Biopsy: Purpose, Types, And Risks

Biopsy: Purpose, Types, And Risks

Write a short note on the biopsy.

Answer. A biopsy is the removal of tissue from a living organism for microscopic examination and diagnosis.

Types Of Biopsy

• Excisional biopsy: If a lesion is excised for histological evaluation it is called an excisional biopsy.
• Incisional biopsy: When only a small section of tissue is removed from the lesion for histological evaluation it is called an incisional biopsy.
• Fine needle aspiration cytology (FNAC): It is done by aspirating tissue material inside a lesion which is later on diagnosed microscopically after preparing a smear.
• Frozen section biopsy: It is performed to get an immediate histological report of a lesion.
  The tissue is obtained from the lesion and is kept in deep freeze and then frozen tissue is sectioned and stained to get a prompt diagnosis.

Procedure Of Biopsy

• Anesthesia: Give a block to anesthetize the region where the specimen is to be obtained.
  Local infiltration and injections into the tissue which should be biopsied should be avoided as it leads to the artifacts in the specimen.
  If a block is not effective give local infiltration at least l cm away from the lesion.
• Stabilization of tissue: Soft tissue biopsies are done over the movable tissues of the oral cavity, i.e. tongue, lips, etc.
  The dental assistant stabilizes the tissue by stretching it.
• Hemostasis: Gauze pieces are the best means for compressing the tissue and achieving hemostasis.
  A gauze piece can also be placed to cover the mouth of the suction tip and is used to prevent the specimen from being sucked inside.
• Incisions: Use a sharp scalpel. Provide two incisions which form an elliptical incision and converge to form a V at the base, this provides a good specimen and a wound that is easy to close.
  Alternatively, a triangular-shaped incision can be made which converges in the form of a tip of a pyramid at the base.
  Incisions should be given parallel to the nerves and vessels in that region to avoid damage.
• Handling of tissues: Tissue that has to be removed should be handled carefully so that histopathological examination can be performed.
  A non-toothed tissue-holding forceps is used and care is taken not to crush the tissues.
• Care of specimen: After removal of the tissues, the specimen is transferred to a bottle containing 10% formalin which should be at least 20 times the volume of the specimen obtained.
• Surgical closure of wound: Primary closure is possible in most cases. Where it is not possible, the tissues are undermined to facilitate closure.