Types Of Biopsy
Describe briefly the different types of biopsy.
Answer. Following are the different types of biopsies:
- Incision biopsy—wedge biopsy
- Excision biopsy
- Trucut biopsy
- Pap smear
- FNAC
- Frozen section biopsy
- Punch biopsy
- Ultrasound-guided biopsy
- Brush biopsy
- Laparoscopic biopsy
- CT-guided biopsy
- Thoracoscopic biopsy
- Endoscopic biopsy (gastroscopic or colonoscopic or through ERCP or cystoscopy)
- Bronchoscopic biopsy
- Open biopsy either laparotomy thoracotomy or craniotomy using
- Dancly’s brain cannula
Incision Biopsy
- This is the excision of a portion of the lesion for microscopic examination.
- This method is employed on large, diffuse lesions which has a size of 2 cm in its greatest dimension.
- This method can also be done on lesions suspected of malignancy.
- This method aims to remove a portion of the lesional tissue in question along with the sample of normal adjacent tissue for comparison.
Types Of Incision Biopsy
- Punch biopsy: This is done by using a surgical punch of diameter 4, 8, or 10 mm. This incisional biopsy is done in mass screening programs.
- Wedge biopsy: This is done by making a wedge-shaped incision that begins 2 to 3 mm from normal tissue and penetrates the region surrounding abnormal tissue.
Tissue should always be incised narrow and deep.
Excision Biopsy
- This procedure should be done for the small lesions which are clinically benign.
- In this, the complete lesion should be removed for examination and diagnosis. So it is both diagnostic and curative.
Trucut Biopsy
It is done using a specialized device wherein a gun with a true cut tip is inserted into the surface tissue/organ and the gun is fired to close the punching needle to catch and cut the adequate tissue.
It is done in prostate, breast, and surface tumors.
FNAC
- This is the cytological study of tumor cells to find out the disease and also confirm whether it is malignant or not.
- It is done by using 23 or 24-gauge needles fitted to specialized syringes which create negative pressure for aspiration and contents are smeared on slides.
- It is contraindicated in testicular tumor.
Frozen Section Biopsy
- It is done when a biopsy report is needed at the earliest.
- It is done in the pathology set-up existing adjacent to the operation theater.
- In this an unfied fresh tissue is frozen (using carbon dioxide) in a metal and sections are made and stained.
- The advantage of this technique is that it is quick and the surgeon can decide further steps in surgery.
Ultrasound-guided or CT-guided
- This procedure is conducted with a large needle with assisted CT scan equipment.
- Simultaneous CTscanallowidentifiationand visualization of the exact size of the tumor on a computer screen.
- It enables the operator to guide the needle into the tumor and obtain several samples of tissue.
- Tissues were then later examined by a histopathologist.
Brush Biopsy
- In this, a brush biopsy kit is supplied by the manufacturer which consists of a brush biopsy instrument, bar-coded glass slide, alcohol-based fixative and protective plastic case for mailing, and instruction sheet.
- In this, the nylon brush is designed to collect cells from all layers of epithelium including the basal cell layer of epithelium.
- The procedure includes the application of firm pressure on the lesion rotating brush 5–10 times.
After this nylon brush is manipulated on a glass slide so more cells are spread over the slide. - The slide is analyzed by a computer program designed for pathological review.
- Results are interpreted as negative, positive, or typical.
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