Health Talk

Biopsy - The Science of Seeing Life

 A biopsy is a medical process involving sampling of cells or tissues taken from the body of a living subject in order to examine it microscopically, by a pathologist, whether it's normal or abnormal. The term biopsy is of Greek origin, coming from the words 'bio', meaning life, and 'opsia', meaning to see. French dermatologist Emest Besnier introduced the word "biopsy" to the medical community in 1879.

Use of Biopsies in Detecting Cancer:
Biopsies can diagnose diseases, determine extent of the diseases and determine adequacy of surgical removal. Biopsy can determine whether a lesion is benign or malignant, and can help differentiate between different types of cancer and its spread. Biopsies can help to identify many other conditions such as inflammatory conditions, kidney disease, infectious disease, metabolic disease, rejection of transplantation organ, the cause of infertility. In most cases, a biopsy is done to diagnose a problem or to help determine the best therapy option. Where a condition has already been diagnosed, a biopsy can be used to measure how severe it is or what stage it is at.
Sites of Biopsy:
The various sites of biopsy usually done are bone marrow biopsy, gastrointestinal tract biopsy (during endoscopic procedure, if a suspicious lesion is detected, pancreas (needle core biopsies or aspirates through the duodenum and stomach), lung biopsy, liver biopsy, prostate biopsy (transrectal  and transurethral),the nervous system (brain biopsy, nerve biopsy, meningeal biopsy), urogenital system( renal biopsy, endometrial biopsy, cervical conization) and others like breast biopsy, lymph node biopsy, muscle biopsy, skin biopsy, etc.
Types of Biopsies:
There are several types of biopsies. Some biopsies involve removing a small amount of tissue with a needle, while others involve surgically removing an entire lump or suspected tumor. For easily detected and accessed sites (skin, superficial masses), any suspicious lesions may be assessed. 
Biopsies may also be performed using imaging guidance such as ultrasound, computed tomography (CT), or (MRI) and endoscopy guided for deep and smaller masses. In surgical biopsy, surgery is performed. This is a more extensive procedure and may require hospital stay. In "excisional biopsy",' an entire lump or suspicious area is removed with a rim of normal tissue (to evaluate cancer free border). 
In 'incisional biopsy', only a sample of tissue is removed with preservation of the histological architecture of the tissue's cells. Few other techniques of biopsy are fine needle biopsy, vacuum assisted biopsy, brush biopsy, cone biopsy, core biopsy, endoscopic biopsy, percutaneous biopsy, punch biopsy, shave biopsy, stereotactic biopsy, sternal biopsy, etc. 
Post Biopsy Care:
After a biopsy is performed, the sample of tissue that was removed from the patient is sent to the pathology laboratory. When the laboratory receives the biopsy sample, they record the gross morphological feature of the tissue, history and clinical information of the patient. Then the tissue is fixed, processed in various solvents, embedded in paraffin and an extremely thin slice of tissue is removed from the block and attached to a glass slide. 
Any remaining tissue is saved for use in later studies, if required. The slide with the tissue attached is treated with dyes that stain the tissue, which allows the individual cells in the tissue to be seen more clearly. The slide is then given to the pathologist, who examines the tissue under a microscope, looking for any abnormal findings. 
Time Required:
The time required to get the report of biopsy depends on urgency of the disease and type of disease.