Biopsy: Introduction, Types , Indication and list

A biopsy is the removal of tissue from any part of the body to examine it for disease. Some may remove a small tissue sample with a needle while others may surgically remove a suspicious nodule or lump.

Image result for biopsy

  • The tissue samples can be taken from any part of the body. The tissue is removed by placing a needle through the skin (percutaneously) to the area of abnormality.
  • Biopsies can be safely performed with imaging guidance such as ultrasound, x-ray, computed tomography (CT), or magnetic resonance imaging (MRI). These types of imaging are used to determine exactly where to place the needle and perform the biopsy.

Purpose of Biopsy

Biopsy are done for cancer screening. There are following condition :-

  • When a mammogram shows a lump or mass, indicating the possibility of breast cancer.
  • When a mole on the skin has changed shape recently and melanoma is possible.
  • A person has chronic hepatitis and it’s important to know if cirrhosis is present.
  • A needle biopsy can help identify whether there is an infection, and what type of organism is causing it.
  • By examining the cells in, for example, a needle biopsy, the doctor may be able to determine what is causing the inflammation.

Types of Biopsies

Here are some types of biopsies:

  • Needle biopsy: A needle biopsy is a procedure to obtain a sample of cells from body for laboratory testing. Common needle biopsy procedures include fine-needle aspiration and core needle biopsy.
  • CT-guided biopsy: A CT guided biopsy is an interventional procedure which involves the insertion of a biopsy needle into the body in order to collect a tissue sample from the area of interest.
  • Ultrasound-guided biopsy: An ultrasound-guided needle biopsy is an outpatient procedure to obtain a tissue sample of an abnormality discovered on a radiology scan. This is one type of “image-guided” biopsy, which combines the use of ultrasound with either a Fine Needle Aspiration or Core Needle Biopsy.
  • Bone biopsy:  A bone biopsy is a procedure in which bone samples are removed (with a special biopsy needle or during surgery) to find out if cancer or other abnormal cells are present. A bone biopsy involves the outer layers of bone, unlike a bone marrow biopsy, which involves the innermost part of the bone.
  • Bone marrow biopsy:  A bone marrow biopsy is part of a bone marrow test that takes a sample of solid bone tissue. A large needle is used to enter the pelvis bone to collect bone marrow. This detects blood diseases such as leukemia or lymphoma.
  • Liver biopsy: A liver biopsy is a procedure in which a small needle is inserted into the liver to collect a tissue sample. This is performed as an office or outpatient procedure or during surgery. The tissue is then analysed in a laboratory to help doctors diagnose a variety of disorders and diseases in the liver.
  • Kidney biopsy:  kidney biopsy is a medical procedure in which a small piece of kidney is removed from the body for examination, usually under a microscope. Microscopic examination of the tissue can provide information needed to diagnose, monitor or treat problems of the kidney.
  • Aspiration biopsy: Fine needle aspiration is a type of biopsy procedure. In fine needle aspiration, a thin needle is inserted into an area of abnormal-appearing tissue or body fluid.A fine needle aspiration is most often done on swellings or lumps located just under the skin.
  • Prostate biopsy: For a prostate biopsy, a thin needle is inserted through the rectum (transrectal biopsy), through the urethra, or through the area between the anus and scrotum (perineum). A transrectal biopsy is the most common method used.
  • Skin biopsy: A skin biopsy is a procedure in which a sample of skin tissue is removed, processed, and examined under a microscope. Several different methods may be used to obtain a skin sample, depending on the size and location of the abnormal area of skin, called a skin lesion.
  • Punch biopsy: A punch biopsy is a medical procedure that acquires tissue for laboratory examination, usually through tissue culture or microscopy, by taking a punch-size piece of skin from the body.
  • Surgical biopsy: Types of surgical biopsies. With an excisional biopsy, the whole abnormal area (plus some of the surrounding normal tissue) is removed. In certain cases, an incisional biopsy is done. This procedure only removes part of the tumor.

Risk:-  Any medical procedure that involves breaking the skin carries the risk of infection or bleeding. However, as the incision is small, especially in needle biopsies, the risk is much lower.

ProcedureImage result for Surgical biopsy

  • A straightforward result may be ready within 2 to 3 days, but a more complex case may take 7 to 10 days.The tissue samples are sent to the lab and examined by a pathologist. They may be chemically treated and sliced up into very thin sections. They are usually studied under a microscope. A blood specialist, or hematologist, may also study the sample.
  • The thin slice is attached to a glass slide, and remaining tissue is usually saved for later studies. Sometimes the slide has dyes added to it. These stain the tissue, and this helps the pathologist see the cells more clearly.
  • In cases of cancer, the pathologist will need to determine whether the sample is malignant, meaning cancerous, or benign. If it is malignant, they will assess how aggressive or advanced the cancer is. If it is cancer, there are special stains that can be done to help guide treatment and prognosis.
  • Finally, the pathologist prepares a report that includes any abnormal or important findings. This report is sent to the doctor who ordered the biopsy.

Is it painful?

Yes sometimes it can be painful. If anaesthesia is used, there should be no pain during the procedure, although there will be a skin prick during the initial injection.In a needle biopsy, a pin prick will be felt and a sharp pinch.



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