Medical Terminology: Biopsy

1. What is Biopsy?
When a patient has a growth or unusual fluid buildup in the body, the health care provider will likely order noninvasive tests such as an X-ray, CT, or MRI scan that displays an image of the affected portion of the patient’s body.
If the health care provider is unable to diagnose the patient based on signs, symptoms, and images, the health care provider may take a biopsy of the suspicious tissue. In a biopsy, the health care provider removes a small sample of the tissue and sends the sample to a pathologist, who conducts a microscopic study of the tissue to reach a definitive diagnosis. The pathologist determines the type of cells in the sample and whether they are benign or malignant.
Tissue samples are collected by scraping cells on the cervix for a pap smear or the insertion of a large-bore needle to remove a larger number of cells called a core sample (e.g., larger sections of tissue can be removed for study using surgical techniques).
A negative biopsy result does not guarantee that the patient is free of cancer. It simply means that no cancer cells were found in the sample tissue.

2. Lung Biopsy
The lung biopsy is used to assess growths identified on an X-ray, CT, or MRI scan, and is used to diagnose lung cancer and other lung disorders.

Understanding the Lung Biopsy
A lung biopsy is the sampling of lung tissue that appears suspicious on a chest X-ray or CT scan. Typically, a health care provider orders a lung biopsy when signs and symptoms point to lung cancer, pulmonary fibrosis, sarcoidosis, or other lung diseases. There are four methods used to take a lung biopsy:
. Needle: With the guidance of an ultrasound or CT scan, the health care provider inserts a long needle through the chest wall and into the lung to remove tissue.
. Bronchoscope: A bronchoscope is inserted into the patient’s airway by the health care provider and a tissue sample is removed from the bronchi.
. Video-assisted Thorascopic Surgery (VATS): The health care provider makes an incision into the patient’s chest and inserts a thorascope into the incision to remove lung tissue.
. Open: The health care provider makes an incision between the patient’s ribs and into the lungs to remove lung tissue. This is commonly performed if a large tissue sample is being examined or if less intrusive biopsy methods are unsuccessful.

3. Percutaneous Kidney Biopsy
The percutaneous kidney biopsy is used to assess growths identified on a CT scan or ultrasound and is used to diagnose kidney cancer and other kidney disorders.

Understanding the Percutaneous Kidney Biopsy
A kidney biopsy is the sampling of kidney tissue when urinalysis indicates protein or blood in the urine or a CT or ultrasound scan shows a growth in or on the kidney. A kidney biopsy is sometimes performed to assess the progress of disease that affects the kidneys.

4. Liver Biopsy
The liver biopsy is used to assess growths identified on a CT scan or ultrasound and is used to diagnose liver cancer and other liver disorders. It is also used to identify the underlying cause of jaundice or abnormal liver enzyme test results. A liver biopsy is also used to assess the effect of medication on the liver and assess treatment for liver disorders.

Understanding the Liver Biopsy
A liver biopsy is the sampling of liver tissue. The sample is taken by inserting a needle between two right lower ribs. A liver biopsy is typically ordered when a CT or ultrasound scan identifies a growth or unexpected shape of the liver.

5. Lymph Node Biopsy
The lymph node biopsy is used to identify an abnormality that is causing the lymph node to swell.

Understanding the Lymph Node Biopsy
All fluids in the body, including abnormal cells such as cancer cells, are filtered by lymph nodes located throughout the body. Lymph nodes might increase in size when fluids are trapped by the filter, giving the appearance of swollen lymph nodes, which may be a sign that something is wrong with the patient. A health care provider may take a biopsy of one or more lymph nodes to identify the antigen.

6. Sentinel Lymph Node Biopsy
The sentinel lymph node biopsy is used to assess the spread of cancer cells.

Understanding the Sentinel Lymph Node Biopsy
A sentinel lymph node biopsy removes tissue samples from one or more lymph nodes to determine if cancer cells have spread from the site of the cancer. The sentinel node is the node most likely to indicate cancer cells may have spread from the primary cancer site. If the sentinel lymph node biopsy is positive, then the health care provider will likely order a lymph node dissection, which is the removal of the entire lymph node.

7. Testicular Biopsy
The testicular biopsy is used to assess if the patient is infertile.

Understanding the Testicular Biopsy
The testicular biopsy removes tissue samples from one or both testicles to determine if the patient is infertile. A testicular biopsy is not performed to determine if the patient has testicular cancer. An orchiectomy, which is a surgical procedure, is performed to diagnose testicular cancer.

8. Thyroid Biopsy
The thyroid biopsy is used to assess an enlarged thyroid gland (goiter) or assess a growth on the thyroid gland.

Understanding the Thyroid Biopsy
The thyroid biopsy removes tissue samples of the thyroid gland to determine if the patient has thyroid cancer or other thyroid disorders. There are two types of thyroid biopsies:
. Fine-Needle: A needle is inserted through the skin into the thyroid gland to retrieve sample cells.
. Open: An incision is made through the skin, making the thyroid gland visible to the health care provider as tissue samples are retrieved. The open biopsy is performed under general anesthesia.

9. Prostate Biopsy
The prostate biopsy is used to assess an enlarged prostate gland or to assess a growth on the prostate gland.

Understanding the Prostate Biopsy
A prostate biopsy removes tissue samples of the prostate gland to determine if the patient has prostate cancer. There are three types of prostate biopsies:
. Transrectal: A needle is inserted through the rectum to remove samples of prostate tissue.
. Transurethral: A needle is inserted through the urethra to remove samples of prostate tissue.
. Transperineal: A needle is inserted in the skin between the anus and scrotum to remove samples of prostate tissue.

10. Skin Biopsy
The skin biopsy is used to assess changes in the skin.

Understanding the Skin Biopsy
A skin biopsy removes tissue samples of the skin to identify skin lesions that have changed in color, size, and appearance. There are four common skin biopsies:
. Shave: A sample of the skin lesion is shaved using a scalpel.
. Excision: The entire skin lesion is removed from the patient.
. Punch: A circular sample of the skin lesion is removed using a punch.
. Incision: A piece of the skin lesion is removed from the patient.

Basic Questions
Biopsy

1. What is a biopsy?
The health care provider removes a small sample of the tissue and sends the sample to a pathologist, who conducts a microscopic study of the tissue to reach a definitive diagnosis.

2. What is meant by a negative biopsy result?
No cancer cells were found in the sample tissue.

3. Does a negative biopsy results guarantee that the patient is free of cancer?
No. It means that no cancer cells were found in the sample tissue.

4. What is the purpose of a lung biopsy?
The lung biopsy is used to assess growths identified on an X-ray, CT, or MRI scan, and is used to diagnose lung cancer and other lung disorders.

5. What is a needle biopsy?
With the guidance of an ultrasound or CT scan, the health care provider inserts a long needle through the chest wall and into the lung to remove tissue.

6. What is a bronchoscope biopsy?
A bronchoscope is inserted into the patient’s airway by the health care provider and a tissue sample is removed from the bronchi.

7. What is video-assisted thorascopic surgery (VATS)?
Video-assisted thorascopic surgery (VATS) occurs when the health care provider makes an incision into the patient’s chest and inserts a thorascope into the incision to remove lung tissue.

8. What is an open biopsy?
The health care provider makes an incision between the patient’s ribs and into the lungs to remove lung tissue. This is commonly performed if a large tissue sample is being examined or less intrusive biopsy methods are unsuccessful.

9. What is the purpose of a percutaneous kidney biopsy?
The percutaneous kidney biopsy is used to assess growths identified on a CT scan or ultrasound and is used to diagnose kidney cancer and other kidney disorders.

10. When might a percutaneous kidney biopsy be ordered?
A kidney biopsy is the sampling of kidney tissue when urinalysis indicates protein or blood in the urine or a CT or ultrasound scan shows a growth in or on the kidney.

11. What is the purpose of a liver biopsy?
The liver biopsy is used to assess growths identified on a CT scan or ultrasound and is used to diagnose liver cancer and other liver disorders. It is also used to identify the underlying cause of jaundice or abnormal liver enzyme test results. A liver biopsy is also used to assess the effect of medication on the liver and assess treatment for liver disorder.

12. When might a liver biopsy be ordered?
A liver biopsy is typically ordered when a CT or ultrasound scan identifies a growth or unexpected shape of the liver.

13. How is a liver biopsy performed?
A liver biopsy is the sampling of liver tissue. The sample is taken by inserting a needle between two right lower ribs.

14. Why might a lymph node biopsy be ordered?
All fluids in the body, including abnormal cells such as cancer cells, are filtered by lymph nodes located throughout the body. Lymph nodes might increase in size when fluids are trapped by the filter, giving the appearance of swollen lymph nodes, which may be a sign that something is wrong with the patient. A health care provider may take a biopsy of one or more lymph nodes to identify the antigen.

15. What is the purpose of a sentinel lymph node?
The sentinel lymph node biopsy is used to assess the spread of cancer cells.

16. What is a sentinel lymph node?
The sentinel lymph node is the node most likely to indicate cancer cells may have spread from the primary cancer site.

17. What might be ordered if the sentinel lymph node biopsy is positive?
If the sentinel lymph node biopsy is positive, then the health care provider will likely order a lymph node dissection, which is the removal of the entire lymph node.

18. Why might a health care provider order a testicular biopsy?
The testicular biopsy is used to assess if the patient is infertile.

19. Is a testicular biopsy used to diagnose testicular cancer?
A testicular biopsy is not performed to determine if the patient has testicular cancer. An orchiectomy, which is a surgical procedure, is performed to diagnose testicular cancer.

20. What is a transrectal biopsy?
A transrectal biopsyoccurs when a needle is inserted through the rectum to remove samples of prostate tissue.

21. What is a transurethral biopsy?
A transurethral biopsy occurs when a needle is inserted through the urethra to remove samples of prostate tissue.

22. What is a transperineal biopsy?
A transperineal biopsy occurs when a needle is inserted in the skin between the anus and scrotum to remove samples of prostate tissue.

23. What is an excision biopsy?
An excision biopsy occurs when the entire skin lesion is removed from the patient.

24. What is a punch biopsy?
A punch biopsy occurs when a circular sample of the skin lesion is removed using a punch.

25. What is an incision biopsy?
An incision biopsy occurs when a piece of the skin lesion is removed from the patient.