This document provides an overview of biopsy procedures including: - A biopsy is the removal of tissue for examination under a microscope to diagnose a condition. - The goals of a biopsy are to establish a diagnosis, grade tumors, detect receptors, and more. - Indications for a biopsy include persistent lesions, lesions not responding to treatment, swelling or masses, and lesions with characteristics of malignancy like ulceration or rapid growth.

1. GOOD MORNING
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2. BIOPSY

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TABLE OF CONTENTS
• Introduction
• History
• Definitions
• Indications &
Contraindications
• Classification
• Various biopsy procedures
• Special considerations
• Essential biopsy principles

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• Errors
• Biopsy artifacts
• Healing of a biopsy
wound
• Complications
• Conclusion
• References

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Introduction
• Biopsy is a Greek word. By-Op-See. Bio-Life, Opsy-To Look.
• Ruge and Johamvert in 1870, in Berlin, first introduced a concept of biopsy. In
1889,Emarch emphasized on the confirmation of the diagnosis via biopsy.
• The term biopsy most often indicates the removal of suitably representative tissue
from a living subject for histological microscopic evaluation and analysis to obtain
diagnosis.
• Despite the sophisticated imaging techniques, the precise blood studies, and the
nuclear and positive electron transmission (PET) scans available today, the scalpel
blade and light microscope remain the best and most often used diagnostic tools.
• Tissue specimens determine the majority of diagnoses made by oral and maxillofacial
surgeons and other practitioners.
• The challenge for the clinician is to provide a representative tissue specimen that is
adequate in quantity, properly fixed, and without artifacts or distortion.
• The approach to a biopsy depends somewhat on the size, shape, location, and type of
disease the practitioner anticipates.

6. Aims
• To establish the diagnosis of the lesion
• To grade the tumor
• To detect the receptors
• To carry out mass screening for community based detection programs
• To detect enzymes and antigens
• To monitor treatment, recurrence, prognosis, for
• research purpose
• For microbiological studies
• For medicolegal purpose.

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INDICATIONS FOR BIOPSY
• Any lesion that persists for more than 15 days with no apparent etiologic basis.
• Any inflammatory lesion that does not respond to local treatment after 10–14
days.
• Persistent hyperkeratotic changes in surface tissues.
• Any persistent swelling/mass, either visible or palpable beneath relatively
normal tissue.
• Inflammatory changes of unknown cause that persists for long periods.
• Lesions that interfere with local function.
• Bone lesions not specifically identified by clinical and radiographic findings.
• Any lesion that has the characteristics of malignancy.

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• Erythroplasia—lesion is totally red or has a speckled red
appearance.
• Ulceration—lesion is ulcerated or presents as an ulcer.
• Duration—lesion has persisted for more than 15 days.
• Growth rate—lesion exhibits rapid growth
• Bleeding—lesion bleeds easily even on gentle manipulation or
even without it
• Induration—lesion and surrounding tissue is firm to the touch
• Fixation—lesion feels attached to adjacent structures/base
Lesions that Raise the Suspicion of Malignancy