Soft Tissue Lesions & Biopsy Flashcards
what is a biopsy and its use?
- sample of tissue for histopathological analysis
- confirm/establish a diagnosis
- determine prognosis
Needing a blood sample: where is it taken from and what can be assessed?
- venous blood
- FBC, Urea & Electrolytes, haematinics, glucose etc
difference between EXCISIONAL & INCISIONAL biopsy?
Excisional:
- ALL clinically abnormal tissue removed
- Commonly used for tumours, cysts, discrete lesions
- Usually fairly confident of provisional diagnosis
Incisional:
- Only portion of tissue removed
- Uncertain diagnosis
- Leukoplakia, Lichen Planus, SCC - to assess what it is
what is a punch biopsy?
- type of incisional biopsy
- Usually hollow inside
- Removes core of tissue
- minimal damage (reducing sutures/avoiding need of suturing)
what are the things to consider when selecting the area to biopsy?
- must be large enough
- must be representative
- maybe more than one biopsy
- dont just biopsy ulcers (normal tissue surrounding it)
- Refer?
[Suspicious lesions]
[Lumps within upper lip (lip cancer?)]
when sending a biopsy sample to the lab, how should the sample be handled?
- PLACE IMMEDIATELY INTO 10% FORMALIN (dont place on gauze swab)
- putting a suture in as a reference point may help pathologist orientate the sample
why should you not use gauze for a biopsy sample?
- distorts & damages the sample
What are all the examples of soft tissue lesions?
- Carcinoma
- Denture hyperplasia
- Fibrous epulis (epulis = growth on gingiva)
- Fibrous overgrowth
- Giant cell epulis
- Pregnancy epulis
- Haemangioma/lymphangioma (abnormal growth - benign)
- Lipoma (Benign growth - fat cells)
- Pyogenic granuloma
- Squamous cell papilloma
- Salivary gland lesions
What are some ORAL MEDICINE type soft tissue lesions?
- lichen planus/Lichenoid reactions
- pemphigus
- pemphigoid
- behcet’s
- leukoplakia
- erythroplakia
what are fordyce spots?
whiteish/yellow spots occurring inside lips & cheeks
sebum glands
what is a fibrous epulis?
- swelling from gingivae
- hyperplastic response to irritation (epulis = growth gingivae)
- excisional biopsy
- Remove source of irritation
what are fibrous overgrowths?
- fibroepithelial polyp (skin tag)
- frictional irritation/trauma
- pink
- smooth surface
- most common B mucosa + inner surface of lip
- surgical excision
- no need for deep excision
Giant cell epulis?
- peripheral giant cell granuloma
- multinucleated giant cells in vascular stroma
- teenages, anterior regions of mouth
- need xray to ensure not centrally originating
- surgical excision with curettage of base
haemangioma?
- Hamartoma (benign growth of cells not belonging to that region)
- developmental overgrowths
- exophytic (grows outwards)
- blue
- pressure causes loss of colour
- surgical removal or cryotherapy (extreme cold)
what is a lipoma?
- benign growth of fat
- soft swelling
- pale yellow
- excision
Pregnancy epulis?
Squamous cell papilloma?
- most common palate, B mucosa or lips
- benign neoplasm
- white surface
- cauliflower appearance
- excision at base
Mucocele?
- most common minor salivary gland problem
- damage to minor gland duct -> saliva leaks into submucosal layer
- soft bluish swelling fluid filled
- recurrent
= Ranula - if floor of mouth
Squamous cell carcinoma?
- may present as lump, red or white patch, non-healing ulcer
- Classical description: Ulcer, rolled margins, hard
- lesion may bleed easy
- histological diagnosis (incisional biopsy to check)
- RAPID REFERRAL PATHWAY FOR CANCER
