Chapter 20 Biopsy General Principles

Question 1

List 3 types of ‘needle-core biopsy’ needles

Answer 1

1. Trucut (=sample notch type)
2. Jamshidi (=’aspiration needle core biospy’)
3. Franklin-Silverman (split needle design)
4. Menghini (=’aspiration needle core biospy’)
5. Klatskin (=’aspiration needle core biospy’)

Question 2

For needle-core biopsy needles, how much further does needle usually need to be advanced?

Answer 2

1.5cm

Question 3

What % of needle-core biopsies result in same result as surgically obtained biopsy?

Answer 3

56-94%

Question 4

List 3 considerations for an incisional biopsy?

Question 5

List 3 indications for excisional biopsy

Answer 5

1. Benign based on FNA
2. Small skin masses
3. Masses where incomplete margins do not preclude secondary excision w clean margins

Question 6

What is show in image A and B. And what sixe recommended for bipopsies in dogs and cats?

Answer 6

A = biopsy cut forceps (tend to tear tissue)

B = punch biopsy forceps (tend to cut tissue)

5 mm size recommended

Question 7

What is shown in the image and how does it work?

Answer 7

Illustration of the components of a self-ligating loop (SurgiTie): A, preformed loop;

B, knot;

C, nylon carrier;

D, scored black band;

E, proximal end;

F, optional delivery system for endoscopic surgery.

The loop is placed around the tissue to be removed, section E is snapped off from the main section C at the scored area D, and section E is pulled to cause the loop to tighten in a guillotine fashion around the tissue of interest.

Question 8

What is the % accuracy of needle core biopsy vs surgical excision histo for cutaneous and subcutaneous masses in dogs?

And for soft tissue sarcomas specifically?

Answer 8

96% overall

59% for STS (29% underestimated, 12% overestimated)

Question 9

Define ‘sentinel lymph node’

In dogs with MCTs, sentinel LN evaluation resulted in a change in tratment plan in what % of dogs?

Answer 9

Firts LN to which tumour drains.

42%

Question 10

What margin (distance) should be ensured between Tru-cut vs neurovascular/biliary structures for liver biopsy?

Answer 10

2cm

Question 11

What is the reported mortaloity rate for cats undergoing automated percutaneous needle-core biopsy? And what was cause of death?

Answer 11

20%

Vagotonia

Question 12

For liver biopsy what is the accurace of needle core vs wedge biospy

Answer 12

48%

Question 13

What is the agreement between splenicn FNA vs histo

Answer 13

60%

Question 14

For endoscopic biopsies, how many samples are recommended per site from each if these regions:

Stomach

SI

LI

Answer 14

Stomach: 6-8

SI: 10-15

LI: 3-4

N.B. From each site, i.e. 10-15 from duodenum, 10-15 from jejunum…

Question 15

What has been reported as a risk factor for leakagefollowing GI surgery in dogs?

Answer 15

Hypoalbuminaemia

(and ?intra-op hypotension)

Question 16

Where should renal needle core biopsy be obtained from?

Answer 16

Cortex only.

Higher risk of bleeding, infaction and fibrosis if medulla sample.

Question 17

What is the most common comploication of renal bipsy and what is the rate of this complication in dogs and in cats?

Answer 17

Haemorrhage

Dogs 10%

Cats 15%

(with normal coag profiles)

Other complications: AV fistula, cyst formation, infarction, thrombosis, infection, fibrosis

Question 18

What was the complication rate of CT guided needle core biopsies of thoracic masses?

Answer 18

43% inc pneumothorax and pulmonary haemorrhage (but none clinical or needing tx)

Question 19

What is the reported accuracy of Jamshidi bone biopsy?

Name a benefit vs Michele trephine

Answer 19

82%

Reduced risk of iatrogenic fracture with Jamshidi as smaller

Question 20

What are the preferred inking colours?

Answer 20

Black and green (+blue in one study)