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32 Cards in this Set
- Front
- Back
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Why biopsy?
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Know what disease is so administer right treatment
-don't want to under-treat: 1st surgery is best chance for a cure -don't wan to over-treat= more morbidity to the patient, more cost to client |
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What is the purpose of the biopsy?
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Obtain a piece of tissue that will reveal the disease present
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What are fine needle aspirates good for diagnosing?
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Round cell tumors:
-lymphoma -histiocytoma -plamacytoma -mast cell tumor -transmissible veneral tumor -melanoma *epithelial or mesenchymal tumors don't exfoliate readily so harder to diagnose |
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Biopsies lead to ______ (gold standard) and _____ leads to cytology (some false +).
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Biopsies= histology
FNA= cytology |
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What information can you infer from a negative fine needle aspirate of a mass?
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Not a round cell tumor
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What are 2 situations where you want to perform a preoperative biopsy?
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1) Type of treatment or extent of treatment determined by tumor type
2) Owner's willingness to treat would be altered by knowledge of disease process |
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When do you NOT want to perform a preoperative biopsy?
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When biopsy procedure is as difficult, dangerous or the same as the definitive surgery
-lung mass -brain mass -testicular mass -splenic mass -thyroid tumors |
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What's the purpose of performing advanced imaging before performing a biopsy?
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Imaging study can help determine best site for biopsy
-biopsy procedure could alter results of imaging study if done first |
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What is the definition of an incisional biopsy?
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Biopsy that involves incision into the tumor to remove a section w/ minimal disruption of the remainder of the tumor or the surrounding tissue
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What is the definition of an excisional biopsy?
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Entire suspected tumor mass is excised w/ no attempt made to obtain generous margins of adjacent normal tissue
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What is a downfall of an excisional biopsy?
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Can compromise the chance of a cure if its a malignant tumor and needs more aggressive surgery
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What is the advantage of an excisional biopsy?
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Both diagnostic and therapeutic if benign tumor
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How do you plant the site of biopsy with regards to the biopsy tract?
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Biopsy tract needs to be removed at time of definitive surgery or included in radiation treatment field because biopsy tract is considered contaminated w/ cancer cells
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When performing a biopsy you need to pay close attention to hemostasis and dead space, but why are drains a bad idea?
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Bc principal of drain is comes out through same exit hole not incisions so results in more than one hole= 2 contaminated sites
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How do you make your incision when performing a biopsy on the tail or leg?
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Make an incision in longitudinal plane, NOT transverse
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When performing a biopsy try to include a junction between _____ and ______- except in bone biopsies.
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tumor and normal tissue
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When do you use electrocautery when performing a biopsy?
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DO NOT use electrocautery to obtain sample, use it for hemostasis after obtaining sample
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What can you do if you can't take a large sample of a mass?
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Can take several small samples if possible
-don't traumatize tissue while handling it! |
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If an excisional biopsy is performed, mark the ______.
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Margins- put ink around the tumor
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What can you do to try to prevent contamination of the biopsy tract?
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Use non-contaminated instruments when closing the biopsy tract i.e. change instruments
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How do you properly fixate a biopsy sample?
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10% buffered formalin
10:1 of formalin : tissue |
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What are 5 biopsy methods?
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1) Needle core biopsy
2) Punch biopsy 3) Wedge biopsy 4) Bone trephine 5) Jamshidi |
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How is a fine needle core biopsy different from a FNA?
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Can get a piece of tissue with needle core biopsy so can do histology
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Punch biopsies are good for what tumors?
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Superficial tumors
-have to use scissors to cute bottom of biopsy -take some normal tissue & tumor |
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What is the most common used biopsy method?
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Wedge biopsy
-just use 10 or 15 blade |
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Why do we want to avoid bone trephines?
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take a biopsy of bone that already weakened by tumor then make bone weaker and could cause fractures
-same diameter so lose sample alot of time |
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What do we like to use instead of a bone trephine? Why?
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Jamshidi
-smaller diameter so less likely to result in fractures -end is tapered so when pull out instrument sample stays in needle |
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What are 4 special biopsy techniques?
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1) Endoscopy (naturally occurring orifice)
2) Laparoscopy 3) Thorascopy 4) Image-guided biopsy |
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When do you perform a frozen section?
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When need answers right away, only available in large institutions where specialized personnel and equipment available (e.g. universities)
-used intraoperatively -get info in 20 to 60 minutes |
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Why is it so important to be able to interpret the biopsy report?
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Dictates treatment plan
-dose of surgery -irradiation -chemotherapy |
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What are the 5 goals of pathologic examination?
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1) Neoplasia vs non-neoplasia
2) Benign vs malignant 3) Histologic type 4) Grade 5) Status of margins |
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What are 2 things you can do if you don't believe the results of the biopsy report?
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1) call the pathologist
-resectioning of tissue available -special stains -immunohistochemistry -Second opinion by other pathologist 2) Take another biopsy |
