Summary Biopsy

Medical Surgical Nursing
Wednesday, September 15, 2021

BIOPSY DEFINITION
WHAT IS BIOPSY? Biopsy is a surgical procedure to obtain tissue from a living organism for
Your doctor may recommend a biopsy if he or she finds something its microscopic examination, usually to perform a diagnosis.
suspicious during a physical exam or other tests. A biopsy is the main way
doctors diagnose most types of cancer. Other tests can suggest that WHY ARE BIOPSIES DONE?
cancer is present, but only a biopsy can make a diagnosis. Biopsies are most often done to look for cancer. But biopsies can help
During a biopsy, a doctor removes a small amount of tissue to examine identify many other conditions.
under a microscope. It may take place in your doctor's office. But A biopsy might be recommended whenever there is an important medical
sometimes surgery or another procedure may be needed to get a tissue question the biopsy could help answer. Here are just a few examples:
sample. The type of biopsy you receive depends on where the possible  A mammogram shows a lump or mass, indicating the possibility
tumor is located. of breast cancer.
A biopsy is a sample of tissue taken from the body in order to examine it  A mole on the skin has changed shape recently and melanoma
more closely. A doctor should recommend a biopsy when an initial test is possible.
suggests an area of tissue in the body isn't normal.  A person has chronic hepatitis and it's important to know if
Doctors may call an area of abnormal tissue a lesion, a tumor, or a mass. cirrhosis is present.
These are general words used to emphasize the unknown nature of the In some cases, a biopsy of normal-appearing tissue may be done. This can
tissue. The suspicious area may be noticed during a physical examination or help check for cancer spread or rejection of a transplanted organ.
internally on an imaging test. In most cases, a biopsy is done to diagnose a problem or to help determine
A biopsy is a removal of cells or tissue from the body to be examined in the best therapy option.
the laboratory by a pathologist to determined abnormality such as those
that is caused by not only cancer but inflammatory, autoimmune disorders, CHARACTERISTICS OF LESIONS THAT RAISE THE SUSPICION OF
infection or diseases. Biopsies are also used to match organ tissue before MALIGNANCY
a transplant and to look for a signs of organ rejection following a  Erythroplasia – lesion is totally red or has a speckled red
transplant. Biopsy is not only for cancer, almost any organ in the body can appearance.
be biopsied as well as the bone, bone marrow, thyroid, lymph node, muscles  Ulceration – lesion is ulcerated or presents as an ulcer.
nerve. A biopsy can be excisional where the whole lump or targeted area  Duration – lesion has persisted for more than two weeks.
is surgically removed or can be incised where single tissue or small tissue  Growth Rate – lesion exhibits rapid growth.
is taken.  Bleeding – lesion bleeds on gentle manipulation.
For example in skin biopsy, it is performed in order to obtained tissue for  Induration – lesion and surrounding tissue is firm to the touch.
further examination in the laboratory typically, through microscopy or  Fixation – lesion feels attached to adjacent structures.
tissue culture. Because of relatively low risk of skin biopsy as compared to
the biopsy of other organ, the ability to obtain a sample under simple local HOW TO PREPARE FOR A BIOPSY
anesthesia, the skin biopsy can be safely and routinely performed in an  Ask your doctor or nurse whether you can eat or drink anything
outpatient or ambulatory setting. The usual intent of skin biopsy is to before the biopsy.
further characterize the nature of a skin growth or eruption and assist  Also ask if you should take your regular medications that day.
in diagnosis by allowing histopathologic evaluation of a tissue sample. For certain biopsies, your doctor will want to know if you are
After local anesthetic is administered, the tissue is removed and placed in taking blood thinners or aspirin. Tell your doctor about all
a specimen container with an appropriate fixative, usually 10% formalin medications and supplements you are taking.
for permanent section diagnosis or Michel’s solution for  Tell your doctor about any drug allergies or other medical
immunofluorescence. The specimen is then sent to a pathology laboratory, conditions you may have.
where, after tissue fixation, slide preparation, and staining, a pathologist,  A member of your health care team will explain the procedure
dermatologist, or dermatopathologist can examine the specimen under a to you.
microscope. Alternatively, the tissue is placed in normal saline rather than  You will be asked to sign a consent form that states you
a fixative for viral or bacterial laboratory cultures. understand the benefits and risks of the biopsy and agree to
have the test done.
 Talk with your doctor about any concerns you have.




FERLENE CLYDE P. CAPAPAS, SN. 1

, Prerequisites for a Biopsy Procedures:
 CBC, platelets and coagulation studies should be done.  An 18-gauge needle is connected to a 5 or 10 ml syringe and is
 Cross-sectional imaging to evaluate local anatomy such CT scan inserted into the center of the mass via a small hole in the lesion.
and MRI.  The tip of the needle may need to be positioned in multiple
 Treatment center carrying out biopsy must be capable of directions to locate a potential fluid center.
proper diagnosis and treatment.  The material withdrawn during aspiration biopsy can be
 The surgeon who performs biopsy should preferably be the one submitted for pathologic examination and/or culturing.
who is later going to do the final excision.  The inability to withdraw fluid or air indicates that the lesion is
probably solid.
INDICATIONS FOR BIOPSY  A radiolucent lesion in the jaw that yields straw-colored fluid on
 There are inflammatory changes of unknown cause that persist aspiration is most likely a cystic lesion.
for long periods;  If purulent exudate (pus) is withdrawn, then an inflammatory or
 Lesion interferes with proper local function; infectious process should be considered.
 Bone lesions that are not specifically identified by clinical and  The aspiration of blood might indicate a vascular malformation
radiographic findings; within the bone.
 Any lesion that has the characteristics of malignancy.  Any intra-bony radiolucent lesion should be aspirated before
 Aggressive bone or soft tissue lesions surgical intervention to rule out a vascular lesion.
 Soft tissue lesions larger than 5cm, deep to fascia, or overlying  If the lesion is determined to be vascular in nature, the flow
bone/neurovascular structures rate (high versus low) should be determined because
 Unclear diagnosis in a symptomatic patient uncontrollable hemorrhage can occur if incised
 Solitary bone lesions in a patient with history of carcinoma
SURGICAL BIOPSY
WHEN A BIOPSY IS NOT INDICATED Surgical biopsy either open or laparoscopic surgery may be necessary to
 Asymptomatic latent bone lesions or a symptomatic active bone obtain a biopsy of hard-to-reach tissue. Either a piece of tissue or the
lesions which appear entirely benign on imaging don't necessarily whole lump of tissue may be removed.
need a biopsy
 Soft tissue lesion which are completely benign on MRI don't NEEDLE BIOPSY
necessarily need a biopsy (e.g. Lipoma, hemangioma) Most biopsies are needle biopsies, meaning a needle is used to access the
suspicious tissue. Needle Biopsy are used to collect skin samples or any
TYPES OF BIOPSIES tissue that is easily accessible.
IMAGE-GUIDED BIOPSY. Your doctor may use an image-guided biopsy Needle biopsy procedures include:
approach when he or she cannot feel a tumor or when the area is deeper  Fine-needle aspiration. Use a thin needle that is attached to a
inside the body. During this procedure, your doctor guides a needle to the syringe, allowing fluids and cells to be drawn out.
location with the help of an imaging technique. Your doctor can do an image-  Core needle biopsy. Use medium-sized needle to extract a column
guided biopsy using a fine needle, core, or vacuum-assisted biopsy (see of tissue, in the same way that core samples are taken from
below). This depends on the amount of tissue needed, possible diagnoses, the tissue. There is an inner needle connected to a draft
and other factors. Your doctor will use one of the following types of covered by a sheet and it is attached to a spring loaded device.
imaging based on the location and other factors:  Vacuum-assisted biopsy. Use suction from a vacuum to collect
 Ultrasound cells. It uses a vacuum of a suction to obtain larger pieces of
 Fluoroscopy tissue.
 Computed tomography (CT) scan  Image-guided biopsy. Are guided with imaging procedures —
 X-ray such as X-ray or CT scans — so your doctor can access
 Magnetic resonance imaging (MRI) scan specific areas, such as the lung, liver, or other organs.
A needle is usually used to take tissue or fluid sample from muscles, bones
OTHER TYPES OF BIOPSY and other organs like liver and lungs. There are several types of needles
ASPIRATION BIOPSY that may be used.
 Aspiration biopsy is the use of a needle and syringe to remove The used of needle smaller than a venipuncture needle that is attached to
a sample of cells or contents of a lesion. the syringe
 The inability to withdraw fluid or air indicates that the lesion is Needle biopsies are performed with guidance such as MRI, Ultrasound, CT
probably solid. Scan Fluoroscopy with local anesthetic medication that is being
Indications: administered.
 To determine the presents of fluid within a lesion
 To a certain the type of fluid within a lesion
 When exploration of an intraosseous lesion is indicated



FERLENE CLYDE P. CAPAPAS, SN. 2