Soft tissue lesions and biopsy Flashcards
What are the main types of biopsy?
Aspirational - fluid sample from blood, or lesion. The process can also determine whether the lesion is solid or fluid filled.
Surgical biospsy - Can be incisional or punch biopsy, and typically involves removal of all clinically abnormal tissue.
What is punch biopsy?
Utilizes a hollow trephine and removes the core of the tissue with minimal damage, however care should be taken to select an appropriate representation of the lesion.
How should you select an area of tissue to biopsy?
Must be large enough
Must be representative of lesion
May require more than one site
Include normal perilesional tissue
Refer suspicious lesions and lumps within the upper lip
How should a sample be packaged to be sent to the pathology lab?
Sample placed immediately into 10% formalin, and packaged in a secure marked container.
How can you ensure care for the specimen once it has been taken?
Be careful with sutures
Don’t use gauze
Use filter paper
Which areas should be avoided when collecting a biopsy?
Salivary gland orifices, the tip of the tongue, areas close to nerves and larger blood vessels.
What is a lipoma?
- Benign neoplasm of fat
- Soft swelling
- Pale yellow
- Sessile
What is an epulis?
Epulis is any tumor like enlargement (i.e. lump) situated on the gingival or alveolar mucosa.
What is a pregnancy epulis?
Histologically same as pyogenic granuloma
May be related to calculus often bleed easily
Hormonal changes enhance response to tissue irritation
Small lesions may not require excision and may regress after birth of baby
Larger lesions should be excised
What is a fibrous epulis?
Swelling arising from the gingivae
Hyperplastic response to irritation
Overhanging restoration
Subgingival calculus
Smooth surface, rounded swelling
Pink and pedunculated
What is fibrous overgrowth?
Fibroepithelial polyp
Frictional irritation or
trauma
Semi pedunculated or sessile
Pink
Smooth surface
Most common buccal mucosa and inner surface of lip
What is giant cell epulis?
Peripheral giant cell granuloma
Multi nucleated giant cells in vascular stroma
Teenagers, anterior regions of mouth
Deep red or purple, broad base
Need x-ray to ensure not centrally originating (would
appear as radiolucency)
What is haemangioma?
Hamartomata
Developmental overgrowths of blood vessels
Exophytic (arising from outer surface of an organ)
Blue in colour
Pressure will cause loss of colour
Surgical removal or more commonly cryotherapy
Only drawback of cryotherapy is no histological diagnosis
What is pregnancy epulis?
Histologically same as pyogenic granuloma
May be related to calculus often bleed easily
Hormonal changes enhance response to tissue irritation
Small lesions may not require excision and may regress after birth of baby
Larger lesions should be
excised
What is a pyogenic granuloma?
Arises from failure of normal healing
Overgrowth of granulation tissue
May be related to extraction sockets or traumatic soft tissue injuries
Red in colour
Require surgical excision and curettage of base
