Biopsies (Brush Cytology and Bacterial Sampling)

Introduction

A biopsy is a diagnostic procedure to evaluate unusual growths or suspicious tissue in the body. The procedure involves removal of a piece of tissue or cells from the area of concern which are sent to a laboratory for microscopic examination. 

Indications

Biopsies are usually performed to detect the presence of cancer. A biopsy may also be helpful to diagnose various conditions such as

  • Skin conditions
  • Chronic hepatitis
  • Peptic ulcers
  • Kidney disease

Biopsy Procedures

Biopsies may be obtained by different procedures depending on the part of the body which needs to be examined. Local or general anesthesia will be administered based on the type of procedure. The various procedures include:

Endoscopic biopsy: A biopsy may be obtained through an endoscope, a thin flexible tube consisting of a lighted device and a camera. Depending on the area to be biopsied, the endoscope is inserted either through the mouth, anus, urinary tract or through a small incision in the skin.

Needle biopsy: This technique uses a special needle to extract cells from suspicious tissue. It is often used to obtain samples from lumps or enlarged lymph nodes. Imaging guidance may be performed to obtain samples from deeper tissues. Needle biopsy procedures include:

  • Fine-needle aspiration: A long, thin needle is used to draw fluid and cells from the suspicious area into a syringe.
  • Core needle biopsy involves use of a larger diameter needle with a cutting tip to remove a column of tissue.
  • Vacuum-assisted biopsy uses a needle connected to a suction device to extract cells from the area of abnormality.
  • Image-guided biopsy combines a needle biopsy with an imaging procedure.

Skin biopsy: Skin biopsies are performed to diagnose skin conditions and involves removing cells or tissue from the skin layers. Skin biopsy procedures include:

  • Shave biopsy in which a tool is used to scrape the skins’ surface.
  • Punch biopsy which uses a circular tool to remove a section of tissue from the deep skin layers.
  • Incisional biopsy uses a scalpel to remove a small area of skin.
  • Excisional biopsy involves removal of the entire skin lesion or lump.

Surgical biopsy: When the area of abnormality is difficult to access by other methods, a biopsy may be obtained by making an open incision and removing all or part of the abnormal tissue.

The sample tissue obtained is sent to the laboratory for microscopic analysis.

Post-Procedural Care

Following the biopsy procedure, you may experience a dull pain at the needle or incision site. Your doctor will prescribe medications to relieve any pain. You may have to stay in the hospital overnight if the procedure was performed under general anesthesia, but normally the procedure is performed outpatient. The incision site may be sutured or covered with a dressing before you leave the facility.

Risks and complications

Most biopsies are generally safe. However certain risks do exist depending on the site of the biopsy and the procedure used. Complications that can occur at the biopsy site can include excessive bleeding or hemorrhage, infection, damage to surrounding tissue or organs, or numbness around the biopsy site.

Brush Cytology and Bacterial Sampling

Brush cytology of the gastrointestinal tract is a technique to scrape or brush certain cells and microorganisms from the tissue that lines the mouth, oesophagus and stomach. Bacterial sampling is the identification of pathogens in the sample obtained by brush cytology. The sample is analysed in a laboratory to screen for a disease or identify the microorganisms that cause an infection.

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