Soft Tissue Lesions and Biopsy Techniques Flashcards
What is a biopsy?
Removing part of a tissue for histopathological analysis.
Why might you want to take a biopsy?
Confirm or establish a diagnosis
Determine prognosis
What tissue sampling techniques are available?
Aspiration biopsy
Fine needle aspiration biopsy
Incisional biopsy- punch biopsy
Excisional biopsy
What type of biopsy samples might you want to do an aspiration biopsy?
Blood sample- venous blood, FBC, U&E’s, haematinics, glucose
From an abscess- to determine the bacteria present within the pus.
- protects the anaerobic species from the environment.
From cysts- determine whether it its old or fluid filled.
What situations might you want to do a fine needle aspiration biopsy?
Aspiration of cells from solid lesions
- Neck swellings, salivary gland lesions.
Not commonly done in the OS department.
What is an excisional biopsy?
Removal of all clinically abnormal tissue.
Usually do this when you are confident of the diagnosis.
For what conditions might you do an excisional biopsy?
Fibroepithelial polyp
Denture hyperplasia
Mucoceles
What is an incisional biopsy?
Representative tissue sample.
- i.e. punch biopsy.
What conditions would you do an incisional biopsy?
Lichen Planus
Leukoplakia
Squamous cell carcinoma
What would you do for a punch biopsy?
Anaesthetise the area
Use the hollow trephine- comes in either 4, 6 or 8mm diameter.
Remove the core of the tissue.
Place into the pot of 10% formalin.
Suture the biopsy site back together
Post-op instructions.
Which area are you going to biopsy?
Must be large enough sample
Must be representative of the whole sample
Might need to take more than 1 biopsy
Include perilesional tissue as well
After you have taken the biopsy, what do you do with the sample?
Place it immediately in 10% formalin- don’t place on gauze because this distorts the sample.
- Patient label on the front of the pot.
Can place a suture mesial to distal and this can show the pathologist the orientation of it.
Filter paper is the only acceptable means of placing on the sample but most of the time, it just goes straight into the pot.
Carry out pathology form on Trakcare.
Send specimen via courier to the QEUH pathology department.
What do you include on the pathology form?
Patient’s information- name, DOB, CHI number, sex.
Your details- referrer name, practice address and practice phone number.
Tick histopathology box.
Give details of when the biopsy was taken, where from, brief history of the lesion and a description of the lesion and your provisional diagnosis.
Medical history of the patient.
Which areas of the oral cavity should you be wary of taking a biopsy from?
Salivary gland orifices
Top of the tongue
Areas close to nerves and larger blood vessels
