An
incisional biopsy is a medical procedure wherein a small sample of tissue is removed from a suspicious lesion or mass for diagnostic purposes. Unlike an excisional biopsy, which aims to remove the entire lesion, an incisional biopsy targets only a portion of the abnormal tissue. This type of biopsy is particularly useful when the lesion is too large to be completely removed or when its removal would cause significant morbidity.
Purpose and Indications
The primary purpose of an incisional biopsy is to obtain a representative tissue sample for
histological examination. It is typically indicated in cases where non-invasive diagnostic methods, such as imaging, have been inconclusive. Conditions that may warrant an incisional biopsy include:
Suspected
malignant tumors Chronic inflammatory conditions
Unexplained masses or lesions
Persistent ulcers
Procedure
An incisional biopsy is usually performed under local anesthesia. The steps generally include:
Preparation: The area around the lesion is cleaned and sterilized.
Anesthesia: Local anesthesia is administered to numb the area.
Incision: A small cut is made to access the suspicious tissue.
Tissue Removal: A portion of the lesion is excised using a scalpel or biopsy punch.
Closure: The incision is closed with sutures or surgical tape.
The excised tissue is then preserved in a fixative solution, usually
formalin, and sent to a laboratory for histological analysis.
Histological Analysis
Once the tissue sample reaches the laboratory, it undergoes several steps before it can be examined under a microscope:
Fixation: The tissue is fixed to preserve its structure and prevent degradation.
Embedding: The tissue is embedded in a paraffin block to facilitate sectioning.
Sectioning: Thin slices of the tissue are cut using a microtome.
Staining: The sections are stained with dyes such as
Hematoxylin and Eosin (H&E) to highlight cellular structures.
Microscopic Examination: The stained sections are examined under a microscope by a pathologist.
Benefits and Limitations
An incisional biopsy offers several benefits:
Less invasive compared to an
excisional biopsy Provides adequate tissue for a definitive diagnosis
Can be performed quickly and usually on an outpatient basis
However, it also has limitations:
Risk of sampling error: The biopsy may miss the most representative area of the lesion.
Potential for inadequate sample size for certain diagnostic tests.
Risk of infection or bleeding at the biopsy site.
Post-Procedure Care
After the biopsy, patients are usually advised to keep the biopsy site clean and dry. Mild discomfort or soreness is common and can usually be managed with over-the-counter pain relievers. It’s essential to follow the healthcare provider's instructions to minimize the risk of complications such as infection.
Conclusion
An incisional biopsy is a valuable diagnostic tool in histology, providing critical insights into various pathological conditions. While it has some limitations, its benefits often outweigh the risks, making it a preferred choice for diagnosing complex lesions. Through meticulous histological examination, pathologists can uncover crucial information that guides subsequent treatment decisions.
