LEARN It! Challenge 1, Topic 5
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Biopsies

dr-rob February 23, 2019
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A large sample of tissue is called a biopsy. A biopsy is obtained with surgery and often allows for diagnosis so that the treatment can get started.

A biopsy means taking a small sample and studying it under a microscope.
When the history, physical, and lab, or an image such as a photo, scan, or x-ray suggest a series problems, a clinician may choose to take the step of doing a biopsy to figure out what is wrong.

Clinicians can obtain biopsies from the bone marrow using needles, for example, or from colon and lung utilizing a robot with a scope or even by doing open surgery. Doing the least risky way is the best practice. Often, a biopsy shows that no further surgery is needed. Other times, it leads to the decision to remove the diseased part of the body or excise the diseased portion.

Usually, biopsies are done as an outpatient with the person heavily sedated or put under anesthesia during the procedure. For superficial biopsies such as the skin often involve just simple local anesthetic or numbing medicine is placed into the skin to reduce or prevent any pain.

 

A biopsy is then sliced very thinly and examined under a microscope. In this case above, the normal layers of the skin are observed without any cancers.

Human stratified squamous epithelium under microscope​


Endoscopy technique is used for inspection, photography, cleaning-out, sampling for germs, taking biopsies, and utilizing a LASER or balloon to treat an internal problem.

Fiber-optic endoscopy


The use of a fiber optic scope allows a doctor to go far into the body through existing passageways to see and even take small samples (biopsies) of any abnormalities they see.

When they go into the lungs through the nose or mouth, it is called bronchoscopy, and the tool used is called bronchoscope.

During the colonoscopy, doctors use a longer a larger scope called colonoscope to go into the colon through the anus.

A needle can also be used to find an internal area, and often that is done with help from ultrasound, X-ray or CT scan guidance.

These tools and techniques allow diagnosis and some treatments to be done without surgeries with incisions and stitches, which used to be the only way to treat diagnosis. During sampling for biopsies, a patient is sedated and often is not uncomfortable with or even remembers the procedure.

Sometimes the images are shown on a video screen in the room, and depending on the procedure, the patient can watch or have pictures taken for their records. 


If doctors need to biopsy something, it is a serious situation and can sometimes lead to bad news.

Patients need to be prepared and make a treatment plan with the doctor once the results are known.

Having a plan can help patients stay positive and get better sooner or manage the condition better.

Often, a team of pathologists will consult to agree on the diagnosis after evaluating the biopsy. Then a team is sometimes assembled to figure out the best treatment plan in complex cases such as cancer. The patient and family or caregiver can be part of the team to determine the best course of action to take medical, social, and financial issues into account.