Soft tissue lesions and biopsy

Question 1

Excisional biopsy

Answer 1

• Removal of all clinically abnormal tissue
  
  • Usually fairly confident of provisional diagnosis
  • Usually benign lesions e.g. polyps, fibrous overgrowths, denture hyperplasia, mucoceles
  • Discrete lesions (possible to remove all of)

Question 2

Incisional biopsy

Answer 2

• Representative tissue sample
  
  • Larger lesions
  • Uncertain diagnosis
  • e.g. leukoplakia, lichen planus, squamous cell carcinoma (need to leave some evidence of where lesion started so surgeons have something to go on)

Question 3

What should sample be placed in once taken?

Answer 3

10% formalin

Question 4

Areas to try avoid when taking biopsies

Answer 4

salivary gland duct orifices, tip of tongue, areas close to nerves and larger blood vessels

Question 5

What could cause a fibrous epulis?

Answer 5

Overhanging restoration, tissue calculus

Question 6

Mucocele

Answer 6

• Mucus extravasation cyst
  
  • Most common minor salivary gland problem
  • Damage to minor gland duct
  • Saliva leaks into submucosal layer (instead of coming out orifice)
  • Soft bluish swelling fluid filled
  • Recurrent
  • Tend to get bitten, disappear then come back
  • Floor of mouth - ranula

Question 7

What should pt be warned about before mucocele excision?

Answer 7

Recurrence and possible damage to other salivary glands