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glossary:biopsy

Biopsy:

(1) Procedure in which tissue samples are removed from the body for examination of their appearance under a microscope to find out if cancer or other abnormal cells are present; can be done with a needle or by surgery.

(2) The removal of a sample of tissue for purposes of diagnosis. (Many definitions of “biopsy” stipulate that the sample of tissue is removed for examination under a microscope. This may or may not be the case. The diagnosis may be achieved by other means such as by analysis of chromosomes or genes.)

A biopsy may be done, for example, because of concern about cancer. The physical exam, imaging, endoscopy, and laboratory tests may indicate that something is abnormal, but a biopsy may be the only sure way to know whether the problem is, in fact, cancer. In a biopsy, the doctor removes a sample of tissue from the abnormal area or may remove the whole tumor. A specialist trained to examine such tissues is called a pathologist. A pathologist examines the tissue under a microscope. If cancer is present, the pathologist can usually tell what kind of cancer it is and may be able to judge whether the cells are likely to grow slowly or quickly.

Bone marrow biopsy

Bone marrow aspiration, also called bone marrow sampling, is the removal by suction of the soft, spongy semisolid tissue (marrow) that fills the inside of the long and flat bones. Bone marrow biopsy, or needle core biopsy, is the removal of a small piece (about 0.75 X 0.06 in, or 2 X 0.16 cm) of intact bone marrow. The bone marrow is where blood cells are made.

Breast Biopsy

Breast biopsy: A procedure in which a sample of a suspicious breast growth is removed and examined, usually for the presence of cancer. The sample is suctioned out through a needle or removed surgically.

A breast biopsy may be done in a doctor's office, outpatient facility, or hospital operating room. The setting depends on the size and location of the growth, the patient's general health, and the type of biopsy performed.

Breast biopsy procedures include fine needle aspiration biopsy (FNAB), core needle biopsy (CNB), and excision biopsy (surgery). Both types of needle biopsy (FNAB and CNB) are generally less stressful than a surgical biopsy, do not disfigure the skin, leave no internal scar to interfere with the accuracy of future mammogram, and minimize the risk of complications. But needle biopsies are not always as reliable as surgical biopsies in producing a conclusive diagnosis.

The basic aim of a breast biopsy is to determine whether a worrisome lump is cancer and, if so, what type it is. Another way to view the procedure is to assure that a lump is benign, or harmless. Fortunately, 4 out of every 5 breast biopsies bring good news and are benign.

Among the most common benign growths in the breast are cysts (sacs filled with fluid or semisolid material), intraductal papillomas (small wart-like growths that project above a tissue surface), and lumps formed by fat necrosis (the death of tissue often as a result of trauma to the breast).

Aspiration biopsy

Aspiration or FNA Biopsy is performed with a fine needle attached to a syringe. Aspiration biopsy is often referred to as Fine Needle Aspiration (FNA). FNA biopsy is a percutaneous (through the skin) biopsy. FNA biopsy is typically accomplished with a fine gauge needle (22 gauge or 25 gauge). The FNA procedure is often performed, for example, to diagnose nonpalpable breast abnormalities (Click here to learn more about FNA on the breast). FNA may be performed under image guidance such as ultrasound. The area is first cleansed and then usually numbed with a local anesthetic. The needle is placed into the region of the abnormality such as a cyst or tumor. Once the needle is placed, a vacuum is created with the syringe and multiple in and out needle motions are performed. The cells to be sampled are sucked into the syringe through the fine needle. Three or four samples are usually taken.

Chorionic villus biopsy

Chorionic villus sampling - a prenatal test to detect birth defects at an early stage of pregnancy; tissue from the chorionic villi is assayed

Core Biopsy

Removal of a tissue sample with a hollow needle. The tissue is then looked at under the microscope to see if it's normal or abnormal.

Core Needle Biopsy (or core biopsy) is performed by inserting a small hollow needle through the skin and into the organ or abnormality to be investigated. The needle is then advanced within the cell layers to remove a sample or core. Needle biopsy is also a type of percutaneous (through the skin) biopsy. The needle may be designed with a cutting tip to help remove the sample of tissue. Core biopsy is often performed with the use of spring loaded gun to help remove the tissue sample.

Core biopsy is typically performed under image guidance such as CT scan imaging, ultrasound or mammography. The needle is either placed by hand or with the assistance of a sampling device. Multiple insertions are often made to obtain sufficient tissue, usually multiple samples are taken. Patients may experience a slight pressure, but usually do not experience significant pain. As tissue samples are taken, a click may be heard from the sampling instrument. The core tissue samples will be sent to the pathology laboratory for diagnosis. In some cases, the pathologist can attend the biopsy to examine imprints of the samples with a microscope. This can allows the pathologist to determine the adequacy of the sample and perhaps offer preliminary results.

Endoscopic Biopsy

Endoscopic Biopsy is a very common type of biopsy. Endoscopic biopsy is done through an endoscope (a fiber optic cable for viewing inside the body) which is inserted into the body along with sampling instruments. The endoscope allows the physician to visualize the abnormality and guide the sampling. Endoscopic biopsy may be performed of the gastrointestinal tract (alimentary tract endoscopy), urinary bladder (cystoscopy), abdominal cavity (laparoscopy), joint cavity (arthroscopy), mid-portion of the chest (mediastinoscopy), or trachea and bronchial system (laryngoscopy and bronchoscopy), either through a natural body orifice or a small surgical incision. The endoscopist can directly visualize an abnormal area on the lining of the organ in question and pinch off tiny bits of tissue with forceps attached to a long cable that runs inside the endoscope.

Excisional biopsy

The removal of an entire lesion, usually including a significant margin of contiguous normal tissue, for microscopic examination and diagnosis.

Incisional biopsy

The surgical removal of a selected mass of a lesion and adjacent normal tissue for microscopic examination and diagnosis.

Liver biopsy

A liver biopsy is a medical procedure performed to obtain a small piece of liver tissue for diagnostic testing. Liver biopsies are sometimes called percutaneous liver biopsies, because the tissue sample is obtained by going through the patient's skin.

Lymph Node Biopsy

(a) A lymph node biopsy removes lymph node tissue to be looked at under a microscope for signs of infection or a disease, such as cancer. Other tests may also be used to check the lymph tissue sample, including a culture, genetic tests, or tests to study the body's immune system (immunological tests).

Lymph nodes are part of the immune system. They are found in the neck, behind the ears, in the armpits, and in the chest, belly, and groin.

Why It Is Done Lymph node biopsy is done to:

Check the cause of enlarged lymph nodes that do not return to normal size on their own. Check the cause of symptoms, such as an ongoing fever, night sweats, or weight loss. Check to see if a known cancer has spread to the lymph nodes. This is called staging and is done to plan cancer treatment.

(b) Lymph nodes are small balls of tissue that are part of the body's immune system. The nodes produce and harbor infection-fighting white blood cells (lymphocytes) that attack both infectious agents and cancer cells. Cancer, infection, and some other diseases can change the appearance of lymph nodes. For that reason, your doctor may ask a surgeon to remove lymph nodes, to be examined microscopically for evidence of these problems.

Usually, one or more entire lymph nodes are removed and examined under the microscope by a pathologist. On occasion, the doctor does a needle biopsy to remove a portion of a lymph node to see whether a cancer already diagnosed has spread to that point.

Punch biopsy

The removal of tissue for diagnostic purposes using a sharp, cylindrical, hollow instrument placed over the tissue to be excised and rotated with slight pressure until an incision of proper depth is achieved. The tissue within the incision is lifted, and the base is excised with a scissor or scalpel blade.

Surface Biopsy

Surface Biopsy involves sampling or scraping the surface of a sore or tumor to remove cells for pathologic testing. Surface biopsy is often performed by dermatologists to remove a small piece of skin to test for carcinoma (cancerous tissue).

Surgical Biopsy

Surgical Biopsy (or Excisional Biopsy): surgical biopsy can be excisional (removal of an entire lesion) or incisional (removal of a piece of a lesion). Until about a decade ago, most biopsies performed were open surgical procedures. However, surgical biopsy is less common now. Surgical biopsies can be performed on abnormalities that can be seen or felt by the surgeon or pre-operative imaging can help provide a road map to the lesion. In cases of non-palpable breast lesions, a percutaneous wire can be placed in or near the lesion using mammogram or ultrasound for guidance. This marker wire provides a target for the surgeon. The removed tissue is then histologically analyzed by a pathologist (a special laboratory physician uses microscopic analysis of the tissue to determine its type).

Vacuum Assisted Biopsy

Vacuum Assisted Biopsy: Core biopsy is sometimes suction assisted with a vacuum device. This method enables to removal of multiple samples with only one needle insertion. Vacuum assisted core biopsy is being used more and more in breast biopsy procedures and is guided via stereotactic mammography or ultrasound imaging. However, unlike core biopsy, the vacuum assisted biopsy probe is inserted just once into the tissue through a tiny skin nick. Multiple samples are then taken using a rotation of the sampling needle aperture (opening) and with the assistance of suction.

Wedge biopsy

A biopsy in which a wedge-shaped sample of tissue is obtained; also: the tissue sample itself

Internal Articles for Biopsies

* core_needle_biopsy

* excisional_biopsy

*Axillary Node Biopsy

*Sentinel Node Biopsy

*Small Needle Biopsy

*Extraperitoneal para-aortic lymph node dissection (EPLND)

This page also includes:

  • Retroperitoneal Lymph Node Dissection
  • Laparoscopic Retroperitoneal Lymph Node Dissection
glossary/biopsy.txt · Last modified: 2012/10/16 14:40 (external edit)