Flashcards in Biopsy Deck (23):
comes from the Greek words
dia (“through,” “apart”) and
meaning literally _______.
to know apart or to distinguish
A diagnosis is defined as
An accurate diagnosis is obviously important and occasionally critical to the patient so that the most appropriate treatment can be initiated as soon as possible.
determination of the nature of a disease or pathologic condition.
• Occasionally the diagnosis is relatively straightforward
• _________: represents a listing of the more likely diagnostic considerations for a particular pathologic finding or condition, ranked in descending order of probability
• Clinician’s evaluation
Construction of the differential
1. Clinical signs
• List of diagnoses is subject to modification or refinement (radiographic imaging and hematologic or serum analysis)
• _________ of the treating clinician
Experience and knowledge base
• The designation of ______ is used when the clinician believes that the nature of the disease has been identified to a reasonable degree of certainty.
Depending upon the experience and expertise of the practitioner, a confident final diagnosis may require nothing more than clinical inspection.
HOWEVER, EVEN THE MOST EXPERIENCED DIAGNOSTICIAN REQUIRES _________.
ADDITIONAL INFORMATION FROM APPROPRIATE IMAGING OR LABORATORY STUDIES
It is a surgical procedure in which a ________ from a patient and submitted for laboratory examination.
The word biopsy is of Greek derivation, originating from the words bio (life) and
opsia (to see)
tissue sample is removed
Despite the sophisticated images techniques, blood studies, nuclear and positive electron transmission (PET), _______ is the best and most often used dx tools.
The approach to a biopsy depends somewhat on the size, shape, location, and type of disease the practitioner anticipates.
Scapel blade and light microscope
• To aid in deriving a working __________.
• The challenge for the clinician is to provide a ________ that is adequate in quantity, properly fixed, and without artifacts or distortion.
1. diagnosis and confirm the differential diagnosis
2. representative tissue specimen
• When the patent’s clinical presentation, past history, or imaging studies ________.
• Any mucosal, skin, or bone abnormality that _________.
• Any lesions suspected to be of _______ are indicated for biopsy
1. do not allow a definitive diagnosis.
2. persists despite either removal of the associated irritant or treatment with adjunctive means deserves a biopsy. (2 weeks)
3. neoplastic origin
Limitations and Contraindications
• An area of ______ has no need of a biopsy.
• Pts with known ________ may require an alteration in the usual biopsy routine.
• Pts with _________ may need the aid of (CT) or ultrasound (US) to facilitate the determination of the exact type of biopsy needed.
• Pts undergoing treatment with ________ as well as _________.
2. allergies to local anesthetics or history of bleeding
3. deeply positioned lesions
4. IV or oral bisphosphonates; prior irradiated bone
• Exfoliative Cytology (Brush)
• Fine-Needle Aspiration
• Incisional Biopsy
• Excisional Biopsy
• It is a relatively ________ technique that may be used to provide additional information related to lesions of _______.
• Candidiasis, herpesvirus (herpes simplex virus, human herpesviruses 1 and 2) infections, and pemphigus vulgaris
1. inexpensive noninvasive
2. surface origin
• (FNA) is a useful method for evaluating _________.
• Most widely used in determining the nature of _______.
1. subcutaneous or more deeply situated mass lesions.
2. salivary gland or neck masses.
• Indicated for large lesions (_____) and those that could represent ________.
• It is a diagnostic surgical procedure in which a _______ of a lesion is removed
1. > 2 cm
2. unencapsulated or potentially malignant neoplasms
3. sample or portion
• Used to manage clinically ______ that are ____ in diameter.
• Defined as a diagnostic surgical procedure in which _______.
1. benign lesions
2. < 2 cm
3. all clinically abnormal tissue is removed
• Quick and accurate.
• It allows the pathologist to view the entire biopsy in its natural anatomic arrangement.
• To _________.
• Any _______ punch will require at least one _____. Punch biopsies rarely scar or become infected.
1. remove small lesions or to incisionally biopsy larger ones.
2. larger diameter; suture
• Patient’s general health.
• Malignant potential.
• Physical properties.
• Surgical expertise.
PHYSICAL PROPERTIES OF LESION
• Surface characteristics
• Depth of extension
• Quality of tissue
• Soft tissue or bone
• Growth rate
• What type of biopsy is best?
• Where do you take the biopsy?
• Multiple sites for biopsy.
• Anesthesia via block technique
• Take adequate tissue
• Do not mutilate tissue
• Retract and orient tissue with suture
• Palpate all lesions
• Aspirate all radiolucent lesions
1. Parallel to vessels and nerves.
2. Parallel to line of tension
3. Elliptical shape
• Send all excised tissue to the pathologist (_________)
(teeth, lesion/granulation tissue, normal tissue)