Removal of tissue from the living organism for the purposes of microscopic examination and diagnosis .

EXCISIONAL BIOPSY
Total excision of a small lesion for microscopic study. It is preferred if the size of the lesion is such that it may be removed along with the margins and the wound can be closed proximally.

INCISIONAL OR DIAGNOSTIC BIOPSY

Lesions that are too large to excise initially without having established a diagnosis ,a small piece is removed. Useful in dealing with large lesions,which the operator suspects may be treated by some means other than surgery once the diagnosis is made ,or the lesion in which the diagnosis will determine whether the treatment should be conservative or radical.

Should include surrounding normal tissue with adequate depth of underlying connective tissue.

Surgical excision by scalpel Surgical removal by cautery or a high-frequency cutting knife Laser Removal by biopsy forceps or biopsy punch Aspiration through a large bore needle Exfoliative cytology technique

Do not paint the surface of the area to be biopsied with iodine or a high colored antiseptic. If using infiltration anesthesia,inject around the periphery of the lesion. Use a sharp scalpel to avoid tearing tissue. Remove a border of normal tissue if at all possible. Use care not to mutilate the specimen when holding it with the forceps. Fix the tissue immediately upon removal in 10% formalin or 70% alcohol.If the specimen is thin,place it upon a piece of glazed paper and drop into fixative to prevent curling of tissue.

The report of a biopsy is usually returned to the operator by the pathologist within a few days unless some special procedures,such as decalcification of tooth or bone substance or application of special stains,are necessary. A negative biopsy report or a diagnosis not in confirmity with the expected diagnosis should never be considered final.it means only that there are no features to suggest the expected diagnosis in that particular tissue,which was removed at a particular time.A repeat biopsy should always be performed when there is any doubt about the adequacy or representative nature of the original specimen.