Contents
A biopsy is a diagnostic test consisting in taking a piece of tissue for histological examination. The examination is ordered in patients with lumps and lesions of an unclear nature, e.g. when diagnosing breast, kidney and prostate cancer. There are several types of biopsy.
Fine needle aspiration biopsy (FNA)
Fine needle aspiration biopsy is a method of collecting material for bacteriological, cytological or histological examination using a thin needle. It is a source of a small amount of material and only gives the possibility of assessing the type of aspirated cells and tissues. this type of biopsy is not recommended for flat lesions, but it is justified in oval-shaped tumors.
Core needle biopsy
Core-needle biopsy (punch biopsy) allows for a complete histopathological examination thanks to the use of a special, sharp, cylindrical instrument with a diameter of 2 to 8 mm, allowing the collection of tissue material reaching the subcutaneous tissue. Due to the small number of complications (approx. 1% of patients) and high diagnostic value (approx. 93%), core-needle biopsy is a particularly recommended test.
Sentinel lymph node biopsy
Sentinel lymph node biopsy allows to assess the stage of e.g. malignant melanoma by assessing the lymph node into which lymphatic drainage occurs from the area where the lesion is located (the so-called sentry knot). Subsequent sections of the harvested node are examined histologically, and after showing metastases, all lymph nodes in the area are removed. The indications for a sentinel node biopsy are:
- malignant melanoma,
- squamous cell carcinoma,
- Merkel cell carcinoma,
- skin appendages cancer,
- sarcomas.
Excision biopsy
Excisional biopsy is a widely recognized and reliable source of material for histopathological examination. Tissue material, at least 1 × 1 cm in size, is taken from the border of the lesion and healthy skin, reaches the subcutaneous tissue, while wound management consists in placing situational sutures only in the area of healthy skin. The wound in the area of the diagnosed tumor is covered with a pressure dressing, possibly using haemostatic dressings.
Tangent fragmentary biopsy
Tangential biopsy (saucer biopsy) involves taking the tissue with a scalpel after lifting the skin at the midpoint of the lesion with a needle and cutting the base of the raised fragment.
Spindle biopsy
A spindle (elliptical) biopsy is performed using a scalpel with the wound being closed with skin sutures.
Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House