Needle biopsy

Overview:

Needle biopsy is a procedure to obtain tissues or a sample of cells from various body parts. The tissues or samples obtained will be observed in the laboratory to identify any signs of disease or cancer. A needle biopsy obtains cells or tissues from body fluids, muscles, and bones.

Indications:

A needle biopsy is done to diagnose diseases or health conditions. It is used to identify any masses that can cause tumors, cancers, swelling, or infection. A needle biopsy is used to identify the organisms if it is an infection.

Detects bone infection or cancer
To differentiate between different cancers
Identify blood cancers in bone marrow
Diagnose breast lump for breast cancer
Identify uterine lining for abnormal bleeding or cancers
Detect any liver conditions like infections, cirrhosis, and cancers
Identify lung infections from the fluids and cancers
Study the abnormalities of lymph nodes
Detect abnormalities in thyroid diseases
Diagnose any connective tissue diseases or blood vessel abnormalities
It can also detect inflammations, autoimmune conditions, and infections.
It can also be used.

Types of Needle biopsies:

Needle biopsies are done in many ways. The two important varieties are Fine-needle aspiration (FNA) and Core-needle biopsy (CNB). Both methods are minimally invasive biopsies done using needles.

FNA: This procedure uses thin needles to draw cells through capillary action. The needles used in this procedure are small. For superficial lumps FNA can directly draw the cells but for deeper lumps ultrasound-guided procedure is used. This is a rapid procedure that is less traumatic. It is less expensive and can be done anywhere. The results will also be obtained quickly.
CNB: This procedure cuts out tissue cores by taking larger fragments and preserving the architecture. The needles used in this procedure are larger than FNA needles. It gives better results where the tissues can be further processed. This is relatively more expensive, and time-consuming than FNA.

Generally, interventional radiologists carry out the CNB and image-guided FNA procedures. The laboratory processing is also different for both procedures.

Advantages:

FNA and CNB offer many advantages. They are:

In palpable lumps of salivary glands, FNA can be used for diagnosis and treatment planning. FNA and CNB give a clear understanding of the tissues. CNB gives accurate results, especially for cancers.
FNA is the preferred method for diagnosing Thyroid nodules. CNB can be used when FNA results are inconclusive.
CNB gives more sensitive results for diagnosing diseases like breast cancers, neck swelling, metastatic cancers, tuberculosis, and lymphomas. Both FNA and CNB can be used when less invasive sampling is needed.
FNA and CNB are crucial while planning chemotherapy or radiotherapy in soft tissue and musculoskeletal disorders.
FNA and CNB are the preferred initial tests for suspicious kidney lesions before planning surgery or other treatments, as they give information about the specific type of disorder and grade its severity.
Endoscopic ultrasound-guided FNA or CNB are the go-to tests for pancreatic disorders. They give better diagnostic results with more tissue for additional testing and specific tumor identification.

Before the procedure:

Before needle biopsy, complete details are collected from the patient. Diet will be restricted, and a list of medications to be stopped and to be used before the procedure will be given. A needle biopsy will be done on an empty stomach if done under intravenous sedatives or general anesthesia. Hence, it is necessary to refrain from eating anything 8-12 hours before the procedure. Inform the healthcare provider of any previous allergies to anesthesia. In case of pregnancy, inform the healthcare provider as certain imaging studies cannot be done during pregnancy. Jewelry should be removed.

During the procedure:

An individual is made to sit comfortably on the table such that the area to be biopsied is accessible to the healthcare professional. Imaging procedures are sometimes done during the biopsy to get access to the site if it is an interventional procedure. This depends on the part of the body that is undergoing biopsy.

Anesthesia is given, and the biopsy site is cleaned with an antiseptic solution. Sometimes sedatives are given to calm the individual. A needle is guided through a vein to collect a sample of cells. This procedure is done multiple times until enough cells are retrieved. Based on the tissue to be removed, either of the procedures, fine needle aspiration or core needle biopsy of tissues are done. Sometimes guided aspiration is done to access deeper tissues.

After the procedure:

After the procedure, the biopsied area is covered with a bandage. Mild discomfort and pain may be present. If the procedure is done under general anesthesia, an individual is monitored until the vitals are stabilized. Instructions for applying pressure over the bandaged area to control bleeding are given. The collected sample is then sent for lab analysis.

Interpretation:

Pathologists and cytologists are specialists who interpret the results. The report consists of a detailed description of the biopsy sample, including the color and consistency of the samples and gross details. The cells that are observed under the microscope are also described in the report. The details contain the types of cells, conditions, and dyes used. Finally, the report ends with the diagnosis given by a pathologist as observed from the microscope. FNA results are obtained sooner than CNB results.

Risks and complications:

The risks and complications that come with this procedure are fewer, and it is a safe procedure. However, certain complications like fever, intense pain and, uncontrolled bleeding from the biopsy site, drainage of contents from the site can develop.

Conclusion:

Needle biopsy is a valuable diagnostic procedure for obtaining tissue samples from various body parts. It provides valuable diagnostic information for the diagnosis and treatment plan. It is a safe, effective tool with minimal risks for managing various body diseases and cancers.

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