Principles of tissue biopsy in OMFS

Question 1

______ is an examination of tissue removed from a living person to discover the
presence, cause, or extent of a disease.

Answer 1

Biopsy

Question 2

• lesion is totally red or has
  speckled red appearance

Answer 2

Erythroplakia

Question 3

• lesion is ulcerated or presents as an ulcer and the lesion has persisted more than 2 weeks.

Answer 3

Ulceration

Question 4

• lesion exhibits rapid growth

Answer 4

Growth rate

Question 5

• lesion bleeds on gentle manipulation

Answer 5

Bleeding

Question 6

• lesion and surrounding tissue is hard to the touch

Answer 6

Induration

Question 7

• lesion feels attached to adjacent structures

Answer 7

Fixation

Question 8

Any suspicious lesion persists for more than _______ with no apparent etiology basis needs biopsy

Answer 8

2 weeks

Question 9

If there is a lesion associated with a PARL with a pt w Hyperparathryroidism, what should you be suspicious of?

Answer 9

Browns tumor

Question 10

A radiolucency with defined
borders is often a ______

Answer 10

cyst.

Question 11

Total excision of a lesion for microscopic study is called “Excisional
biopsy”.

• Slow growing lesions that appear benign on clinical examination.
• Removal of the entire lesion
• A perimeter of normal tissue surround the lesion is also excised to ensure total removal
• Constitute definitive treatment

Answer 11

Excisional biopsy

Question 12

HOw much beyond the lesion should an excisional biopsy go?

Answer 12

2-3 cm

Question 13

Some lesions are too large to excise initially without having established diagnosis or are
of such a nature that excision would be inadvisable.

In  such  instances  a  small  section  is  removed  for  examination  called  incisional  or  diagnostic biopsy. 
 
Use: For large lesions or when there is a suspicion of malignancy.

Answer 13

Incisional biopsy

Question 14

Principles of ______
* Representative areas of lesion should be incised in wedge fashion.

• Selected in an area that shows complete tissue changes (the lesion extends into normal tissue at
  the base and/or margin of the lesion).
• Necrotic tissue should be avoided
• Taken from the edge of the lesion to include some normal tissue
• A deep, narrow biopsy rather than a broad, shallow one

Answer 14

Incisional biopsy

Question 15

What is the best type of biopsy type to get for an incisional biopsy, broad and shallow or narrow and deep?

Answer 15

Narrow and deep

Question 16

• ________ is the use of a needle and syringe to penetrate a lesion for aspiration of its content.
• A 18-gauge needle is connected to a 5 or 10 ml syringe
• The tip of needle may have to be repeatedly repositioned to locate a fluid center

Answer 16

Aspiration

Question 17

_____ should be carried out on all lesions thought to contain fluid or any intra-
osseous lesion before surgical exploration

• A fluctuant mass in the soft tissues should also be aspirated to determine its contents
• Any radiolucency in the bone of the jaw should be aspirated to rule out a vascular
  lesion that can cause life threatening hemorrhage.

Answer 17

Aspiration

Question 18

Any intraosseous lesion like tumors, cyst, infections(osteomyelitis) diseases like
fibro-osseous lesions require a _______ procedure.

• Bone and other hard tissues that contain calcium takes extra time for processing in the
  histopathological lab.

Answer 18

bone biopsy

Question 19

A surgical instrument is used to punch out a representative portion of tissue.

Answer 19

Punch biopsy

Question 20

Use: to biopsy deep-seated lesions

Answer 20

Fine needle aspiration biopsy

Question 21

• Advantages:
• Does not require incision on skin.
• Biopsy results available the same day
• Disadvantages:
• Needle cannot remove enough tissue for diagnosis

Answer 21

Fine needle aspiration biopsy

Question 22

When taking biopsy, should block or local anesthesia be used?

Answer 22

Block

Question 23

How far away from lesion should anesthesia be administered?

Answer 23

At least 1 cm away

Question 24

What is the solution of choice for tissue preservation?

Answer 24

10% formalin

Question 25

In lichenoid/vesiculobullous situations, should erosive samples or non erosive samples be taken?

Answer 25

NOn erosive samples

Question 26

How long should results take for soft tissue lesions?

Answer 26

1 week

Question 27

How long should results take for hard tissue lesions?

Answer 27

2-3 weeks