Biopsy

Source: Wikipedia, the free encyclopedia.
Biopsy
Brain biopsy
Specialtysurgery
ICD-10-PCS0?D???X (without force),
0?B???X (with force)
MeSHD001706
OPS-301 code1-40...1-49 (without incision)
1-50...1-58 (with incision)
MedlinePlus003416

A biopsy is a

cancerous
or inflammatory conditions.

History

The

goiter and then characterized the material.[2][verification needed
]

Etymology

The term biopsy reflects the Greek words βίος bios, "life," and ὄψις opsis, "a sight."[3]

The French dermatologist Ernest Besnier introduced the word biopsie to the medical community in 1879.[4]

Medical use

Cancer

Lung biopsy in a case of suspected lung cancer under control of computed tomography.

When cancer is suspected, a variety of biopsy techniques can be applied. An excisional biopsy is an attempt to remove an entire lesion. When the specimen is evaluated, in addition to diagnosis, the amount of uninvolved tissue around the lesion, the surgical margin of the specimen is examined to see if the disease has spread beyond the area biopsied. "Clear margins" or "negative margins" means that no disease was found at the edges of the biopsy specimen. "Positive margins" means that disease was found, and a wider excision may be needed, depending on the diagnosis.[citation needed]

When intact removal is not indicated for a variety of reasons, a wedge of tissue may be taken in an incisional biopsy. In some cases, a sample can be collected by devices that "bite" a sample. A variety of sizes of needles can collect tissue in the lumen (core biopsy). Smaller diameter needles collect cells and cell clusters,

fine needle aspiration biopsy.[5]

pathologic "staging"
).

Liquid biopsy

Main article: Circulating tumor cell

There are two types of liquid biopsy (which is not really a biopsy as they are blood tests that do not require a biopsy of tissue): circulating tumor cell assays or cell-free circulating tumor DNA tests.[6] These methods provide a non-invasive alternative to repeat invasive biopsies to monitor cancer treatment,[7] test available drugs against the circulating tumor cells,[8] evaluate the mutations in cancer and plan individualized treatments. In addition, because cancer is a heterogeneous genetic disease, and excisional biopsies provide only a snapshot in time of some of the rapid, dynamic genetic changes occurring in tumors, liquid biopsies provide some advantages over tissue biopsy-based genomic testing.[9] In addition, excisional biopsies are invasive, cannot be used repeatedly, and are ineffective in understanding the dynamics of tumor progression and metastasis.[10][11] By detecting, quantifying and characterisation vital circulating tumor cells or genomic alterations in CTCs and cell-free DNA in blood, liquid biopsy can provide real-time information on the stage of tumor progression, treatment effectiveness, and cancer metastasis risk.[12] This technological development could make it possible to diagnose and manage cancer from repeated blood tests rather than from a traditional biopsy.[12][13][14][15]

Circulating tumor cell tests are already available but not covered by insurance yet at maintrac and under development by many pharmaceutical companies. Those tests analyze

circulating tumor cells (CTCs)[13][16] Analysis of individual CTCs demonstrated a high level of heterogeneity seen at the single cell level[17] for both protein expression and protein localization and the CTCs reflected both the primary biopsy and the changes seen in the metastatic sites.[citation needed
]

Analysis of cell-free circulating tumor DNA (cfDNA) has an advantage over circulating tumor cells assays in that there is approximately 100 times more cell-free DNA than there is DNA in circulating tumor cells.[6] These tests analyze fragments of tumor-cell DNA that are continuously shed by tumors into the bloodstream. Companies offering cfDNA next generation sequencing testing include Personal Genome Diagnostics and Guardant Health.[9] These tests are moving into widespread use when a tissue biopsy has insufficient material for DNA testing or when it is not safe to do an invasive biopsy procedure, according to a recent report of results on over 15,000 advanced cancer patients sequenced with the Guardant Health test.[18]

A 2014 study of the blood of 846 patients with 15 different types of cancer in 24 institutions was able to detect the presence of cancer DNA in the body. They found tumor DNA in the blood of more than 80 percent of patients with metastatic cancers and about 47 percent of those with localized tumors. The test does not indicate the tumor site(s) or other information about the tumor. The test did not produce false positives.[19]

Such tests may also be useful to assess whether malignant cells remain in patients whose tumors have been surgically removed.[20] Up to 30 percent are expected to relapse because some tumor cells remain.[21] Initial studies identified about half the patients who later relapsed, again without false positives.[19]

Another potential use is to track the specific DNA mutations driving a tumor. Many new cancer medications block specific molecular processes. Such tests could allow easier targeting of therapy to tumors.[19]

Precancerous conditions

For easily detected and accessed sites, any suspicious lesions may be assessed. Originally, this was skin or superficial masses.

CT, MRI, and ultrasound along with endoscopy extended the range.[citation needed
]

Inflammatory conditions

A biopsy of the temporal arteries is often performed for suspected vasculitis. In inflammatory bowel disease (Crohn's disease and ulcerative colitis), frequent biopsies are taken to assess the activity of the disease and to assess changes that precede malignancy.[22]

Biopsy specimens are often taken from part of a lesion when the cause of a disease is uncertain or its extent or exact character is in doubt. Vasculitis, for instance, is usually diagnosed on biopsy.

Biopsied sites

Bone A bone biopsy is a procedure in which bone samples are removed to find out if cancer or infection or other abnormal cells are present. A bone biopsy involves the outer layers of bone, unlike a bone marrow biopsy, which involves the innermost part of the bone. Bone biopsy should as rule be done after all necessary imagings performed. Jamshidi needle has replaced the open-biopsy and fine-needle aspiration
Bone marrow Since
trabecular bone using a trephine
, and then aspirating material.
Breast Breast biopsy is often performed to assess or diagnose breast cancer, and can be performed by various methods such as fine needle aspirate (FNA), core needle biopsy (CNB), or surgical removal.[24]
Endovascular endothelial cells A micro-3D-printed device adapted for endovascular techniques has been shown to harvest endothelial cells for transcriptomic analysis.[25]
Gastrointestinal tract Flexible
colon and terminal ileum are commonplace. A variety of biopsy instruments, such as the bioptome, may be introduced through the endoscope and the visualized site biopsied.[26] Until recently, the majority of the small intestine could not be visualized for biopsy. The double-balloon "push-pull" technique allows visualization and biopsy of the entire gastrointestinal tract.[27]

Needle core biopsies or aspirates of the pancreas may be made through the duodenum or stomach.[28]

Lung Biopsies of the lung can be performed in a variety of ways depending on the location.
Liver In hepatitis, most biopsies are not used for diagnosis, which generally occurs by other means. Rather, it is used to determine response to therapy which can be assessed by reduction of inflammation and progression of disease by the degree of fibrosis or, ultimately, cirrhosis.

In the case of

quantitative copper
level.

Pancreatic cysts Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of cystic lesions, followed by liquid cell analysis, has been used as a diagnostic tool for differentiating benign, potentially malignant, and malignant pancreatic cysts.[29][30] 'Through‐the‐needle' cytologic brushes have been developed for increasing the cellular content in the aspirates.[31][32][33][34]
Prostate Forms of prostate biopsy include transrectal biopsy, transperineal biopsy and transurethral biopsy
Nervous system Forms include brain biopsy, nerve biopsy, and meningeal biopsy
Urogenital system
 Forms include renal biopsy, endometrial biopsy and cervical conization
Other Other sites include lymph node biopsy, muscle biopsy, and skin biopsy

Analysis of biopsied material

After the biopsy is performed, the sample of tissue that was removed from the patient is sent to the

diseases (such as cancer) by examining tissue under a microscope. When the laboratory (see Histology) receives the biopsy sample, the tissue is processed and an extremely thin slice of tissue is removed from the sample and attached to a glass slide. Any remaining tissue is saved for use in later studies, if required.[citation needed
]

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. The pathologist then prepares a report that lists any abnormal or important findings from the biopsy. This report is sent to the surgeon who originally performed the biopsy on the patient.[citation needed]

References

  1. ^ Xianghong Li Pitfalls in the pathological diagnosis of lymphoma Archived 2022-09-20 at the Wayback Machine
  2. S2CID 45618809
    .
  3. ^ "biopsy" Archived 2016-12-29 at the Wayback Machine. Online Etymology Dictionary.
  4. PMID 7975522
    .
  5. ^ Sausville, Edward A. and Longo, Dan L. "Principles of Cancer Treatment: Surgery, Chemotherapy, and Biologic Therapy", Harrison's Principles of Internal Medicine, 16th Ed. Kaspar, Dennis L. et al., eds. p.446 (2005).
  6. ^
    S2CID 12659213
    .
  7. PMID 20694797
    .
  8. doi:10.1158/0008-5472.sabcs-09-2044
    .
  9. ^
    S2CID 205128210
    .
  10. PMID 19722757
    .
  11. PMID 25579085
    .
  12. ^
    PMID 22894671
    .
  13. ^
    PMID 22306961
    .
  14. PMID 22530147
    .
  15. PMID 15801980
    .
  16. S2CID 25537784
    .
  17. doi:10.1158/0008-5472.sabcs10-p3-10-37
    .
  18. PMID 27628661
    .
  19. ^ a b c Regalado, Antonio (August 11, 2014). "Spotting Cancer in a Vial of Blood". MIT Technology Review. Archived from the original on 2020-03-26. Retrieved 2016-04-23.
  20. S2CID 19839081
    .
  21. S2CID 20074388
    .
  22. ^ Friedman, S. and Blumberg, R.S. "Inflammatory Bowel Disease", Harrison's Principles of Internal Medicine, 16th Ed. Kaspar, Dennis L. et al., eds. pp.1176-1789, 2005.
  23. ^ DiLonardo, Mary Jo. "Orchiectomy: Surgery to Remove the Testicles". WebMD. Archived from the original on 2008-10-12. Retrieved 2022-02-11.
  24. OCLC 857585932.{{cite book}}: CS1 maint: location missing publisher (link
    )
  25. S2CID 251730092
    .
  26. ISBN 9780781755672
    .
  27. PMID 17659666
    .
  28. PMID 17226911
    .
  29. PMID 29166170
    .
  30. PMID 31759419
    .
  31. ISSN 2573-802X
    .
  32. S2CID 261406528
  33. ISSN 1096-2883
    .
  34. PMID 37610663.{{cite journal}}: CS1 maint: multiple names: authors list (link
    )

External links

Wikimedia Commons has media related to Biopsies.
Look up biopsy in Wiktionary, the free dictionary.
  • Mybiopsyinfo.com - What is a biopsy? How is a biopsy examination performed? This website gives you answers to these and many other questions.
  • MyBiopsy.org Archived 2018-09-25 at the Wayback Machine - Links to a video. Information about biopsy results for patients. This site is created by pathologists, the physicians who diagnose cancer and other diseases by looking at biopsies under a microscope.
  • RadiologyInfo - The radiology information resource for patients: Biopsy
  • Biopsia de prostata - Prostate biopsy
Retrieved from "https://en.wikipedia.org/w/index.php?title=Biopsy&oldid=1212357324"
This page is based on the copyrighted Wikipedia article: Biopsy. Articles is available under the CC BY-SA 3.0 license; additional terms may apply.Privacy Policy