Soft Tissue Lesions & Biopsy Techniques Flashcards
What is a biopsy?
- sample of tissue for histopathological analysis
- confirm or establish a diagnosis
- determine prognosis
What types of biopsies are there?
- aspiration biopsy
- excisional biopsy
- incisional biopsy
- punch biopsy
What types of surgical biopsies are there?
- excisional
- incisional
- punch
what are the positives of doing aspirational biopsies?
- avoids contamination by oral commensals
- protection of anaerobic species
- helps to determine if a lesion is solid or fluid filled
When are fine needle aspiration biopsies used?
- aspiration of cells from solid lesions
- neck swellings, salivary gland lesions
- cytology
What is an excisional biopsy?
- removal of all clinically abnormal tissue
- usually benign lesions
What is an incisional biopsy?
- removal of part of a lesion (larger lesions)
- uncertain diagnosis
give an example of a type of incisional biopsy:
punch biopsy
What are punch biopsies?
- type of incisional biopsy
- 4, 6, or 8mm diamete
- removes core of tissue
- minimal damage
What determines the area you choose to biopsy?
- must be large enough
- must be representative
- maybe more than one biopsy
how should samples be sent to lab?
- sample placed immediately into 10% formalin
- include relevant clinical info on form
What is fibrous epulis?
- swelling arising from the gingivae
- hyperplastic response to irritation
how does fibrous epulis present?
- smooth surface
- rounded swelling
- pink & pedunculated
what type of biopsy should be used to test for fibrous epulis?
excisional biopsy with coe pack dressing
what is giant cell epulis?
- peripheral giant cell granuloma
- multi nucleated giant cells in vascular stroma
how does giant cell epulis present?
- deep red or purple
- broad base
how is giant cell epulis treated?
surgical excision with curettage of base
what is a haemangioma?
- hamartoma
- developmental overgrowth
how does a haemangioma present?
- blue in colour
- pressure will cause loss of colour
what is lipoma?
benign neoplasm of fat
- soft swelling
- pale yellow
- sessile
what is pregnancy epulis?
- hormonal changes enhance response to tissue irritation
- histologically same as pyogenic granuloma
what is pyogenic granuloma?
- overgrowth of granulation tissue
- arises from failure of normal healing
- red in colour and must be surgically excised
what is a squamous cell papilloma?
- benign neoplasm
- usually pedunculated
- white surface
- cauliflower appearance
where are common sites for squamous cell papillomas?
- palate
- buccal mucosa
- lips
what is denture induced hyperplasia?
- hyperplastic reaction of tissue due to poorly fitting denture
what is a leaf fibroma?
- chronic irritation from denture
- would be round if not covered by denture
- becomes flattened
- excision
what is a mucocele?
A mucous extravasation cyst
- soft bluish swelling fluid filled
- damage to minor gland duct
How are mucoceles treated?
- surgical excision
- blunt dissection
- patients should be warned about recurrence
what is the classic description of a squamous cell carcinoma?
- ulcer
- rolled margin
- induration
how should potential squamous cell carcinomas be biopsied?
incisional biopsy
- should be referred urgently
