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Cytology

2 V

Aspiration

3 V

Incisional biopsy

4 V

Excisional biopsy

5 V

Exploratory biopsy

6 V

Punch biopsy

7 V

Curettage biopsy

SLIDE 5

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Cytology

( " # `(4; O!" )N7 AQ; : ` V

Exfoliative cytology

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Oral brush cytology

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Positive of cancer

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Oral brush cytology

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N" B( c N" (, 0 )" ( )4L^ ( )^"

SLIDE 6

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Koch

Q ] 21 [ B( " & ~ ) ) 34(5 >:?; J 4 / 86 J B( 78! & 7 82 J- 7 . 2 # I7J7 )

Aspiration

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Straw –colored fluid

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FNA Fine needle aspiration

( )2 c >:?; 0 " D{ / C* /+ - BAN0 )4(" )& ) g A0 .

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D"A 8]A ^

FNA

" w 60 0 f !" =D{ A(4 B R /+ )", , ) l!" /+ A . )

FNA

B( L6; ( (, 0 !"Wq 4(5 ) ) ( " $A =)%! ( " ( =)N;

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#$!" ) J B( c )& = C" ( ( ;

SLIDE 7

L %' & 89

E" /6 ( =- <+ $ " BQ g"Wq )+!

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/+ )0 )" ( !2

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C* ] 23 .[ ) g 8; 0 " $ )8:?;

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FNA

] 25 [ "%&'%<&= >? @ M3:4 O! ? !0 !"WN,

";0 O! ) O.K.C (

• c

+ ) /6 /"0 (

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• "0
• A
• Low grade

Papillary cystic adenoma B; ; C; C(~ )+2 R(

• )+2 g(,

)( A – ( Cystic hygroma (~$A "N-; * 0

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FNA

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23 = 22 .[ J B( f - )+ c !"Wq 4 A"0 !" • ( ( 4(5 )%! ) /6 +! >:?; 0 # )+ (O;!

FNA

; , ( BAN0 >:?; ) A0 ] 24 [ ) /Q

HI 1 . @%"AB C 7&' D @E?# F%G+ )NOP 07 Str !(0

• !N0

Thick, yello /Q C+ B;0 N" =v2 =)f =B;0 # Q" ) A C+ )N; Sticky T B B BN- !? )( ~0 3 ( , ` ( )f !] Dark, Yel !]

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$" Yellow o [ C; – x ! C- 3

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5 ( 4 #c

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B' g ( g J A2 J- " 3$! = 4(5 ( >:?; )

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I Q$ Straw–colured llowish–white granular Yellowish y, clear, viscous Thick-straw Bluish blood Bright blood Cloudy or forthy ) , `0 rk, amber–colured ellowish–white w or yellowish white

SLIDE 8

L %' &

• 7

1

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• .

^ " BQ 4(5 /0 4(5 , )78! / ] 26 = 7 = 2 [

5 4 . ;"% J K%L+ ] 26 [ 5 5 . ;"% HM%;) ] 20 [

(: )

Exploratory biopsy

(

• 2 0 );4(5

+ '( 6 A2 = gQ 3We2 )f =" ( 0 g g( ( 4(5 . ) y& 4 ; ) %& , )! + ( 4(5 C ; ) 1:! J B( 0 )Q ( A0

Incisional biops

( Q; h"; 4(5 +f ) ; )-A( Q; B( ) +

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=J B(

Wedg

( p4 0 )@^A )

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( ) /] /0 3d; #A 4(5 ) >:?; " #( . * g" ) 0 @ ( 37 ) " 2 [ ) /Q 3 ( .

;"% HM ] 20 [

Wed

34(5 >:?; %& )

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(" L J B( , f 0

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Excisional biop

( 4(5 /0 B! 4(5 p^ )4L^ ! ( /0 ) /Q 5 ( .

5 5

5 # (:D %& J B( ) #$!"

• 0 gQ 34(5

; # A0 ; 0 ' g 8; ( . !L

3

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90

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Q; 0 " ) )2 ) ! )& B( (O; )" 4(5 #- /Q )

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edge

! " 4(5 #A( ? 0 1:! ]

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;Q @ # " !% ! . " !% BA9 %; o 2 ] 26 = 23 = 3 = 2

5 3 . HM%;L?

AQ;

edge biopsy

) #$!" lQ( J , N & = )(( #, 37

Mirror-image

Q /7 K(! " + ( g@! R"N ( ] 29 V 27 ) [ /Q 4 .( 4 # TU )

• psy

" 3L2 ) ~0 @ J B( 0 =)&

SLIDE 9

3

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L %' & 7 1

• 1390

91

)& >8:! #(

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1 .[ 6 #

Punch biopsy

B( J /+ c ) 0 " );4(5 …8: + )@ 2 l!" . A … /(" J B( ) #$!" '( …8: /(" ( ‰ ( Rj" ) x =#A0 4(5 )! + , AA0 . =J B( !L

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) ) ; ( %& N" #$!" , ; . J B( )"!" N2 );5 1 ] 1 ) [ /Q 6 .( ) ( / J B( (

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` V " D"A f0 34(5 >:?; . 1 V : . a V L , 0 J ", 4 )& " ; . (] #$!" /+ =J B( 4" " ;, ] . h@ J B( 0 ~A( ) ] 31 = 30 .[ 7 #

Curettage biopsy

+ x /(" h"; )Qf0 …8: " 30 C = :!" …8 0 ?0 4 •, 3$ /

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B J

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, ( = 6 A2 = 0 x 4 - ) 0Q? ) ( =g

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/01 Y%* 1 V

Direct biopsy

) g@! :( t: )]{" 34(5 ) /+ )! 0 A . 2 V

Indirect biopsy

) g@! c :( 0 )@ 2 34(5 # # g" t:

• ]

7 = 3 .[

HI 2 . O D 'P >? @E?# !' ;"% !D ] 2 [ /01 ? J 34(5 f0 g : ‹ ) L L =- O R =N; N

• ! ' 4(5 - =/"0 =!"Wj(

Excisional g =ƒ 34(5 [Q? 34(5 =B SCC 0WQ 0W!( 34(5 =W BQ Incisional ):!" #; C )+ c "j", W BQ =0WQ l'$ /6 lQ( 34(5 )e4 :L; = O!"

SLIDE 10

3

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L %' &

• 92

7 1

• 1390

5 # =< I 1 V

Pre-operative

) / 2 /L+ :( MA /0 )& /L+ )4{+ >:?; 34(5 ] 9 = 3 [ . 2 V

Intra-operative

) / 2 B :( g …8 34(5 o+ B4; MA )& ) ] 9 = 3 = 2 .[ =< 0 " )8:?; J ( C K ) C* + ) , ( = 0 #" " ) =z]7 )& 37 D{ );0 3 (s C* #" )Q " . ) C* %& C N0 &

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= 4

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32 = 2 .[

HI 3 . Q' RS ;"% !' QT0 5?& ] 33 [ )45 ) ) /(" /jQ" ) # d; 15 ( B" !] ) ? ; [ )9+ Rj" `(k )! f0 3!"

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J ) [Q? 34(5 M )( | MA J!" AQ; N B(•; , ) #$!" ) %& … t@ 1:!

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!" " t: ! =N B(•; , 1 7 ) ! N B(•; )Q, N] Rj" = 1 7 ) #$!" M /] @+ ( 3 , R !" " # M 1 # ?! 7 )

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N" N B(•; | ) g )N; #( | ), ) 37 =# !"Wj( )

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4 V 2 .[ 2 . A ]^ &7 ' @ %f C, 3L0; h"; )& 5 )(; )$2 )

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5 #AA0 )$2 #$!" (L ( w 0 f ) B!- | i2

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References

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12(7): 504-10.

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• ral brush biopsy technique in a specialist Oral Medicine unit. Oral Oncol 2004; 40(8): 829-34.

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95

• 18. Potter TJ, Summerlin DJ, Campbell JH. Oral malignancies associated with negative transepithelial brush biopsy. J

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Contemporary oral and maxillofacial surgery. St. Louis: Mosby Elsevier; 2008. p. 423-80.

• 21. Koch FP, Kunkel M, Biesterfeld S, Wagner W. Diagnostic efficiency of differentiating small cancerous and

precancerous lesions using mucosal brush smears of the oral cavity-a prospective and blinded study. Clin Oral Investig 2010.

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415-560.

• 23. Frable WJ, Frable MA. Thin-needle aspiration biopsy in the diagnosis of head and neck tumors. The

Laryngoscope 1974; 84(7): 1069-77.

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URL: http://www.fpnotebook.com/endo/Gen/PtntEdctnInEndcrnlgy.htm

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maxillofacial surgery: an objective-based textbook. Philadelphia: Churchill Livingstone; 2007. p. 100-14.

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Tehran: School of Dentistry, Shahid Beheshty University of Medical Sciences; 1998.

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via cell culture. Shahid Behashti Univ Dent J 2006; 24(1): 86-94.

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2010; 22(1): 23-9.

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• 32. Harahap M. How to biopsy oral lesions. J Dermatol Surg Oncol 1989; 15(10): 1077-80.
• 33. Bermejo-Fenoll A, Lopez-Jornet P. Instrument for biopsy of oral lesions: an improved chalazion forceps.

Dermatol Surg 2006; 32(12): 1493-5.

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Livingstone; 2002. p. 7-10.

• 35. Lolli R, Venezia A, Bellardini M, De Nisi S, Demuro G. Technical artifacts in biopsy of the oral cavity. I. Clinical

and histopathologic aspects. Minerva Stomatol 1989; 38(1): 37-45.

• 36. Margarone JE, Natiella JR, Vaughan CD. Artifacts in oral biopsy specimens. Journal of Oral and Maxillofacial

Surgery 1985; 43(3): 163-72.

• 37. Seoane J, Varela-Centelles PI, Ramirez JR, Cameselle-Teijeiro J, Romero MA. Artefacts in oral incisional

biopsies in general dental practice: a pathology audit. Oral Dis 2004; 10(2): 113-7.

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Biopsy, how and why?

Sayed Mohammad Razavi, Atefeh Tavangar*, Laleh Maleki

Abstract

The term biopsy indicates the removal of tissue from a living body for diagnostic microscopic

• examinations. Biopsy is the most accurate and appropriate of all diagnostic histologic procedures.

Without biopsy, accurate diagnosis of lesions is impossible. Biopsy procedures should be performed whenever a definitive diagnosis cannot be established by common clinical examinations. The purpose

• f taking a biopsy is to distinguish different lesions with similar clinical or radiographic features or

diagnosis of malignancies. This article presents different types of biopsies, indications, contraindications and common problems in biopsy procedures. Key words: Aspiration, Biopsy, Cytology, Excisional, Incisional, Punch. Received: 24 Oct, 2010 Accepted: 22 Feb, 2011 Address: Assistant Professor, Department of Oral Medicine, School of Dentistry and Torabinejad Dental Research Center, Isfahan University of Medical sciences, Isfahan, Iran. Email: dr.tavangar_at@yahoo.com Journal of Isfahan Dental School 2011; 7(1): 83-100.