Biopsy Techniques Flashcards
(22 cards)
1
Q
Hemotoxalin & Eosin (H&E) Transport Medium
A
Formalin
2
Q
Direct Immuno Fluorescence (DIF) Transport Media [4]
A
- Normal saline
- Michel
- Zeus
- LN2
3
Q
Culture transport medium
A
Non-bacteriostatic saline
4
Q
Electron microscopy transport medium
A
2.5% glutaraldehyde solution
5
Q
Flow cytometry transport media [2]
A
- Fresh specimen on saline soaked gauze
2. RPMI medium
6
Q
Autoimmune Bullous disease biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Saucerized intact bulla, OR broad saucerization of peripheral bulla
- DIF - Perilesional skin <1cm from bulla
- Comments - Avoid lower extremities. Trunk skin is preferred. Saline is superior to other DIF transport media if delivered to the lab within 48 hours.
7
Q
Epidermolysis bullosa biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Saucerized intact bulla, OR broad saucerization of peripheral bulla
- DIF - NONE
- Comments - Avoid blisters >12 hours old. Can induce fresh blister on nearby clinically uninvolved skin.
8
Q
Vasculitis biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Punch or deep shave of lesion >72hrs old
- DIF - Punch or deep shave of lesion <24 hrs old
- Comments - Specimens should show both post capillary venule and deep plexus
9
Q
Panniculitis biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Deep incisional biopsy at the edge of necrotic focus
- DIF - NONE
- Comments - 6mm punch is the smallest size that can be divided for culture and H&E
10
Q
Lupus biopsy technique
- H&E
- DIF
- Comments
A
- H&E - >4mm punch biopsy of lesion >6 months old that is still active
- DIF - Punch biopsy of lesion >6 months old that is still active
- Comments - NONE
11
Q
Dermatomyositis biopsy technique
- H&E
- DIF
- Comments
A
- H&E - >4mm punch biopsy of lesion >6 months old that is still active
- DIF - Punch biopsy of lesion >6 months old that is still active
- Comments - NONE
12
Q
SJS/TEN/SSSS biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Shave or punch biopsy of acute lesion including full thickness of epidermis
- DIF - NONE
- Comments - Can submit desquamating sheets
13
Q
Scarring alopecia biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Two >4mm punch biopsies of lesions >6 months old that are still active
- DIF - >4mm punch biopsy of a lesions >6 months old that is still active
- Comments - Two biopsies: 1 for vertical and one for horizontal sectioning. Avoid active advancing border. Place punch at same angle as emerging hairs.
14
Q
Pattern alopecia or Telogen effluvium biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Two >4mm punch biopsies from an established area of alopecia
- DIF - NONE
- Comments - Two biopsies: 1 for vertical and one for horizontal sectioning. Submit transverse section or intact specimen for lab to section with HoVert or Tyler techniques
15
Q
Alopecia areata or Syphilis biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Two >4mm punch biopsies of active lesions with recent onset
- DIF - NONE
- Comments - Two biopsies: 1 for vertical and one for horizontal sectioning. Submit intact.
16
Q
Non-melanoma skin cancer biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Shave or punch biopsy with enough depth to demonstrate invasive pattern and detect perineural invasion
- DIF - NONE
- Comments - Use more superficial shave techniques on convex sites or thin facial skin
17
Q
Suspected melanoma skin cancer biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Complete excisional removal
- DIF - NONE
- Comments - Saucerization is acceptable. Consider scoring or tagging at 12 o’clock for orientation
18
Q
Dermatofibroma sarco protuberans biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Deep incisional biopsy
- DIF - NONE
- Comments - NONE
19
Q
Cutaneous T-cell lymphoma biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Broad shave biopsy below the depth of DEJ
- DIF - NONE
- Comments - Broad shaves are superior to punch biopsies. Consider sending specimens from multiple anatomic sites
20
Q
Primary cutaneous B-cell lymphoma biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Deep incisional biopsy
- DIF - NONE
- Comments - Punch biopsy or saucerization are superior to shave biopsies
21
Q
Nail matrix biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Punch biopsy or horizontal distal matrix elliptical excision with Vicryl closure
- DIF - NONE
- Comments - Total or partial nail plate avulsion is usually done prior to nail matrix biopsy. Punch biopsy <3mm does not need sutured closure
22
Q
Nail bed biopsy technique
- H&E
- DIF
- Comments
A
- H&E - Punch biopsy or longitudinal elliptical excision with Vicryl closure
- DIF - NONE
- Comments - Nail plate avulsion is usually done prior to nail bed biopsy, but is not necessary
