Principles of tissue biopsy in OMFS Flashcards
______ is an examination of tissue removed from a living person to discover the
presence, cause, or extent of a disease.
Biopsy
- lesion is totally red or has
speckled red appearance
Erythroplakia
- lesion is ulcerated or presents as an ulcer and the lesion has persisted more than 2 weeks.
Ulceration
- lesion exhibits rapid growth
Growth rate
- lesion bleeds on gentle manipulation
Bleeding
- lesion and surrounding tissue is hard to the touch
Induration
- lesion feels attached to adjacent structures
Fixation
Any suspicious lesion persists for more than _______ with no apparent etiology basis needs biopsy
2 weeks
If there is a lesion associated with a PARL with a pt w Hyperparathryroidism, what should you be suspicious of?
Browns tumor
A radiolucency with defined
borders is often a ______
cyst.
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
Excisional biopsy
HOw much beyond the lesion should an excisional biopsy go?
2-3 cm
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.
Incisional biopsy
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
Incisional biopsy
What is the best type of biopsy type to get for an incisional biopsy, broad and shallow or narrow and deep?
Narrow and deep
- ________ 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
Aspiration
_____ 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.
Aspiration
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.
bone biopsy
A surgical instrument is used to punch out a representative portion of tissue.
Punch biopsy
Use: to biopsy deep-seated lesions
Fine needle aspiration biopsy
- Advantages:
- Does not require incision on skin.
- Biopsy results available the same day
- Disadvantages:
- Needle cannot remove enough tissue for diagnosis
Fine needle aspiration biopsy
When taking biopsy, should block or local anesthesia be used?
Block
How far away from lesion should anesthesia be administered?
At least 1 cm away
What is the solution of choice for tissue preservation?
10% formalin
In lichenoid/vesiculobullous situations, should erosive samples or non erosive samples be taken?
NOn erosive samples
How long should results take for soft tissue lesions?
1 week
How long should results take for hard tissue lesions?
2-3 weeks
