Soft Tissue Biopsy Flashcards
What is a biopsy?
A sample of tissue for histopathological analysis
To establish/ confirm a diagnosis and determine prognosis
What is are 3 examples of aspiration biopsy?
Blood sample
From a lesion (abscess/ cyst)
FNA- aspirate cells from a solid lesion for cytology (eg salivary glands)
What is an excisional biopsy? When would this be used?
A biopsy in which all abnormal tissue is removed - must be a discrete lesion and must be confident of your provisional diagnosis
Eg for a mucocele or polyp
What is an incisional biopsy? When would this be used?
A biopsy technique which captures a representative sample (may need more than 1 in some cases)
Eg. LP, leukoplakia, SCC
What is a punch biopsy?
A type of incisional biopsy in which the instrument has a 4/ 6/ 8 mm diameter core which removes the tissue
This is so minimal it may not require sutures
How should your sample be prepared before sending to lab?
Immediately place in 10% formalin
Never use gauze- can distort the sample (instead use filter paper although still not ideal)
May place sutures to help orientate the sample
Be careful of crush/ tearing the sample
Ensure sample is thick enough to support itself (eg 5mm deep to support epithelium)
What information is recorded on the lab sheet?
Patient details
Referrer details
Date and time of biopsy
Label path pot with patient details
Nature of sample (site, size etc), clinical background
Provisional diagnosis
What are fordyces spots?
Sebaceous glands underneath mucosa
Benign
No need for biopsy
What is a fibrous epulis?
A swelling arising from the gingivae
Hyperplastic response to irritation
Presentation - smooth surface, pedunculated, round lesion
Treatment - excise and remove source of irritation
What is a fibrous overgrowth?
A polyp
Frictional trauma/ irritation resulting in a semi-pedunculate/ sessile lesion, pink and smooth
Most common on buccal mucosa
Excision
What is a giant cell epulis?
Peripheral giant cell granulosa
Multi nucleares giant cell in a vascular stroma
Common in teenagers in anterior jaw
Deep red/ purple
Treatment- radiograph to ensure no central involvement
If peripheral - surgical excision with curettage of base
What is a haemangioma?
A collection of small blood vessels (developmental overgrowth)
Blue in colour - will blanch when applying pressure
Surgical excision or cryotherapy
What is a lipoma?
A benign neoplasm of fat
Appears as yellow sessile swelling
What is a pregnancy epulis?
Histologically the same as a progenie granuloma
Can be plaque related- enhanced tissue response due to hormone changes
Regress after birth of baby
What is a pyogenic granuloma?
An overgrowth of granulation tissue eg from XLA socket
Deep red in colour
Treatment - surgical excision with curettage of base
