Biopsy is a procedure, wherein a piece of tissue is removed from the body and submitted for examination by the pathologist. Biopsy is used to diagnose wide variety of condition from skin problems to cancer…says Consultant Pathologist Dr. Vindu Srivatsava
What is a biopsy?
Many a medical condition including all cases of cancer require diagnosis by removing a sample of tissue from the body. A biopsy may also be ordered to monitor the disease condition like evidence of rejection following renal transplant or recurrence of cancer following treatment which may be surgery, Radiotherapy or chemotherapy.
The tissue to be examined may be as small as few mm or an entire organ like breast intestine, lymph node etc. The word BIOPSY comes from ‘bio’ which means life and ‘psy’ meaning vision.
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Therefore biopsy is looking at and examination of tissue in life i.e as it would be in the body. Any organ or part of the body can be biopsied using a wide variety of techniques.Some procedures may require major surgery, while others may be performed without anaesthesia.
The types of biopsies include:
- Excisional biopsy where a whole organ or lump is removed. It requires general anesthesia.
- Incision biopsy wherein surgeon takes a small sample of tissue. This is done when tumors of muscle and fatty tissue are suspected.
- Endoscopic biopsy is done through fibreoptic tube which views inside of the organ and biopsy taken using special forceps from the abnormal areas under direct vision,
- Colposcopic biopsy is taken from cervix by the gynecologist using a special microscope which visualizes the abnormal area
- Fine needle aspiration biopsy or FNAB is a simple outpatient technique and requires no
anaesthesia. Here a few thousand cells are removed from the body using a needle no wider than ones used for injections, Results can be given as early as two hours as the situation warrants. FNAB can also be done under the guidance of ultrasound and CT scan, in presence of radiologist.
- Punch biopsies are used for skin lesions. It is done under local anesthesia. The biopsied area is then stitched and it usually heals without a scar.
- Sterotactic biopsy is where a special needle is inserted into the organ under the guidance of special Xrays. The computer-generated image helps to map the exact location of abnormal areas which may not be detectable clinically; this area is then biopsied. This is most useful in mammogram detected abnormalities of the breast which may not be clinically obvious.
- Bone marrow is where blood cells are produced. In bone marrow biopsy a tiny piece of tissue is removed usually from the hipbone and examined.
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Once a tissue is taken out of the body it begins to rot or decompose due to bacterial action. This is prevented by putting the tissue immediately into a special fluid called fixative. The fixed tissue is then processed and treated with paraffin wax. The tissue is then cut into very thin sections, spread over glass slides, stained by suitable dyes and ready to examine under the microscope by the pathologist. The sections prepared are called permanent sections. They can either be handed over to the patient or stored for further references. These permanent sections along with the paraffin blocks can be stored for many years.
After examining the tissue a written report is prepared for the referring doctor. The report has three parts apart from basic data like name, age sex referral no, serial number, The three parts include a gross or macroscopic appearance of the tissue i.e. what the tissue looks to the naked eye, microscopy – appearance under the microscope and bottom line consisting of the impression or diagnosis.
The results can be had as early as two days, but it may not be possible for all types of tissue. The final written report is to be taken to the referring doctor and results discussed with them.
Pic courtesy: healthline