principles of biopsy Flashcards
Biopsy Definition
Biopsy is an examination of tissue removed from a living person to discover the presence, cause, or extent of a disease.
biopsy of vascular lesions
NEVER, use diascopy or aspiration to determine this
Indications for Biopsy:
* Any persistent?
* Persistent?
* Lesion that interfere with?
* Bone lesions identified by?
* Any lesion that has the characteristics
* of?
- Any persistent swelling, either
visible or palpable beneath
relatively normal tissue - Persistent hyperkeratosis changes in tissue
- Lesion that interfere with local function (ex: fibroma)
- Bone lesions identified by radiographic finding.
- Any lesion that has the characteristics
of malignancy.
Characteristics of lesions that raise the suspicion of malignancy
- Erythroplakia - lesion is totally red or has speckled red appearance
- Ulceration - lesion is ulcerated or presents as an ulcer and the lesion has persisted more than 2 weeks.
Characteristics of lesions that raise the suspicion of malignancy
* Growth rate?
* Bleeding ?
* Induration?
* Fixation?
- Growth rate - lesion exhibits rapid growth
- Bleeding - lesion bleeds on gentle manipulation
- Induration - lesion and surrounding tissue is hard to the touch
- Fixation - lesion feels attached to adjacent structures
Indications for Biopsy
* Any suspicious lesion persists for more than?
- Any suspicious lesion persists for more than 2 weeks with no apparent etiology basis
systemic approach and planing with biopsies
- It is important to develop a systematic approach in evaluating a patient with a
lesion/pathology in the Oral and Maxillofacial region before performing a biopsy procedure. - Careful planning prior to performing a biopsy is essential.
pt health hx and biopsies
Determine the health status of the patient to rule out any systemic disease that can cause a pathological condition in the head and neck region.
Browns Tumor of Hyperparathyoidism
Hairy Leukoplakia –HIV Patient
History of the Lesion - Questions to Ask
- Duration.
- Changes in size and rate of change.
- Changes in the character of the lesion.– Lump to ulcer, etc
- Changes in color
- Pain- infection
- Anesthesia- tumor encroachment on nerves
- Swelling or tenderness of adjacent lymph nodes
- Associated systemic symptoms:
– Fever
– Dysphagia
common etiologies of lesions
- Trauma to the area (with an ill fitting denture, traumatic cheek bite etc.,)
- Habits (Tobacco use, Smoking, Alcohol)
The clinical examination should include when possible:
– Inspection
– Palpation
Clinical Examination desciptors
* The anatomic location?
* The size and shape?
* Single vs. multiple?
* The surface?
* The color?
* The sharpness of?
* The consistency of the lesion to?
* Presence of?
* Lymph nodes?
Always document these and take pictures
* The anatomic location of the lesion/mass
* The size and shape of the lesion/mass
* Single vs. multiple lesions
* The surface of the lesion
* The color of the lesion
* The sharpness of the boundaries of the lesion
* The consistency of the lesion to palpation- vascular
* Presence of pulsation
* Lymph node examination
Radiographic Examination
- The radiographic appearance may provide clues that will help determine the nature of the lesion.
lesions with well defiend radiogrpahic borders
radiolucent
A radiolucency with defined
borders is often a cyst
ragged or indistinct radiolucencies
A ragged (indistinct) radiolucency will often be a more aggressive lesion.
advanced imaging options
- CBCT Scan
- Conventional C.T. Scan (Medical Grade)
- M.R.I
- Ultrasound
deep seated lesion biopsies
often done in hosptial with pathologists using CT or MRI