Biopsy Principles

Question 1

Incisional biopsy

Answer 1

Biopsy that involves incision into the tumor to remove a section with minimal disruption of the remainder of the tumor or the surrounding tissues

Question 2

Excisional biopsy

Answer 2

Entire suspected tumor mass is excised with no attempt made to obtain generous margins of adjacent normal tissue

• both diagnostic and therapeutic if benign tumor
• can compromise the change of a cure if malignant tumor
• if you need to come back and excise more can you? if yes, then excisional is okay to do… if not or if it will be difficult, then do incisional

Question 3

Biopsy on tail or leg

Answer 3

make incision in longitudinal plane, not transverse

Question 4

General guidelines - biopsy

Answer 4

Reminder to look on ppt - pretty straightforward

Question 5

Proper fixation of sample

Answer 5

10% buffered formalin; if large sample, slice like a loaf of bread

Question 6

Biopsy methods

Answer 6

• Needle core biopsy (TruCut)
• Punch biopsy
• Wedge biopsy
• Bone trephine (not used anymore)
• Jamshidi (bone)

Question 7

Goals of pathologic exam

Answer 7

• neoplasia vs non-neoplasia
• benign vs malignant
• histologic type
• grade
• status of margins

Question 8

“I don’t believe the results of the biopsy report”

Answer 8

call pathologist

take another biopsy