2. Biopsy
• Biopsy is a procedure by which a doctor takes a piece of
tissue / whole organ in order to closely examine the
tissue/ cells for pathological conditions affecting tissue
morphology.
• Its always performed under strict medical supervision in
an OT.
• Depending on type of biopsy performed a patient may or
may not require hospitalization.
• Some biopsies require previous planning.
3. Biopsy Advantages
Most sought after and confirmatory investigation for
differentiating malignant vs non malignant
To have a closer look at the tissue
Some special investigation can only be carried out at
tissue only. ( FISH/IHC/Special stains to demonstrate
disease specific changed morphology)
4. Biopsy disadvantages
-There are different types of biopsies. Most of the time it can be
performed in small OT/ OPD but some
• may require earlier planning
• Patient may need to be hospitalised
• Performed under anaesthesia
• cost
6. Fine needle aspiration Biopsy
• Similar to core BX
• Better on palpable region
• Fine needle is used
• Liquid/ few cells are collected
• Sometimes USG/CT guided ( Image guided)
7. Core Needle Biopsy
• Used Mostly in Breast ? CA
• Slightly wide bore needle is used
• Provides cores of tissue, sufficient for HPR studies.
8. Surgical Biopsy
- Incision Biopsy
Small piece/ part of tissue is received which may not require
further grossing, entire sample is taken for processing. Less fixation
/ processing time, TAT within 1-2 days
- Excision Biopsy
Large specimen is received, need grossing prior to processing.
Fixation 24-48 hrs
TAT 3-4 days
9. Skin Biopsy-
• Used in melanoma and chronic skin diseases
• Depending on size of growth
• Shave/ Punch
• Excision biopsy if growth is small.
10. Bone Marrow Biopsy
• BM needle
• Punctures skin, soft tissue and bone
• Spongy bony bits/ Marrow is collected
11. Endoscopic Biopsy
• With special tool -contains camera, light
source, scissor etc.
• Used in GI Cases
• Only small pieces/ tiny bits of tissue is
received.
• Handle with care, if possible add little dye
to the fixative container for better
visualization.
12. Preparation before Biopsy
• To be done by OT staff!
• HPR form- demographic, site, time, nature of biopsy/ surgery,
Investigations request
• Labelled container
• Fixative
13. Initial Fixation
• As far as possible immediately after removal form
the body
• 1:15/20 ratio
• Sealed pre labelled container
• Sample is ready to be transported to Histopath
Lab.
