Biopsy: Uses, analysis, results, and what to expect

A biopsy is a way of diagnosing diseases. A doctor removes a sample of tissue or cells to be examined by a pathologist, usually under a microscope.

A pathologist is a specialist who is trained to examine a sample of tissue for signs and extent of disease under a microscope.

Tissue for a biopsy is normally taken from a living subject.

The word biopsy comes from the Greek words “bios,” meaning “life,” and “opsis,” meaning “a sight.” Together, they mean “to view life.”

What is a biopsy?

[biopsy under microscope]
Examining tissue under a microscope can provide information about various conditions.

Depending on the aim, a biopsy may be excisional or incisional:

An excisional biopsy is when a whole lump or targeted area is surgically removed

An incisional biopsy, or core biopsy, involves taking a sample of tissue

There are different types of biopsy.

A scrape: Cells are removed from the surface of tissue, for example, from the inside of the mouth or the neck of the womb, or cervix. It is often used in cervical cancer screening, commonly known as pap smears. It can be used to confirm fungal infections of the skin.

A punch biopsy: A punch is a round-shaped knife that is used to cut and remove a disk of tissue. This is used to collect a sample of skin tissue to check for malignancy, or cancer It can also be used to check for inflammation.

A needle biopsy: A needle is used to remove a sample, usually of liquid. A wide needle is used for a core biopsy, while a thin one is used for a fine-needle aspiration biopsy (FNAB). It is often used for breast and thyroid sampling.

A capsule biopsy: This is used to take a sample from the intestines.

Stereotactic biopsy: Samples are taken from the brain, using stereotactic surgery to find the biopsy site. A stereotactic system uses three-dimensional coordinates to locate small targets inside the body.

Colposcopic biopsy: This is used to evaluate a patient who has had an abnormal pap, or cervical, smear. The colposcope is a close-focusing telescope that allows the doctor to see areas of the cervix in detail.

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, a nephroscope for the kidneys, a bronchoscope for the bronchi, in the lungs, a laryngoscope for the voice box, or larynx, and an otoscope for the ear.

Almost any organ can be biopsied.

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Uses

We cannot visualize the organs or tissues inside of our body, but a biopsy helps in making a diagnosis by providing a piece of tissue for examination. Biopsies are often associated with cancer, but they can be used to diagnose other conditions and to see how far a disease has progressed. They often help rule out cancer.

Conditions where a biopsy can play a role include:

Cancer: If the patient has a lump or swelling somewhere in the body with no apparent cause, the only way to determine whether it is cancerous or not is through a biopsy.

Peptic ulcer: A biopsy can help a doctor determine whether there is ulceration caused by non-steroidal anti-inflammatory drugs (NSAIDs). A small bowel biopsy may be used to assess patients with malabsorption, anemia, or celiac disease.

Diagnosis of liver disease This can help the doctor diagnose tumors, or cancer, in the liver. It can be used to diagnosis cirrhosis, or liver fibrosis, when the liver is completely scarred from a previous injury or disease, such as long-term alcohol abuse or hepatitis. It can also be used to assess how well the patient is responding to treatment, for, for example, in the case of hepatitis.

Infection: A needle biopsy can help identify whether there is an infection, and what type of organism is causing it.

Inflammation: By examining the cells in, for example, a needle biopsy, the doctor may be able to determine what is causing the inflammation.

Sometimes, biopsies are done on transplanted organs to determine whether the body is rejecting the organ, or whether a disease that made a transplant necessary in the first place has come back.

If there is a lump or tumor, this may be removed at the same time, as part of the biopsy procedure.

Analysis and results

How long it takes to get the results will depend on the type of biopsy. A straightforward result may be ready within 2 to 3 days, but a more complex case may take 7 to 10 days.

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