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Indian Journal of Ophthalmology Sep 2020An intraocular biopsy is performed for diagnostic, prognostic and investigational purposes. Biopsies help to confirm or exclude malignancies and differentiate... (Review)
Review
An intraocular biopsy is performed for diagnostic, prognostic and investigational purposes. Biopsies help to confirm or exclude malignancies and differentiate inflammatory from infectious processes. Histopathological analysis is the final verdict in unresponsive uveitis, atypical inflammation, metastases and masquerade syndromes. Advances and refinement of techniques in cytopathology, immunohistochemistry, microbiological and molecular biologic study offer much more than just diagnosis. They provide prognosis based on cell characteristics and are helpful in planning treatment and intervention. Many biopsy procedures have evolved to provide more safety and minimise complications thus improving the quality of specimens or samples available for analysis. The type of biopsy and technique adopted varies based on the clinical suspicion, size and location of lesions. In uveitis, a working diagnosis of intraocular inflammation is made on clinical examination and laboratory investigations and ancillary tests. Malignancy and uveitis is interlinked and masquerade syndromes are among the commonest indications for biopsy and analysis of specimen. The various types of intraocular biopsies include aqueous tap, fine needle aspiration biopsy, vitreous biopsy, iris and ciliary body, and retinochoroidal biopsy. They will be reviewed in this article with respect to current perspective.
Topics: Biopsy; Biopsy, Fine-Needle; Humans; Inflammation; Iris; Prognosis; Uveitis
PubMed: 32823400
DOI: 10.4103/ijo.IJO_1325_20 -
Japanese Journal of Radiology Jun 2020To assess specimen weight difference of six types of semi-automatic cutting biopsy needles.
PURPOSE
To assess specimen weight difference of six types of semi-automatic cutting biopsy needles.
MATERIALS AND METHODS
We compared 18- and 20-gauge needles, one aspiration-type (STARCUT aspiration-type, TSK Laboratory, Tochigi, Japan) and five non-aspiration-type (MISSION, BARD, AZ; SuperCore™, Argon Medical Devices, TX; Temno Evolution, Care Fusion, IL; FINE CORE, Toray Medical, Tokyo, Japan; Quick-Core, Cook, IN) needles. Four biopsies were performed with each needle with the longest throw length on an excised bovine liver. The biopsies were repeated with new needles, four times with four different livers. STARCUT was used both with and without aspiration.
RESULTS
Sixteen specimens were obtained with each needle. In needles of gauges, STARCUT with aspiration provided the heaviest specimen and significantly heavier specimens were obtained with STARCUT with aspiration (P < 0.05) than five non-aspiration-type needles. The specimen weight differed significantly (P < 0.001) among all 18- and 20-gauge needles. The specimen weights did not differ significantly between aspiration and non-aspiration biopsies with STARCUT (6.32 vs. 5.97 mg with 18-gauge needle, P = 0.342; 1.95 vs. 1.92 mg with 20-gauge needle, P = 0.886).
CONCLUSION
Although STARCUT with aspiration provided the heaviest specimen, specimen weights were not significantly different between aspiration and non-aspiration biopsies. We assessed the specimen weight difference of six types of semi-automatic cutting biopsy needles. Significantly heavier specimens were obtained with STARCUT with aspiration than the other needles. The specimen weight differed significantly among all 18- and 20-gauge needles but did not differ significantly between aspiration and non-aspiration biopsies with STARCUT.
Topics: Animals; Biopsy, Needle; Cattle; Equipment Design; Female; Humans; Liver; Male; Models, Animal; Specimen Handling
PubMed: 32124166
DOI: 10.1007/s11604-020-00935-3 -
The Veterinary Clinics of North... May 2017Histopathologic evaluation of liver biopsy specimens yields information that is not otherwise obtainable and is frequently essential for diagnosing hepatic disease.... (Review)
Review
Histopathologic evaluation of liver biopsy specimens yields information that is not otherwise obtainable and is frequently essential for diagnosing hepatic disease. Percutaneous needle biopsy, laparoscopic biopsy, and surgical biopsy each have their own set of advantages and disadvantages. Care should be taken to ensure an adequate amount of tissue is collected for meaningful histologic evaluation. Because sampling error is a limitation of hepatic biopsy, multiple liver lobes should be biopsied. This article discusses the indications for liver biopsy, associated risks, advantages and disadvantages of different biopsy techniques, and strategies to get the most useful information possible out of this process.
Topics: Alanine Transaminase; Alkaline Phosphatase; Animals; Biopsy; Cat Diseases; Cats; Dog Diseases; Dogs; Laparoscopy; Liver Diseases; Reference Values; Specimen Handling
PubMed: 28081862
DOI: 10.1016/j.cvsm.2016.11.007 -
International Journal of Dermatology Feb 2023Skin biopsies are crucial for the diagnosis of many cutaneous pathologies, yet specimen adequacy is essential for definitive diagnosis. Recent literature has noted a...
BACKGROUND
Skin biopsies are crucial for the diagnosis of many cutaneous pathologies, yet specimen adequacy is essential for definitive diagnosis. Recent literature has noted a trend in decreasing biopsy size over time, which has created concern over implications regarding adequacy for diagnosis.
METHODS
This study sought to evaluate if clinician training length or type of residency training impacted the average biopsy size and sample adequacy. Dermatopathology reports for shave biopsies between January 1, 2021, and June 30, 2021, at Penn State Health were queried through PathNet, the software application for pathology reports in this health system's electronic medical record system. Biopsy dimensions, volume, diagnosis, location, clinician training level, and descriptions of evaluation of deeper sections (recuts) and superficial sampling were recorded for each biopsy. Basic statistical calculations were performed to assess the mean and standard deviation for biopsy sizes per clinician group.
RESULTS
Differences in biopsy size between training levels were statistically significant despite qualitatively similar biopsy locations and final diagnosis categories for each clinician training group. After evaluating measures for sample adequacy, our data showed significantly smaller biopsies; however, overall frequencies were minimal. Additionally, more inadequate specimens were noted for clinician groups with the least amount of dermatology experience.
CONCLUSIONS
The results of this study identify a correlation with decreasing biopsy size amidst increased experience in dermatology training but find no evidence to support that this trend currently threatens sample adequacy.
Topics: Humans; Biopsy; Skin
PubMed: 35567519
DOI: 10.1111/ijd.16212 -
Current Opinion in Nephrology and... Mar 2022Traditional histopathology of the kidney biopsy specimen has been an essential and successful tool for the diagnosis and staging of kidney diseases. However, it is... (Review)
Review
PURPOSE OF REVIEW
Traditional histopathology of the kidney biopsy specimen has been an essential and successful tool for the diagnosis and staging of kidney diseases. However, it is likely that the full potential of the kidney biopsy has not been tapped so far. Indeed, there is now a concerted worldwide effort to interrogate kidney biopsy samples at the cellular and molecular levels with unprecedented rigor and depth. This review examines these novel approaches to study kidney biopsy specimens and highlights their potential to refine our understanding of the pathophysiology of kidney disease and lead to precision-based diagnosis and therapy.
RECENT FINDINGS
Several consortia are now active at studying kidney biopsy samples from various patient cohorts with state-of-the art cellular and molecular techniques. These include advanced imaging approaches as well as deep molecular interrogation with tools such as epigenetics, transcriptomics, proteomics and metabolomics. The emphasis throughout is on rigor, reproducibility and quality control.
SUMMARY
Although these techniques to study kidney biopsies are complementary, each on its own can yield novel ways to define and classify kidney disease. Therefore, great efforts are needed in order to generate an integrated output that can propel the diagnosis and treatment of kidney disease into the realm of precision medicine.
Topics: Biopsy; Female; Humans; Kidney; Kidney Diseases; Male; Precision Medicine; Reproducibility of Results
PubMed: 34982521
DOI: 10.1097/MNH.0000000000000770 -
Chest Apr 1998To determine the bronchoscopist's ability to predict specimen quality at the time of transbronchial biopsy and to determine the influence of biopsy specimen size and...
STUDY OBJECTIVES
To determine the bronchoscopist's ability to predict specimen quality at the time of transbronchial biopsy and to determine the influence of biopsy specimen size and alveolar content on diagnostic value.
DESIGN
Prospective, blinded, observational analysis.
SETTING
Tertiary care academic hospital-based pulmonary practice.
PATIENTS
Forty-three adult patients who underwent transbronchial lung biopsy.
INTERVENTIONS
Each of 170 biopsy specimens was rated as to likelihood of containing diagnostic tissue, size and ability to float, tissue types present, number of alveoli, and pathologic diagnosis.
RESULTS
Fifteen percent of biopsy specimens were small and 40% were large. Seventy-six percent of specimens floated; 61.8% of the 170 biopsy specimens contained abnormal lung tissue; and 14.7% of individual specimens were diagnostic. Fifty-two percent of specimens contained >20 alveoli. Larger biopsy specimens were more likely to contain diagnostic tissue (r=0.29, p=0.001). Cup forceps retrieved smaller pieces of tissue (p=0.007) and were less likely to obtain diagnostic tissue (p=0.06). Physician ratings of specimen quality (mean+/-SD) did not differ between specimens containing normal and abnormal tissue (5.98+/-2.3 vs 5.46+/-5.5; p=0.24) or between specimens containing diagnostic vs nondiagnostic tissue (5.56+/-2.5 vs 6.25+/-2.1; p=0.14). Specimens that floated were no more likely to be diagnostic or abnormal than specimens that sank (p<0.05). Diagnosis when established was made by the first biopsy specimen in 53.3% and the second in 33.3%
CONCLUSIONS
Physician estimate of biopsy specimen quality and the float sign are not helpful in predicting that the biopsy specimen contains abnormal or diagnostic tissue. Diagnostic biopsy specimen will likely be obtained if the size of the specimen fills the forceps, 2 to 4 biopsies are performed, and toothed forceps are used.
Topics: Adult; Aged; Aged, 80 and over; Biopsy; Bronchoscopy; Female; Humans; Lung; Male; Middle Aged; Prospective Studies
PubMed: 9554644
DOI: 10.1378/chest.113.4.1037 -
The Annals of Thoracic Surgery Aug 2019Lung adenocarcinoma histologic subtype is an important indicator of patient outcomes, so preoperative knowledge of subtype may be helpful to guide surgical planning. We...
BACKGROUND
Lung adenocarcinoma histologic subtype is an important indicator of patient outcomes, so preoperative knowledge of subtype may be helpful to guide surgical planning. We evaluated the sensitivity and prognostic efficacy of specimens from computed tomography-guided core needle biopsies to predict histologic subtype and patient outcome after surgery.
METHODS
We retrospectively identified 221 patients with lung adenocarcinoma who underwent computed tomography-guided lung biopsy and subsequent surgical resection. Concordance, accuracy, specificity, and sensitivity of histologic subtypes from core biopsy specimens were compared with surgically resected specimens. Tumor characteristics and biopsy procedural factors were analyzed to determine impact on diagnostic sensitivity. Histologic subtype based on biopsy specimen, clinical, tumor, and treatment variables were also examined in relation to time to progression.
RESULTS
Overall concordance of biopsy samples with the predominant subtype from surgical specimens was 77%. Specificity (sensitivity) of detecting a nonaggressive and aggressive subtype were 86% (93%) and 95% (48%), respectively. Length of core specimen and percentage subtype composition in the surgically resected specimen were correlated with improved sensitivity but to a lesser extent with aggressive subtypes. Presence of an aggressive subtype in biopsy specimens was an independent predictor of progression after surgery (subdistribution hazard ratio, 2.51; 95% confidence interval, 1.28-4.94; p = 0.0075).
CONCLUSIONS
Specimens from computed tomography-guided core biopsies can predict lung adenocarcinoma progression after surgical resection. Future prospective studies should address the role of core biopsy in preoperative planning.
Topics: Adenocarcinoma of Lung; Adult; Aged; Aged, 80 and over; Biopsy, Large-Core Needle; Female; Humans; Image-Guided Biopsy; Lung; Male; Middle Aged; Neoplasm Staging; Reproducibility of Results; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 30986416
DOI: 10.1016/j.athoracsur.2019.03.043 -
Journal of Stomatology, Oral and... Oct 2022To analyze the relation between biopsy specimen's size and the definitive diagnosis. In addition, other variables including oral mucosa region, type of disease and...
AIM
To analyze the relation between biopsy specimen's size and the definitive diagnosis. In addition, other variables including oral mucosa region, type of disease and general versus specialist practitioner were also assessed.
METHODS
Data from specimens submitted to histopathological examination between 2007 and 2017 were retrospectively analysed.
RESULTS
We analysed data on 792 patients. Out of 1089 archived reports, 81 (7.4%) had no definitive diagnosis. Multivariate analysis rendered biopsy length as the factor influencing the possibility to reach a definitive diagnosis.
CONCLUSION
The size of the specimen is an important parameter to achieve a correct histopathological diagnosis of the oral lesions investigated. According to our results, it seems that a 10 mm length is adequate to optimize the biopsy outcome. No statistically differences were observed between GPDs and oral surgery specialists, probably because biopsies were performed by experienced general practitioners, although not formally trained.
Topics: Biopsy; Humans; Mouth Mucosa; Retrospective Studies; Surgery, Oral
PubMed: 35176511
DOI: 10.1016/j.jormas.2022.02.005 -
Canadian Association of Radiologists... Nov 2019Although medical factors such as hypertension and coagulopathy have been identified that are associated with hemorrhage after renal biopsy, little is known about the...
INTRODUCTION
Although medical factors such as hypertension and coagulopathy have been identified that are associated with hemorrhage after renal biopsy, little is known about the role of technical factors. The purpose of our study was to examine the effects of biopsy needle direction on renal biopsy specimen adequacy and bleeding complications.
METHODS
Two hundred and forty-two patients who had undergone ultrasound-guided renal biopsies were included. A printout of the ultrasound picture taken at the time of the biopsy was used to measure the biopsy angle ("angle of attack" [AOA]) and to determine if the biopsy needle was aimed at the upper or lower pole and if the medulla was targeted or avoided.
RESULTS
Of the 3 groups of biopsy angle, an AOA of between 50°-70° yielded the most glomeruli per core (P = .001) and the fewest inadequate specimens (4% vs 15% for > 70°, and 9% for < 50°, P = .038). Biopsy directed at a pole vs an interpolar region resulted in fewer inadequate specimens (8% vs 23%, P = .005), while biopsies that were medulla-avoiding resulted in fewer inadequate specimens (5% vs 16%, P = .004) and markedly reduced bleeding complications (12% vs 46%, P < .001) compared to biopsies where the medulla was entered.
DISCUSSION
An AOA of approximately 60°, aiming at the poles, and avoiding the medulla were each associated with fewer inadequate biopsies and bleeding complications. While biopsy of the medulla is necessary for some diagnoses, the increased bleeding risk emphasizes the need for communication between nephrologist, pathologist, and radiologist.
Topics: Adult; Biopsy, Needle; Female; Hemorrhage; Humans; Image-Guided Biopsy; Kidney Diseases; Male; Middle Aged; Retrospective Studies; Ultrasonography, Interventional
PubMed: 30928202
DOI: 10.1016/j.carj.2018.11.006 -
Surgical Pathology Clinics Mar 2020Given the growing desire in clinical practice to detect lung carcinoma early, small biopsies are becoming more common and vital to the diagnostic process. Accurately... (Review)
Review
Given the growing desire in clinical practice to detect lung carcinoma early, small biopsies are becoming more common and vital to the diagnostic process. Accurately diagnosing lung carcinoma on small biopsies is challenging but can significantly affect patient management. The challenge is due in part to the overlapping features between benign, reactive, and malignant processes and the lack of discriminating biomarkers. Specimen preservation for ancillary tests is also increasingly important to provide targeted precision medicine. We focuses on the morphologic features and diagnostic pitfalls of the most common lung carcinoma seen in small biopsies and the appropriate specimen handling practice.
Topics: Biopsy; Biopsy, Fine-Needle; Diagnosis, Differential; Humans; Lung; Lung Neoplasms; Neoplasm Staging; Terminology as Topic
PubMed: 32005427
DOI: 10.1016/j.path.2019.11.001