Biopsy
CCo
The correct biopsy technique is critical rorrect biopsy technique is critical
An adequate sample of the tumor is necessary to make diagnosis by looking at:
- Histopathology
- Cytogenetics
- Biological markers
Biopsy approach should not cause contamination of uninvolved adjacent normal tissues
The biopsy scar should be planned so that it can be excised when the definitive resection is performed.
Uninvolved lymphatic drainage should not be contaminated.
Adequate staging is sometimes necessary at the time of biopsy.
Image guided biopsy:
- In some situations tumors can be biopsied percutaneously - either with ultrasound or CT guidance by an interventional radiologist.
- Sometimes this technique may not obtain sufficient tumor for all the studies necessary to make the diagnosis of tumors such as lymphoma.
- The biopsy tract should be planned with the surgeon so as not to contaminate adjacent tissues (for a soft tissue sarcoma the biopsy tract should be excised with the primary tumor).
Important Biopsy Examples:
- Ewings sarcoma of the chest wall is a good example of a tumor that should be carefully approached to avoid contamination of the pleural cavity and unnecessary contamination of chest wall tissue above and below the tumor. Incisional biopsy should be carefully planned in this situation.
- Testicular Tumors should be biopsied using a TRANS-INGUINAL approach and NOT a TRANS-SCROTAL approach. A trans-scrotal approach will contaminate the scrotum, which has lymphatic drainage via the inguinal and iliac system.
