Pathology

Anatomical Pathology Overview

What is anatomical pathology?

Anatomical pathology is the study of organs and tissues to determine the causes and effects of particular diseases. Today, with advanced technology, a tissue specimen can be obtained from almost any organ or any part of the body by using various biopsy techniques. Biopsies can be taken during surgery or during an autopsy (an after-death examination).

What is a biopsy?

A biopsy is a procedure performed to remove tissue or cells from the body for examination under a microscope. Some biopsies can be performed in a physician's office, others need to be done in a hospital setting. In addition, some biopsies require use of an anesthetic to numb the area, while others do not require any sedation.

Biopsies are usually performed to determine whether a tumor is malignant (cancerous) or to determine the cause of an unexplained infection or inflammation.

How is a biopsy performed?

A biopsy can be obtained in various ways, depending on the type of specimen needed. Flexible endoscopes (flexible fiberoptic tube with a viewing lens and lights) allow a surgeon to view the inside of the body through a small incision and take a tissue sample. Tissue samples are usually small and taken from tissue that appears changed in structure, such as a tumor.

Types of biopsies:

excisional or incisional biopsy
This type of biopsy is often used when a wider or deeper portion of the skin is needed. Using a scalpel (surgical knife), a full thickness of skin is removed for further examination, and the wound is sutured (with surgical thread).

When the entire tumor is removed, it is called excisional biopsy technique. If only a portion of the tumor is removed, it is called incisional biopsy technique. Excisional biopsy is the method usually preferred when melanoma is suspected.

fine needle aspiration (FNA) biopsy
This type of biopsy involves using a thin needle to remove very small pieces from a tumor. Local anesthetic is sometimes used to numb the area, but the test rarely causes much discomfort and leaves no scar.

FNA is not used for diagnosis of a suspicious mole, but may be used to biopsy large lymph nodes near a melanoma to see if the melanoma has metastasized (spread). A computed tomography scan (CT or CAT scan) -- an x-ray procedure that produces cross-sectional images of the body -- may be used to guide a needle into a tumor in an internal organ such as the lung or liver.

punch biopsy
Punch biopsies involve taking a deeper sample of skin with a biopsy instrument that removes a short cylinder or "applecore" of tissue. After a local anesthetic, the instrument is rotated on the surface of the skin until it cuts through all the layers including the dermis, epidermis, and the most superficial parts of the subcutis (the fat).

shave biopsy
This type of biopsy involves removing the top layers of by shaving it off. It is also performed with a local anesthetic.

skin biopsy
Skin biopsies involve removing a sample of skin for examination under the microscope to determine if melanoma is present. The biopsy is performed under local anesthesia. The patient usually just feels a small needle stick and a little burning for about a minute, with a little pressure, but no pain.

Following a biopsy, the tissue specimen is sent to one of the following areas of anatomical pathology to be examined and analyzed:

Surgical Pathology
Cytology
Autopsy

This page was last updated on: October 18, 2007.