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What is a biopsy?

A biopsy is a procedure in which a small piece of body tissue is removed for the purpose of microscopic examination. The size of the sample varies depending on the organ from which it is taken and the nature of the illness. The procedure may require a local or general anaesthetic.

Once a biopsy specimen is obtained, it is sent to a pathologist who will examine it and provide a report describing the specimen and suggesting the most likely diagnosis.

Types of biopsies

A biopsy can be performed on any organ in the body. Brief descriptions of the some of the more common types of biopsies follow:

 1) Fine Needle Aspiration (FNA) Biopsy

This simple technique is often used for breast lumps. A fine gauge needle is inserted into a lump and some cells are drawn up into a syringe and then smeared on a microscope slide and sent to a pathologist for examination. The procedure takes only a few minutes .

Usually the procedure is not very painful and local anaesthetic in the skin also may helpful.

FNA biopsies can also be done for deep organs (such as the liver, for example), usually under guidance by ultrasound or CT scan and performed by a radiologist.

 2) Endoscopic biopsy

This type of biopsy is performed at the time of having an endoscopy, for example gastroscopy (examination of the stomach)or colonoscopy(large bowel). A doctor performing an endoscopy might see an abnormal area and be able to take small pieces of tissue with a pair of forceps attached to a long cable which runs inside the fibreoptic endoscope.

 3) Punch biopsy

This technique is often used to sample skin rashes and small lumps. After injection of local anaesthetic, a small cylindrical piece of tissue is removed with the use of a specially designed instrument.

 4) Bone Marrow Biopsy

As blood cells are manufactured in the bone marrow, a bone marrow biopsy may be required in some cases of abnormal blood counts. In adults, the sample is usually taken from the pelvic bone. The procedure involves the patient lying on his/her stomach and having a local anaesthetic injection in a buttock, before a needle is inserted through the skin into the bone marrow and cells are drawn up by suction from the syringe. This part of the procedure (aspiration) is often followed by a 'core biopsy', which involves using a slightly larger needle to extract core of bone. The aspiration is usually the more painful part.