction
Handle specimen properly and fix at once
Submit good case history
Submit radiographs and photos

Question 15

What should be used to fix tissues?

Answer 15

10% formalin solution

Question 16

If a laser biopsy is done, how much extra tissue do you need around the sample ?

Answer 16

You need 2 mm extra around the samples

Question 17

What should be done if biopsy results don’t corroborate with your clinical impression?

Answer 17

Make sure the tissue was looked at by an oral pathologist, ask for a second opinion, talk to your oral pathologist and if necessary, repeat the biopsy

Question 18

When should a doctor refer a patient?

Answer 18

When the health of the patient requires special management that the dentist fells unprepared to handle
When the size and surgical difficulty is beyond the level of skill that the dentist fells they possess
If the dentist is concerned about malignancy

Question 19

What is a differential diagnosis?

Answer 19

A list of all the possibilities of diagnosis rearranged in rank order from the most to least common