Types of Biopsy

Biopsy is a procedure to obtain tissue for microscopical examination, usually to arrive at a diagnosis. Types of biopsy is given in following sections. Skin biopsies are vital in dermatology to help in the correct diagnosis of different conditions and also to help with therapeutic preparation. Different skin biopsy strategies exist, consisting of shave, saucerization, curettage, snip, incisional and excisional biopsy. An excisional biopsy is defined by the procedure of completely eliminating a solitary skin lesion. TYPES OF BIOPSY Anatomy and Physiology Correct perioperative planning is essential to prevent perioperative complications as well as to attain a cosmetically ideal result. Crucial cutaneous landmarks, cosmetic units, and also relaxed skin tension lines ought to be evaluated to finest camouflage the resultant scar from the procedure. Types of biopsy Indications for biopsy1 Any lesion or swelling in skin, subcutaneous tissue, muscle or organs such as liver, lung, tongue, rectum, bone marrow, prostate, brain, kidney and almost all organs in the body before excision are meant for definitive diagnoses.Any lesion suspicious of malignancy (Persistence of lesion or ulcer, sudden increase in size, change in character, color or consistency, bleeding to touch, becomes fixed to surrounding structures).Precancerous lesions (Leukoplakia, etc.)Inflammatory lesions: Ulcerative colitis, Crohn’s disease, amyloidoses, vasculitis, etc.Bone lesions not identified by clinical and radiographic findingsNonhealing ulcers. Types of biopsy1 Aspiration biopsy cytology or fine needle aspiration cytology.Trucut biopsy.Incisional biopsy - wedge biopsy or punch biopsyExcisional biopsy. Trucut (core needle) biopsy It is the aspiration biopsy using trucut needle with 20 mm specimen notch and centimeter depth markings that assist in depth perception and sharp cutting edge which help in cutting, high quality specimen cleanlly.It can be done directly by palpation or under ultrasound, MRI or stereotactic guidance or vaccum assisted core biopsy. Indications– Breast lesions, liver lesions, bone lesions are common indications Advantage of Trucut Biopsy The histological architecture of the tissue is retained here as it is not aspiration but rather a type of core needle incision biopsy wherein cylinders or cores of tissues are removed and not cells alone. Incisional biopsy The intent of an incisional biopsy is to sample a portion of the lesion.If the lesion is large, more than one area may require sampling. IndicationsIn all the lesions which are very large to directly undergo excisional biopsy or where excision biopsy can produce functional limitations not justified for all diagnoses of the lesion, incisional biopsy is to be done first to confirm the diagnoses. TechniqueA wedge resection of the lesion is done such that margin extend into the normal tissue on deep surface and sometimes also on the lateral surface. Necrotic tissue should be avoided. Punch biopsy Can be used for incisional or excisional biopsy . TechniqueBiopsy punches should range in size from 2 to 10 mm in diameter and the residual wound should be allowed to heal by secondary intention.Disadvantages - It is difficult to obtain adequate, representative tissue deeper than the superficial lamina propria. Brush biopsy Firm pressure with a circular brush is applied, rotated for about ten times to cause an abrasion.The cellular material picked up by the brush is transferred to a glass slide, preserved and dried. Excisional biopsy Indications:Used for small lesions, When complete excision with a margin of normal tissue is possible without functional debility or amputation.Technique - Complete removal of the lesion with 2–3 mm normal tissue surrounding the lesion is performed.–Direct infiltration of anesthesia into the lesion and use of electrocautery near the lesion should be avoided.–The specimen should be immediately placed and completely immersed in 10% formalin solution after orientation to allow determination of the right, left, superior, deep and inferior surfaces of the specimen–Primary closure of the wound is usually done. Contraindications. The option of biopsy site depends on the place of the lesion of rate of interest, nonetheless, in widespread condition, it is wise to prevent troublesome areas that may yield unremarkable histopathologic results or may lead to a cosmetically undesirable end result. Complications Complications may include Bleeding at the surgical siteHematomaSurgical site infectionNerve damage Intraoperative hemostasis and postoperative pressure dressings and ice decrease the likelihood of excessive postoperative bleeding or hematoma formation. Surgical site infection is mostly dependent on wound care by the patient with daily cleaning and bandage changes. Prophylactic antibiotics are indicated if the patient is considered high risk. TYPES OF BIOPSY What is BiopsyBiopsy is a procedure to obtain tissue for microscopical examination, usually to arrive at a diagnosis.What are the Complications of BiopsyComplications may include -Bleeding at the surgical siteHematomaSurgical site infectionNerve damage What are the Contraindications of BiopsyThe option of biopsy site depends on the place of the lesion of rate of interest, nonetheless, in widespread condition, it is wise to prevent troublesome areas that may yield unremarkable histopathologic results or may lead to a cosmetically undesirable end result. TYPES OF BIOPSY References - Ramsey ML, Rostami S. Skin Biopsy. [Updated 2020 Jan 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470457/ 1. Ramsey M, Rostami S. statpearls. January 2020. http://www.ncbi.nlm.nih.gov/books/NBK470457/. DNB ENT OSCE Stations Youtube channel Trans Oral Robotic base of tongue surgery - DNB ENT OSCE Station Question - DnbMentors.comDNB MentorsNow PlayingHome Care Instructions: Tympanoplasty and MastoidectomyDNB MentorsNow PlayingSurgery for CholesteatomaDNB MentorsNow PlayingBiomedical Waste Management - DNB ENT OSCE Question, OSCE Viva question - DnbMentorsDNB MentorsNow PlayingBiomedical Waste Disposal Methods - DNB ENT OSCE Station, OSCE Viva, Theory - DNBmentorsDNB MentorsNow PlayingBell's Palsy or Facial Palsy Clinical Features - Dnb Ent Theory Question, Ent osce viva stationDNB MentorsNow PlayingBasic Microsuture Technique - DNB ENT OSCE skill station DnbMentorsDNB MentorsNow PlayingAudiological assessment prior to Cochlear Implantation - DNB ENT Viva, Osce Station - DnbMentorsDNB MentorsNow PlayingAnatomy of Phonation - Dnb ent theory question, dnb ent osce station - DnbMentorsDNB MentorsNow PlayingNasal Fracture Managment - Historical Video 1976 - DnbMentorsDNB MentorsNow PlayingCochlear implant surgical steps - Dnb ent theory question, ent viva question - DnbMentorsDNB MentorsNow PlayingRole of Speech Therapy Post Cochlear Implant Surgery - Dnb ent Viva, Theory questions - DnbMentorsDNB MentorsNow PlayingTemporal bone cadaver anatomy points by Prof Mario Sanna DNB ENT Theory and OSCE DnbMentorsDNB MentorsNow PlayingTemporal bone anatomy pearls by Dr Sampath Chandra Prasad Bangalore DnbMentorsDNB MentorsNow PlayingSyndromes with congenital hearing loss presentation Dnb Ent Theory Question - DnbMentorsDNB MentorsNow PlayingSuperior Orbital Fissure SyndromeDNB MentorsNow PlayingSuperior Orbital fissure syndromeDNB MentorsNow PlayingSuperior orbital fissure vs cavernous sinus vs Orbital apex lesionsDNB MentorsNow PlayingSpeech Therapy in DysphoniaDNB MentorsNow PlayingSpeech Therapy in Dysphonia DNB ENT and OSCE station DnbMentorsDNB MentorsNow PlayingStep by step Uncinectomy DNB ENT OSCE Surgical Video Station - DnbMentorsDNB MentorsNow PlayingStep by Step Maxillary Dilation DNB ENT OSCE Video Station DnbMentorsDNB MentorsNow PlayingMedical Procedures: How to measure Blood PressureDNB MentorsNow Playing15 COMMANDMENTS OF FESS [ New Video ] - Dr. Narayanan JanakiramDNB MentorsNow Playing15 COMMANDMENTS OF FESS [ Old Video ] - Dr. Narayanan JanakiramDNB MentorsNow PlayingHouse Brackmann - Facial Nerve GradingDNB MentorsNow PlayingPaediatric Tracheostomy - Dr. Vidya sagarDNB MentorsNow PlayingSurgical diathermy or Electrocautery DNB ENT Question - DnbMentorsDNB MentorsNow PlayingSuture Basic Techniques DNB ENT OSCE Skill Station - DnbMentorsDNB MentorsNow PlayingEndoscopy Basics DNB ENT OSCE - DnbMentorsDNB MentorsNow Playing

Anatomy and Physiology

Continue reading