Biopsy

What It Is

A biopsy is a test that's performed to examine tissue or cells from a part of the body. It can be done by cutting or scraping a small piece of the tissue or by withdrawing a sample of tissue with a needle and syringe.

Sometimes, needle biopsies are done in a radiology department so the tissue can be seen with an ultrasound or CAT scan (also called a CT scan or computed axial tomography scan) to show exactly where to insert the needle.

Other biopsies may be done by inserting a tiny telescope into the body, such as an endoscope into the esophagus and stomach, or a laparoscope into the belly. Other times, surgery might be required to reach an organ that needs to be biopsied (called an open biopsy).

Why It's Done

Doctors order biopsies when they're concerned about a problem in a particular organ. A biopsy is performed to look for a disease or condition such as an infection, inflammation, or cancer.

Some commonly biopsied organs include bone marrow, liver, kidney lymph nodes, skin, esophagus, stomach and other parts of the digestive tract, and muscle tissue.

Preparation

After the procedure is explained to you, you'll have time to get all of your questions answered. You'll then be asked to sign an informed consent form — this states that you understand the procedure and its risks and alternatives and give your permission for it to be performed.

The person doing the biopsy will know your child's medical history, but might ask additional questions, such as what medicines your child is taking or whether your child has any allergies. Be sure to report any bleeding tendencies in your child, and whether your daughter might be pregnant.

Some biopsies require only local anesthesia. Others require sedation or general anesthesia. If that's the case, your child will need to stop eating and drinking at a certain point before the procedure to make sure his or her stomach is empty. Sedation and anesthesia medications are given through an IV line (intravenous tube) to help your child stay asleep during the entire test.

Depending on the procedure, you might be able to stay in the room with your child during the procedure for reassurance and support or you might need to step outside to a waiting area.

Procedure

The time required for a biopsy varies according to the specific type of biopsy. For example, a simple skin biopsy usually takes just a few minutes, while a bone marrow biopsy can take half an hour. Biopsies requiring surgery can take much longer.

The technique of the procedure will vary according to the type of biopsy. For example, in a skin biopsy, the skin is cleaned and then numbed with a local anesthetic. Then a small piece of tissue is cut away and stitches will be placed to close the wound, if needed.

In a needle biopsy (such as a bone marrow or liver biopsy), the skin is also cleaned and numbed, and a needle is inserted through the skin to obtain the tissue. Additional numbing medication may be necessary once the needle has gone through the skin into the soft tissues.

In an endoscopic biopsy, a small pinching instrument at the end of the endoscope is used to snip off a small tissue sample. In a biopsy performed during open surgery, your child will be receiving general anesthesia. While asleep, an incision is made in the skin and soft tissues, and a sample of tissue is cut directly from an exposed organ.

Getting the Results

A pathologist (a doctor with expertise in interpreting biopsy samples) will look at the tissue under a microscope and then give the information to your doctor, who will go over the results with you.

In an emergency, the results of a biopsy can usually be available quickly. Otherwise, they're usually ready in several days. In most cases, results can't be given directly to the patient or family at the time of the test.

If an infection is suspected, a culture is sent to a lab and results are usually available in 48 hours. A doctor may start antibiotic treatment while waiting for the results.

Risks

A biopsy is considered a safe procedure with minimal risks. In most cases, there are no complications. In some instances, there may be some discomfort or pain at the biopsy site for a day or two. Rarely, infection or bleeding can occur.

In very rare cases, anesthesia can cause complications (such as irregular heart rhythms, breathing problems, and allergic reactions to medications). The risks depend on the kind of procedure, the condition of the patient, and the type of anesthesia used.

Helping Your Child

You can help prepare your child for a biopsy by explaining that while the test might be uncomfortable, it won't take long. And if sedation or anesthesia is involved, explain that a medicine will be given to induce deep sleep so he or she won't feel anything during the procedure.

Explain the biopsy in simple language, and make sure your child understands where on the body it will be performed. After the procedure, make sure your child rests and follows any other instructions the doctor gives you.

If You Have Questions

If you have questions about the biopsy, speak with your doctor.