BIOPSY

BIOPSY (from Greek bios-life and ops, op6s-eye, vision), the surgical removal of parts of tissues or organs during life for microscopic examination for the purpose of diagnosing one or another pathological process. In a broader sense, by B. or biopsy material should be understood all particles of tissues and organs removed during life, both with the aim of diagnosing a disease, previously unclear, and with the aim of confirming a diagnosis already made, or even with the aim of a purely histological review of the removed material, even if the latter represents no practical, resp. diagnostic, value. In such an extended interpretation, the concept of B. essentially includes any operative intervention accompanied by the excision of one or another tissues. The practical and scientific value of the biopsy method is enormous. B. makes it possible to determine clinically unclear, for example, initial forms of neoplasms, and to recognize inflammatory, hyperplastic, tumor and other processes, differing in content and etiology. The value of the method is also great in those cases when the removed material, clinically, seemingly arouses no doubts, since histological research here can also give interesting or completely new data, changing or significantly clarifying the clinical diagnosis, or finally, data representing special theoretical interest for the pathologist. In general, it should be accepted as a rule that all kinds of tissues removed by operative means, even not for the purposes of B., should be subjected to histological examination by a specialist. Of course, B., as a method of recognition, is not self-sufficient, and the data obtained with its help must be fundamentally subordinated and coordinated with the general clinical data, i.e., each time must pass through a critical, purely clinical evaluation, all the more so since, having only a small piece of tissue before him and not possessing the fullness of the clinical and anatomical picture of the suffering, the pathologist is often forced to exercise considerable caution both in the interpretation and in the formulation of the data obtained. The diagnosis of diseases by the method of B. is by no means always easy; particular difficulties arise in the examination of lymph glands, the changes of which, especially in the early stages of diseases (Hodgkin's disease, lymphosarcomatosis, leukemic, aleukemic processes, etc.) can be very similar. In this field, the percentage of errors in histological diagnoses reaches 15-20 (W. Fischer); in difficult cases it is advisable to repeat B. The production of B. is not complicated; the excision of superficially located parts with little tissue pain can be done without anesthesia; if the latter is used, care must be taken not to cause artifacts in the biopsy piece; the latter should not be subjected to unnecessary injuries, stretching or compression, and should not be too small, so that there is no need for a repeated B. in the future. After excision, the piece is immediately thrown into 10% formalin or pure alcohol (see Fixation). The material on the same day is sent to a specialist (in hospitals, this is the prosector). It is unacceptable for some physicians to divide the biopsy material into several parts and send these parts to different laboratories: with such a division, different answers may indeed be obtained, at least because one laboratory will receive the pathological part of the piece, and the other the part where there are no "special changes". With the material, a note must be attached indicating the patient's surname, sex, age, room number, medical history number, presumed clinical diagnosis and place of B. If the material is delivered to the laboratory partially dried, it is advisable before fixation to place it for several hours in a weak solution of antiformin. Urgent answers on B. should be given within 1/2-1 hour after receiving the material, if the latter permits. Less urgent answers are given within 2-3 days. (Technique of research-see Histological technique.)