What Is A Biopsy? What Are Biopsies Used For?

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Main Category: Medical Devices / Diagnostics
Also Included In: Cancer / Oncology;  Preventive Medicine
Article Date: 15 Dec 2009 - 3:00 PDT

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A biopsy is the removal of a sample of tissue or cells so that they can be examined by a pathologist, usually under a microscope. A specialist trained to examine a sample of tissue for signs and extent of disease under a microscope is called a pathologist. For the true definition of biopsy, the tissue needs to be removed from a living subject.

When a whole lump or targeted area is removed surgically, it is called an Excisional biopsy. When just a sample of tissue is removed, the procedure is called an Incisional biopsy (core biopsy).

There are many different types of biopsy:

• Scrape - cells are removed from the surface of tissue, as may occur when a sample of the inside of the mouth is required, or from the neck of the womb(cervix).
• Punch biopsy - a punch (a round shaped knife) is used for cutting and removing a disk of tissue; commonly used for collecting a sample of skin tissue to check for malignancy (cancer).
• Needle biopsy - a needle is used to remove a sample of (usually) liquid. A wide needle is used for a core biopsy while a thin one is used for fine-needle aspiration biopsy.
• Endoscopic biopsy - an endoscope is used to collect the sample. An endoscope is a long-thin, lighted optical instrument used to get deep inside the body and examine or operate on organs. Specially adapted endoscopes include a cystoscope for the bladder, nephroscope for the kidneys, bronchoscope for the bronchi (in the lungs), laryngoscope for the voice box (larynx), and otoscope for the ear.
• Capsule biopsy - to take a sample from the intestines.
• Sterotactic biopsy - samples are taken from the brain, using stereotactic surgery to find the biopsy site. Sterotactic is a three-dimensional coordinates system to locate small targets inside the body.
• Colposcopic biopsy - used to evaluate a (female) patient who has had an abnormal Pap smear. The colposcope is a close-focusing telescope that allows the doctor to see areas of the cervix in detail.

According to Medilexicon's medical dictionary:

A biopsy is The process of removing tissue from patients for diagnostic examination.

The medical word biopsy comes from:

• The Greek word bios, meaning "life"
• The Greek word opsis, meaning "a sight"
• Together they mean "to view life".

Why are biopsies useful?

A biopsy is used to help a doctor make a diagnosis. Examples include:

• Cancer - if the patient has a lump or swelling somewhere in the body with no apparent cause. Often, the only way to determine whether it is cancerous (malignant) or not (benign) is with a biopsy.
• Peptic ulcer - a biopsy can help a doctor determine whether there is ulceration caused by NSAIDs (non-steroidal anti-inflammatory drugs). A small bowel biopsy may be used with patients with malabsorption, anemia, or celiac disease.
• Liver biopsy - can help the doctor diagnose tumors (cancer). It can also help the doctor decide whether the patient is responding well to treatment, for, for example, hepatitis.
• Infection - a needle biopsy can help doctors identify whether there is an infection, and what type of organism is causing it.
• Inflammation - by carefully examining the cells in, for example, a needle biopsy, the doctor may be able to determine what is causing it.
• Transplanted organs - biopsies of transplanted organs are sometimes done to determine whether the body is rejecting it, or whether diseases that made a transplant necessary in the first place have come back.

Biopsy analysis and results

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 (hematologist) may also study the sample.

The thin slice is attached to a glass slide. Remaining tissue is usually saved for later studies. Sometimes the slide has dyes added to it (they stain the tissue), this helps the pathologist see the cells more clearly.

In cases of cancer, the pathologist can determine whether the sample is malignant or benign, and if it is malignant, how aggressive and/or advanced the cancer is.

Finally, the pathologist prepares a report that includes any abnormal or important findings. This report is sent to the doctor who ordered the biopsy.

Recovery

In most cases, a biopsy is an outpatient procedure; the patient may go home immediately or very soon after it is completed. If a sample has to be taken from an internal organ, the patient may need a general anesthetic and may have to stay in hospital overnight. Otherwise, a local anesthetic will be used.

Scraping tissue sample from, for example, the inside of the mouth usually requires no anesthesia. The patient may feel a bit sore for a while.

Sometimes an incision has to be stitched up and a dressing may be needed.

Patients who had samples taken from a major organ, such as the liver or kidneys, they may have to rest in hospital for a few hours before they can go home.

In 2009 I had a biopsy done to see whether I had prostate cancer. The doctor took 16 samples from various parts of the prostate gland. The procedure was not painful, and for a short while there was a little bit of blood in my urine. (The results showed I had cancer, my prostate was removed. I am now OK).

When a sample is taken from the womb lining or cervix (of a woman) there may be slight vaginal bleeding for a brief period.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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