Biopsy Principles and Techniques

Question 1

Papule

Answer 1

< 1cm not fluid filled

Question 2

Vesicle

Answer 2

< 1 cm fluid filled

Question 3

Macule

Answer 3

pigmented, flat

< 1 cm

Question 4

Patch

Answer 4

pigmented, flat

> 1 cm

Question 5

Plaque

Answer 5

> 1 cm raised, flat topped

Question 6

Bullae

Answer 6

> 1 cm fluid filled

Question 7

Sessile

Answer 7

attached at base

Question 8

Pedunculated

Answer 8

narrower at base, flaps around

Question 9

Brush biop types

Answer 9

D7288 (cheaper)

D7286 (biop kit provided)

Question 10

Brush biop indications

Answer 10

white
red 
chronic ulcers
mucosa lesions
abnormal epithelium
small benign looking abnormalities

Question 11

Brush biop contraindications

Answer 11

lesions with normal intact epithelium
- fibroma
- mucocele
- hemangioma
highly suspicious lesions
lesions with obvious etiology

Question 12

Brush biop results

Answer 12

negative
positive (evidence of epithelial dysplasia/carcinoma)
atypical (abnormal epithelium, more investigation needed)

Question 13

Scalpel biop

Answer 13

laser or electrosurgical

Question 14

Scalpel biop indications

Answer 14

when clinical exam fails to give diagnosis
recognized premalignant lesion
when clinical signs and symptoms suggest malignancy
lesions fail to respond to treatment

Question 15

Biop principles

Answer 15

dont delay
obtain representative specimen
avoid distortion/destruction
handle properly and fix at once
submit good case history
submit radiographs and photos

Question 16

When biop doesnt match clinical signs

Answer 16

repeat biop
see if tissue was looked at the an oral pathologist
ask for a 2nd opinion
call pathologist (specimen mix up)

Question 17

Refer indications

Answer 17

malignant
patient needs special management
size/surgical difficulty beyond dentist