A biopsy is a procedure of taking a tissue sample from an organism to examine. The tissue is examined under a microscope, and therefore microscopic samples are needed.
Sometimes it is enough to scrape the tissue from an area (an example of this is taking a sample with the cervix ).
During a bowel examination, tissue for biopsy can be taken through a tube called an endoscope.
In other cases, for example, a large hypodermal needle is used for a kidney or liver biopsy.
A liver biopsy is used to confirm diagnoses such as hepatitis, cirrhosis, or liver tumors.
The biopsy is usually performed with the patient lying on his left side and keeping his right arm outstretched at the shoulder below his head. It is important that the patient is in this position and that he is as calm as possible. Local is given during the procedure anesthesia.
The needle is inserted between the two ribs towards the liver’s surface, and the biopsy material is taken very slowly.
An endometrial biopsy is done to examine the inner layer of the uterus.
If a woman suffers from irregular menstruation or abnormal vaginal bleeding, this can reveal, for example, polyps, hormonal imbalances, or, less frequently, tumors.
An endometrial biopsy can be reported in several ways. One of them is dilatation and curettage.
Dilation and curettage are common gynecological procedures that are increasingly being replaced by more modern hysteroscopy.
Dilation and curettage are performed under short-term general anesthesia. The cervix is gradually opened by introducing round sticks or dilators. Initially, smaller ones are used, so they gradually increase until the cervix opens enough for a curette to enter – a small spoon-like instrument used to scrape the inside of the uterus.
A flexible optical instrument with a light at the top is passed through the cervix to allow a direct view of the inside of the uterus. The biopsy is performed under eye control using an instrument inserted into the uterus. This procedure is usually performed under local anesthesia, although some women are recommended to be introduced to general anesthesia.
Other methods are being developed to allow a small sample of tissue to be taken from the area inside the uterus without anesthesia and the procedure to be performed on an outpatient basis.
The most common way is with a straw-like device by which the gynecologist makes a light suction and thus reaches the tissue needed for the biopsy.
A prostate biopsy is performed if abnormalities are found during a digit rectal examination. Transrectal ultrasound and blood tests are performed to warn of an elevated PSA value (prostate-specific antigen).
A prostate biopsy is performed in a hospital without the use of anesthesia.
The radiologist or urologist will check that the patient is taking blood-thinning medications, such as acetylsalicylic acid or heparin, to stop taking those medications in time, at least a week before the procedure, thus reducing the chance of bleeding. The patient will be given antibiotics to reduce the possibility of infection.
During the procedure, the patient lies on his side with his knees bent and pulled to his chest. During the procedure, the patient will feel brief pain due to the needle prick entering and exiting the prostate.
If any abnormality is found on the ultrasound, a biopsy must be done soon.
The procedure can be performed without ultrasound control. In this case, the doctor uses his finger to determine the size of the needle prick in the abnormal tissue area and takes samples for biopsy.
After the procedure, the patient may feel discomfort and may sometimes notice blood in the urine a few days after the procedure.
When skin changes require further examination, a skin biopsy may be helpful. First, local anesthesia is given, and then a small piece of skin is cut with a scalpel. Then the place is sewn with a few stitches. A very small, almost invisible scar remains.
Bone marrow biopsy
A bone marrow biopsy is necessary for many different diseases of the bone marrow, blood, or lymphatic system. A biopsy is usually done in the upper hip (area of the iliac bone) but can also be done from the sternum.
Local anesthesia is given first. Then the skin and outer parts of the bone are pierced with a strong needle until the softer, central part of the bone is reached, ie. Marrowbone. The bone marrow sample is sucked in with a syringe from the needle’s tip. The sample is examined under a microscope.
This procedure is used if a lump in the breast is detected by clinical examination, ultrasound, or mammography. A biopsy reveals whether it is a benign or malignant change.
A fine needle aspiration method uses a hypodermal needle that pierces the skin, and a sample is taken. Sometimes this procedure can be performed under the control of ultrasound or X-rays.
Another option is a surgical biopsy, which removes the entire lump.
Small bowel biopsy
It is not always possible to examine the small intestine’s central part with an endoscope, the so-called jejunum. In such cases, a biopsy capsule is used to take biopsy samples.
The patient swallows a capsule that is connected to a thin tube. An X-ray is then used to check if the capsule is in the jejunum. When the capsule is in the right place, partial pressure is made in the tube, with the help of which a small piece of the mucosa is torn off and sucked into the capsule. When the biopsy sample is in the capsule, the capsule is pulled back to examine the sample. The method is most useful when celiac disease is suspected.