A biopsy is the removal of a sample of tissue from the body for examination. The tissue will be examined under a microscope to assist in diagnosis. Therefore, only very small samples are needed.
Sometimes, it’s enough just to scrape over an area.
During examination of the large intestine, a biopsy can be taken with forceps through a tube known as an endoscope.
In other cases, for instance, a liver or kidney biopsy, the biopsy is taken using a large needle.
A liver biopsy can be used to confirm diagnoses such as hepatitis, cirrhosis of the liver or tumors.
The biopsy is usually performed with the patient lying on their left side with their right shoulder extended and their right hand under their head. It’s important to remain in this position and to keep as still as possible. A local anesthetic will be given to numb the skin.
A needle is then guided between two ribs towards the surface of the liver, and the biopsy is taken quickly.
This biopsy is taken in order to examine the lining of the womb.
If a woman is suffering from irregular periods or abnormal vaginal bleeding, it may reveal a hormone imbalance in the body, polyp formation or, less commonly, the development of a tumor.
An endometrial biopsy can be performed in a number of different ways.
Dilatation and Curettage (D&C)
D&C is a common gynecological procedure, but it’s being replaced by the more modern practice of hysteroscopy.
A D&C is performed under a short general anesthetic. The cervix is opened gradually by introducing a series of rounded sticks or dilators. These are initially very small but increase in size until the cervix is dilated sufficiently to accept a curette – a small instrument shaped like a rectangular spoon. The curette is used to obtain a sample from the lining of the womb.
A fiber-optic tube, with a bright light at the end, is inserted through the cervix to obtain a direct view of the lining of the womb.
Biopsy under direct vision can be made by passing forceps through the inside of the tube into the womb. This is usually performed under a local anesthetic, but some women may be advised to have a general anesthetic.
A prostate biopsy may be performed if abnormality is found by the doctor or nurse, while performing a digital rectum examination (DRE).
A trans-rectal ultrasound scan (TRUSS) of the prostate gland may be requested to assess any abnormality felt on DRE, or if a blood test shows an elevated PSA (prostate specific antigen) blood test.
The procedure takes place in hospital and is performed without anesthetic.
The radiologist or urologist performing the procedure will have requested any patients taking blood thinning agents, e.g. aspirin or warfarin, to have discontinued them for up to one week beforehand because of the risk of bleeding. Antibiotics will be given to the patient beforehand to cover the risk of infection.
Throughout the biopsy, the patient lies on his side with his knees bent and his legs pulled up to his chest.
If any abnormality is seen on the ultrasound scan, a biopsy is taken there and then. The patient feels a number of short, sharp pains as a number of small needles move in and out of the prostate.
As many as 16 small cylindrical samples can be taken, four from each quadrant of the gland.
The procedure can also be done without ultrasound guidance. To do this the doctor uses a finger to guide a single needle to the abnormal area and takes a series of biopsies, one after the other.
After the procedure: the patient may experience some discomfort for a short period of time and possibly notice some blood in their urine intermittently for a few days.