Diagnostic Biopsy

Diagnostic Biopsy

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    A Surgery, answered on behalf of
    What Should I Expect During a Breast Biopsy?
    Most biopsies are well-tolerated with minimal pain, says breast surgeon Evan Tummel, MD, of Brandon Regional Hospital. Watch as he describes how breast biopsies are performed.
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    A Clinical Pathology, answered on behalf of
    What Happens to My Biopsy?
    First, a biopsy is looked at overall without a microscope, and then sections are processed separately. In this video, pathologist and chief of staff Alejandra Kalik, MD, of Tampa Memorial Hospital, describes how doctors examine biopsies.
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    A Body Imaging, answered on behalf of
    What are the possible results from a breast biopsy?
    There are three possible results that can come back from a breast biopsy. In this video, Stacy Contreras, director at Good Samaritan Hospital’s Breast Care Center, explains each one and what it may mean for your health.
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    A Body Imaging, answered on behalf of
    What are the different kinds of breast biopsies?
    There are three different types of breast biopsies. In this video, Stacy Contreras, director at Good Samaritan Hospital’s Breast Care Center, explains each procedure and when it is used.
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    A thyroid biopsy is a procedure in which a sample of cells is taken from the thyroid gland, located in the neck, for examination under a microscope. A biopsy is usually performed to check for thyroid disease or cancer if you have a lump or nodule on the thyroid and/or after an abnormal result on a blood test or an imaging scan.

    Before doing the biopsy, the doctor may apply local anesthesia to your neck area. Then the doctor will insert a thin needle into your neck and into your thyroid gland to extract a sample of fluid and cells for viewing by a pathologist in a laboratory. The needle is then taken out and your doctor will apply a bandage to the area.
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    A lung biopsy is a medical procedure in which a sample of tissue is removed from the lungs to be examined under a microscope to look for signs of cancer, infection or lung disease. Usually a biopsy is a follow-up test to an abnormal finding on an x-ray or computed tomography (CT) scan. There are several different types of lung biopsies.
    • Needle biopsy. A needle biopsy is performed after a local anesthetic is given, and in some cases a mild sedative is provided to relax you. It is generally done when the area of concern is believed to be unreachable by other diagnostic techniques, such as bronchoscopy. The doctor refers to a chest x-ray or chest CT scan to find the exact spot for the biopsy. With the imaging scan as a guide, the doctor inserts a needle through your chest wall into a suspicious area of the lung to obtain a tissue sample. This type of biopsy may also be referred to as a closed, transthoracic or percutaneous (through the skin) biopsy.
    • Transbronchial biopsy. This type of biopsy is performed through a fiberoptic bronchoscope (a long, thin tube that has a camera on the end for viewing) through the main airways of the lungs (bronchoscopy).
    • Video-assisted thoracic surgery (VATS). In this procedure, you are given a general anesthetic so you are asleep. The doctor makes two or more small cuts to insert an endoscope (a thin, lighted tube equipped with a camera) through the chest wall into the chest cavity. Different biopsy tools can be inserted through the endoscope to obtain lung tissue for examination. This method of biopsy tends to result in less pain and a faster recovery.
    • Open biopsy. An open lung biopsy is done in a hospital operating room under general anesthesia, which means you are asleep and pain-free during the surgery. A tube will be placed through your mouth and into the airway that leads to the lungs. The surgeon makes a cut in the chest area and removes a small piece of lung tissue. The wound is closed with stitches.
    All four types of biopsies carry certain risks and require at least a day or more to heal and recover after surgery. You and your doctor can discuss your options to pick the best type of lung biopsy for you.
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    A liver biopsy is a medical procedure in which a doctor removes a small piece of the liver for examination under a microscope. A liver biopsy is usually done after tests such as imaging scans and blood tests indicate a problem with the liver. A liver biopsy can diagnose liver diseases and estimate the degree of liver damage as well as help a doctor determine the best treatment for the problem.

    A liver biopsy is performed in one of three ways.
    • In a percutaneous liver biopsy, a hollow needle is inserted through the abdomen to the liver to extract a piece of liver tissue. This type of biopsy is usually done using a local anesthetic (although pain medication and sedatives may be offered if needed), and while using an ultrasound scan to help the doctor guide the needle to the targeted spot on the liver.
    • A transvenous liver biopsy (or transjugular venous biopsy) is also done using local anesthesia and pain medication and/or sedatives if needed. In this procedure, a small incision is made in the neck and a sheath is threaded into the jugular vein and into one of the veins of the liver. A dye is put into the sheath and picked up by the vein in the liver so that an x-ray can be taken that will create an image of the veins of the liver. Then a biopsy needle is threaded into the sheath and used to extract one or more tissue samples from the liver. The needle and sheath are then withdrawn and the doctor applies a bandage to the small incision.
    • A laparoscopic liver biopsy is done with the patient under general anesthesia given through a vein in the arm. The doctor inserts a lighted tube called a laparoscope through a small cut in the abdomen until it reaches the liver. The laparoscope sends images of your liver to a computer monitor. The doctor watches the monitor and inserts instruments into the laparoscope to take tiny tissue samples from the liver. Recovery from a liver biopsy usually takes one or two days.
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    A bone biopsy is the removal of a small piece of bone to examine it under a microscope. During a bone biopsy, a doctor inserts a special kind of hollow needle through the skin and into the bone that is to be sampled. The doctor may use an imaging scan, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI), to guide the needle directly to the correct spot in the bone. If you need to undergo a bone biopsy using a needle, you will likely be mildly sedated and your doctor will apply a local anesthetic, as well.

    Another type of bone biopsy is called an open biopsy. If you undergo this type of biopsy, you will be given general anesthesia so you are asleep during the procedure. Your doctor will make a full incision into the skin to remove a piece of bone surgically, and when the procedure is completed, the incision will be stitched closed.

    Your doctor might recommend a bone biopsy to:
    • identify the cause of bone pain or tenderness
    • determine if bone lesions are malignant (cancerous)
    • investigate an abnormality seen on an x-ray
    • determine the cause of an infection
    • diagnose a bone abnormality
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    A kidney biopsy, also called a "renal biopsy," is a diagnostic test that involves removing small samples of tissue from a kidney in order to examine the cells under a microscope. There are two common types of kidney biopsy.
    • Percutaneous ("through the skin") biopsy. In a percutaneous biopsy, a doctor removes the kidney samples by inserting a needle through the skin to the surface of the kidney. Usually doctors use ultrasound to guide the needle directly to the kidney.
    • Open biopsy. In an open biopsy, a surgeon makes an incision through the skin to the kidney where the sample is taken, then uses stitches to close the incision. You are asleep under anesthesia during the surgery.
    In both types of kidney biopsy, the tissue samples are sent to a laboratory to be examined and evaluated. There are several possible reasons that your doctor might want you to undergo a kidney biopsy, including the following.
    • You have blood in your urine that is not going away.
    • Protein is detected in your urine during a laboratory analysis.
    • Your kidneys do not appear to be functioning normally.
    • You have had a kidney transplant and your doctor wants to monitor how well your new kidney is functioning.
    • Your kidney that has been injured.
    • You have had an abnormal blood test.
    A kidney biopsy can help your doctor diagnose conditions including kidney damage, kidney disease or a tumor on the kidney, and assess how well a transplanted kidney is functioning or how well a treatment for a kidney problem is working.
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    Should I Get a Prostate Biopsy If I Have an Elevated PSA Test?

    Some patients with elevated PSA levels may need a prostate biopsy--but not every one, explains Simon Hall, MD, chairman of the department of urology at The Mount Sinai Medical Center and director of the Deane Prostate Health and Research Center.