Felis ISSN 2398-2950

Biopsy: overview

Synonym(s): Tissue sampling

Contributor(s): Vetstream Ltd, Michael Day

Introduction

  • Standard technique to support diagnosis of inflammatory, proliferative, reactive and neoplastic conditions within tissue.
  • Biopsy refers to the collection of a sample of intact tissue for examination of tissue microarchitecture and structural change. This is distinct from cytopathology which is based on assessment of individual cells or groups of cells derived from a tissue lesion.
Print off the owner factsheet on Biopsy Biopsy to give to your client.

Uses

  • Confirmation of diagnosis or rule-outs.
  • Biopsies are taken to:
    • Establish a specific diagnosis.
    • Eliminate other clinical diagnoses.
    • Follow the course of the disease.
    • Confirm the completeness of excision of a tumor by evaluation of tumor margins. Additionally, biopsy evalutes the potential for metastatic spread of a neoplasm by evaluating vascular or lymphatic invasion.
  • Biopsy specimens are used for several clinical purposes including:
    • Histological diagnosis involving examination of hematoxylin and eosin-stained sections of tissue by light microscopy. 
    • Special tests:
      • Application of histochemical stains to tissue - for example to detect organisms (eg Gram stain Staining techniques: Gram stain, periodic acid Schiff stain Staining techniques: Periodic acid/schiff, Grocott stain or ZN stain Staining techniques: Ziehl-Neelson) or evaluate the presence of collagen, fibrin, amyloid etc.
      • Immunohistochemistry/immunofluorescence  Immunohistochemistry (IHC) - for example to specifically identify micro-organisms, to phenotype neoplastic cells, determine the nature of extracellular matrix tissue or identify deposits of immunoglobulin or complement within tissue lesions.
      • Fresh biopsy tissue may be submitted directly for microbial culture.
      • Molecular diagnostics for example the use of polymerase chain reaction (PCR PCR (Polymerase chain reaction)) for detection of infectious agent, or clonality testing to determine whether a lymphoid infiltration is reactive or neoplastic.
    • Types of biopsy include:

Advantages

  • Can be the most effective way to establish a definitive diagnosis.
  • Facilitates assessment of prognosis and treatment.
  • Excisional biopsy may result in cure if the biopsy procedure removes the lesion.

Disadvantages

  • Invasive in some cases and requires local or general anesthesia General anesthesia: overview.
  • Correct tissue is not always accessible without complex procedures.
  • Minor interference has been suggested to possibly exacerbate some neoplastic and reactive conditions although the evidence for this actually occurring is limited.
  • Biopsy is a relatively slow diagnostic procedure - tissue samples require processing, so turn-around time is generally 24 hours.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good in all cases if planned properly.

Further Reading

Publications

Refereed papers


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