A biopsy is a procedure that removes cells or tissue from your body. If your doctor suspects you may have cancer or another disease, she may order a biopsy for you. Learn about the types of biopsies and more.
Prostate Specific Antigen (PSA), Core Biopsy
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What Is a Biopsy?
Cancer Biopsy
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Cancer Biopsy
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Biopsy
A biopsy is a procedure that removes cells or tissue from your body. A doctor called a pathologist looks at the cells or tissue under a microscope to check for damage or disease. The pathologist may also do other tests on it.
Biopsies can be done on all parts of the body. In most cases, a biopsy is the only test that can tell for sure if a suspicious area is cancer. But biopsies are performed for many other reasons too.
There are different types of biopsies. A needle biopsy removes tissue with a needle passed through your skin to the site of the problem. Other kinds of biopsies may require surgery.
Source: NIH MedlinePlus Magazine
Additional Materials (37)
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Cancer Biopsy
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Cancer Biopsy
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Prostate Biopsy Procedure
If cancer is suspected because something is felt during a digital rectal exam (DRE), or if PSA levels are elevated, small samples of tissue may be biopsied from the prostate. The current standard for biopsy is the transrectal ultrasound (TRUS) method. Guided by ultrasound, a biopsy gun containing spring-loaded hollow needles takes 6-12 core samples from the prostate through the rectum. For larger prostates, many more core samples
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Prostate Specific Antigen (PSA), Core Biopsy
Prostate Specific Antigen (PSA), Core Biopsy: The prostate gland contributes fluid that helps carry ensure survival of sperm in the vaginal tract; the fluid contains a protein called prostate-specific antigen (PSA). Normally, very little of this protein is found in the blood, but higher levels of PSA are associated with prostate cancer. A PSA test does not detect cancer cells, however; a biopsy, typically performed with a needle, is still necessary for a positive diagnosis of prostate cancer. Guided by ultrasound, a biopsy gun containing spring-loaded hollow needles takes 6-12 core samples from the prostate through the rectum. For larger prostates, many more core samples
Image by TheVisualMD
Breast Cancer Biopsy
Dr. Gillian Newstead, breast radiologist at The University of Chicago Medical Center, discusses the use of MRI to stage breast cancer, which determines the growth and spread of the disease.
Image by TheVisualMD
Standard Biopsy for Prostate Cancer
National Cancer Institute urologist and surgeon Dr. Peter Pinto explains the process of the standard multi-core or "blind" biopsy of the prostate.
Image by TheVisualMD
Sentinel Lymph Node Biopsy
This is a picture of the first radio-guided sentinel lymph node biopsy using real-time imaging by means of a portable gamma camera (Sentinella) in a patient with colon cancer
Image by Juliommayol
Drawing of a liver biopsy procedure and a slide with tissue sample, with the text- A small, slender core of tissue is removed with a biopsy needle and looked at through a microscope
Liver biopsy
Image by NIDDK Image Library
Liver biopsy - High magnification micrograph of congestive hepatopathy, also known as nutmeg liver and cardiac cirrhosis.
High magnification micrograph of congestive hepatopathy, also known as nutmeg liver and cardiac cirrhosis. Liver biopsy. Trichrome stain.
Congestive hepathopathy is characterized by:
Perisinusoidal fibrosis,
Hepatic venule dilation, and
Dilation of the sinusoids in zone III (centrilobular).
Image by Nephron
Skin Biopsy
Image by Bart Everson
Punch Biopsy
Empty pilar cyst removed from the scalp of a woman through a small punch biopsy hole through the scalp.
Image by Northerncedar (talk)
Liquid Biopsy
Liquid Biopsy Description: Liquid biopsy is a noninvasive technique that can detect disease biomarkers in blood, urine, and sputum.
Image by National Cancer Institute (NCI)
Transrectal ultrasound with prostate biopsy
Drawing of a transrectal ultrasound with prostate biopsy, showing a needle and needle guide inserted in the rectum. The bladder, transducer, and needle guide are labeled. Inset of enlarged view of prostate with needle inserted.
Image by NIDDK Image Library
Cross-section diagram of transrectal prostate biopsy with ultrasound probe guiding the needle to the prostate. An inset shows a close-up of a needle entering the prostate
Transrectal ultrasound and prostate biopsy
Image by NIDDK Image Library
Cross-section diagram of a transrectal prostate biopsy with an untrasound probe guiding the needle to the prostate
Tranrectal ultrasound and prostate biopsy
Image by NIDDK Image Library
Drawing of a biopsy needle collecting prostate tissue, including tissue from a suspected tumor
The biopsy needle collects prostate tissue for examination with a microscope.
Image by NIDDK Image Library
CT-guided biopsy of an unclear pulmonary focus to clarify the question of whether a primary tumor or metastasis in a known history of colorectal cancer. Lung window. Use of a coaxial system. Small bleeding behind the focus from the first biopsy via the same guide cannula.
CT-guided biopsy of an unclear pulmonary focus to clarify the question of whether a primary tumor or metastasis in a known history of colorectal cancer. Lung window. Use of a coaxial system. Small bleeding behind the focus from the first biopsy via the same guide cannula.
Image by Hellerhoff/Wikimedia
Biopsy centronuclear myopathy HE
Muscle biopsy of a 70-year old female showing histological picture of centrunuclear myopathy, am adult-onset congenital myopathy.
Image by Jensflorian/Wikimedia
Targeted Prostate Biopsy & Treatment
Leonard S. Marks, M.D. diagram of targeted prostate biopsy and treatment.
Image by Mmshabot/Wikimedia
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Transperineal Prostate biopsy - Image 2
Diagram showing a transperineal prostate biopsy
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transperineal prostate biopsy - Image 1
Diagram showing a transperineal prostate biopsy
Image by Cancer Research UK uploader
Bone Marrow Biopsy
Diagram showing a bone marrow biopsy.
Image by Cancer Research UK / Wikimedia Commons
Kidney biopsy (electron microscopy)
Kidney biopsy (electron microscopy): glycosphingolipid inclusions of various size and shape are seen in the cells of distal tubules of the kidney in Fabry disease.
Image by Juan M. POLITEI, Buenos Aires, Argentina; Dominique P Germain
High magnification micrograph of Crohn's disease, Biopsy of colon
High magnification micrograph of Crohn's disease, Biopsy of colon
Image by Nephron
Bone marrow core biopsy microscopy panorama
Section of bone marrow core biopsy as seen under the microscope.
Image by Gabriel Caponetti
CT slide of biopsy-proven bronchiolitis obliterans organizing pneumonia (biopsy-proven)
Image by MBq
Liver biopsy of glycogen storage disorder PAS positive
Liver biopsy of Glycogen Storage Disorder showing uniformly distended hepatocytes with clear to pale eosinophilic cytoplasm due to intracytoplasmic accumulation of glycogen giving a positive PAS reaction, 20X
Image by Department of Pathology, Calicut Medical College/Wikimedia
Hemoxylin & eosin stained muscle biopsy showing variable muscle fibre sizes in an 8 year old male with EDMD. This biopsy was taken from the deltoid muscle.
Image by Ekabe, C.J., Kehbila, J., Sama, C. et al./Wikimedia
Disposable Biopsy Punch-6 mm
Disposable Biopsy Punch-6 mm
Image by Ajay Kumar Chaurasiya/Wikimedia
Graphical scheme of the possible therapeutic platform that translates EVs for liquid biopsy and drug delivery in the scenario of personalized medicine
Graphical scheme of the possible therapeutic platform that translates EVs for liquid biopsy and drug delivery in the scenario of personalized medicine. Note: HCC = hepatocellular carcinoma; CTC = circulating tumor cells; RBC = red blood cells; WBC = white blood cells; Exos = exosomes, ctDNA = circulating free tumor DNA.
Image by D’Agnano, I.; Berardi, A.C./Wikimedia
Skin punch biopsy of Buruli ulcer plaque lesion, H&E and Ziehl-Neelsen stain
From source: "Characteristic histopathological features of tissue samples taken before start of antibiotic treatment.
Histological sections were stained either with Haematoxylin-Eosin (HE) (A, C–E), Ziehl-Neelsen (counterstain methylenblue) (ZN) (B) .. A: Punch biopsy with large necrotic areas, fat cell ghosts and oedema but relatively intact epidermis and dermis. B: a band of extracellular AFBs is present in a deep layer of the necrotic subcutis."
Image cropped from original by uploader.
Image by Ruf MT, Sopoh GE, Brun LV, Dossou AD, Barogui YT, et al./Wikimedia
Punch Biopsy
Punch Biopsy
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Needle biopsy
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Cancer Biopsy
TheVisualMD
Cancer Biopsy
TheVisualMD
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Prostate Biopsy Procedure
TheVisualMD
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Prostate Specific Antigen (PSA), Core Biopsy
TheVisualMD
Breast Cancer Biopsy
TheVisualMD
Standard Biopsy for Prostate Cancer
TheVisualMD
Sentinel Lymph Node Biopsy
Juliommayol
Drawing of a liver biopsy procedure and a slide with tissue sample, with the text- A small, slender core of tissue is removed with a biopsy needle and looked at through a microscope
NIDDK Image Library
Liver biopsy - High magnification micrograph of congestive hepatopathy, also known as nutmeg liver and cardiac cirrhosis.
Nephron
Skin Biopsy
Bart Everson
Punch Biopsy
Northerncedar (talk)
Liquid Biopsy
National Cancer Institute (NCI)
Transrectal ultrasound with prostate biopsy
NIDDK Image Library
Cross-section diagram of transrectal prostate biopsy with ultrasound probe guiding the needle to the prostate. An inset shows a close-up of a needle entering the prostate
NIDDK Image Library
Cross-section diagram of a transrectal prostate biopsy with an untrasound probe guiding the needle to the prostate
NIDDK Image Library
Drawing of a biopsy needle collecting prostate tissue, including tissue from a suspected tumor
NIDDK Image Library
CT-guided biopsy of an unclear pulmonary focus to clarify the question of whether a primary tumor or metastasis in a known history of colorectal cancer. Lung window. Use of a coaxial system. Small bleeding behind the focus from the first biopsy via the same guide cannula.
Hellerhoff/Wikimedia
Biopsy centronuclear myopathy HE
Jensflorian/Wikimedia
Targeted Prostate Biopsy & Treatment
Mmshabot/Wikimedia
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Transperineal Prostate biopsy - Image 2
Cancer Research UK uploader
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transperineal prostate biopsy - Image 1
Cancer Research UK uploader
Bone Marrow Biopsy
Cancer Research UK / Wikimedia Commons
Kidney biopsy (electron microscopy)
Juan M. POLITEI, Buenos Aires, Argentina; Dominique P Germain
High magnification micrograph of Crohn's disease, Biopsy of colon
Nephron
Bone marrow core biopsy microscopy panorama
Gabriel Caponetti
CT slide of biopsy-proven bronchiolitis obliterans organizing pneumonia (biopsy-proven)
MBq
Liver biopsy of glycogen storage disorder PAS positive
Department of Pathology, Calicut Medical College/Wikimedia
Image by National Cancer Institute / Linda Bartlett (Photographer)
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Needle Biopsy
Adult Black female breast visible. Physician's hands are seen performing a needle biopsy to determine nature of lump either fluid-filled cyst or solid tumor.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Biopsy
The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.
Source: National Cancer Institute (NCI)
Additional Materials (2)
Biopsy - What You Need To Know
Video by Rehealthify/YouTube
Biopsy
Lung biopsy guided by computertomography: Lung cancer. Lung biopsy in a case of suspected lung cancer under control of computer tomography.
Image by Hellerhoff
0:47
Biopsy - What You Need To Know
Rehealthify/YouTube
Biopsy
Hellerhoff
Breast Biopsy
Breast Biopsy
Also called: Biopsy of the Breast
A breast biopsy is a test that can confirm or rule out breast cancer. It is used if other breast tests or a physical exam show you might have breast cancer. There are three main types of breast biopsy procedures: fine-needle aspiration, core needle biopsy, and surgical biopsy.
Breast Biopsy
Also called: Biopsy of the Breast
A breast biopsy is a test that can confirm or rule out breast cancer. It is used if other breast tests or a physical exam show you might have breast cancer. There are three main types of breast biopsy procedures: fine-needle aspiration, core needle biopsy, and surgical biopsy.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal biopsy means that no cancer or abnormal cells were found.
Related conditions
A breast biopsy is a procedure that removes a sample of breast tissue so that it can be checked for signs of disease. A doctor called a pathologist looks at the tissue under a microscope to diagnose breast cancer and other breast diseases.
Breast cancer is cancer that forms in the milk ducts (tubes that carry milk to the nipple) and the lobules (the small lobes of breast tissue that make milk). Breast cancer is much more common in women, but men can get it, too. Not much is known about breast cancer risk in transgender people. If you are transgender, talk with your provider about your risk.
There are different ways to do a breast biopsy. Some methods remove breast tissue with a needle and others use a small incision (cut) in your skin to remove part or all of the suspicious tissue.
Most people who need a breast biopsy don't have cancer.
Other names: core needle biopsy; core biopsy, breast; fine-needle aspiration; open surgery biopsy
A breast biopsy is the only way to find out whether a suspicious change in your breast is cancer. You may have a biopsy after other breast tests, such as a physical breast exam or a mammogram, show signs that could be breast cancer.
You may need a breast biopsy if:
You or your health care provider felt a lump, thickening, or other change in your breast.
A mammogram, ultrasound, or MRI test shows a lump, calcium deposits, or other signs that might mean cancer.
The skin on your breast or nipple is red, scaly, or swollen, or your nipple is pulled inward.
You have a discharge of abnormal fluid coming from your nipple.
If your provider suggests that you have a breast biopsy, it doesn't mean you have breast cancer. Most breast lumps and other changes that are checked with biopsies turn out to be benign, which means they are not cancer.
There are three main types of breast biopsy procedures. They are usually done on an outpatient basis, which means you go home the same day:
Fine needle aspiration biopsy uses a very thin needle to remove a sample of breast cells or fluid. The biopsy takes about 15 minutes.
Core needle biopsy uses a wide needle to remove one or more small tissue samples about the size of a grain of rice. Sometimes a small vacuum probe is used instead of a needle. The device gently suctions some tissue and removes it with a small rotating blade. A core needle biopsy takes between 15 minutes and an hour, depending on how it's done.
Surgical biopsy (or open biopsy) is surgery to remove all or part of a lump. The biopsy usually takes about an hour.
Biopsies are often done using mammography, ultrasound, MRI, or x-rays to help see exactly where to take the tissue sample. Your procedure will vary depending on which method is used to guide the biopsy, but the general steps are usually the same.
For a fine needle aspiration biopsy or a core needle biopsy:
Your provider will clean the skin on your breast and give you a shot of medicine to numb the area, so you won't feel any pain. The shot may sting briefly.
You may be sitting or lying down. If images are used to guide the biopsy, you may lie on your side, back, or belly with your breast over an opening on the table.
For a fine needle aspiration biopsy, your provider will insert the needle into the biopsy site and remove a sample of cells or fluid. For a core biopsy, a tiny cut may be made to insert a wide needle or a vacuum device. You may feel a little pressure when the sample or samples are removed.
Pressure will be applied to area until the bleeding stops.
Your provider will cover the biopsy site with a sterile bandage. If you had a small incision, small strips of medical tape may be used to close the wound.
For a surgical biopsy:
You'll lie on an operating table. You may have an IV (intravenous line) in your arm or hand that may be used to give you medicine to relax. The skin over the biopsy area will be cleaned.
To prevent pain, you'll have either:
A shot of medicine to numb your breast. The shot may sting briefly.
General anesthesia, which is medicine given through an IV to make you sleep.
When you are numb or asleep, the surgeon will make a small cut in your breast tissue to remove part or all of the lump. In certain cases, tissue around the lump may also be removed. This may help avoid the need for more surgery if cancer cells are found in the lump.
The cut in your skin will be closed with small strips of medical tape or stitches and covered with a sterile bandage.
The type of biopsy you have will depend on:
The size and location of the suspicious tissue in your breast
How many areas of your breast are involved
How abnormal the tissue looks on a mammogram or other image
Your general health and preferences
Ask your provider about why you need a biopsy and which type is right for you.
Your provider will give you instructions for how to prepare for your biopsy. If you take any blood thinners, including aspirin, you may need to stop taking them before your biopsy. Tell your provider about all the medicines and supplements you take. Don't stop or start taking anything without talking with your provider first.
If you're having general anesthesia, you will probably need to fast (not eat or drink) for several hours before surgery. If you have general anesthesia or medicine to relax, you may be groggy after the procedure, so plan to have someone take you home.
It's common to have some bruising and temporary discomfort after a breast biopsy. Possible risks include:
Infection, which can be treated with antibiotics
Bleeding
Your provider will give you instructions for how to care for biopsy area and manage any discomfort. If you're having general anesthesia, talk with your provider about how it may affect you. General anesthesia is very safe even for most people with other health conditions.
It may take several days to a week to get your biopsy results. The results are called a pathology report. The report is written for your provider and will include a lot of medical terms. Your provider can explain what your report means.
The most important part of your report will be the diagnosis. In general, your results will be one of these categories:
Normal. No cancer or abnormal cells were found.
Abnormal breast changes that aren't cancer and don't increase your risk for breast cancer. Some of these conditions often get better on their own and others may need treatment.
Abnormal breast changes that increase your risk for breast cancer. These cells are not cancer, but if you have them, you are more likely to develop cancer.
If you had a needle biopsy that diagnosed a condition that increases your breast cancer risk, you may need a surgical biopsy to remove all the abnormal tissue. To find out what you can do to reduce your breast cancer risk, you will likely see a doctor who specializes in breast cancer.
Breast cancer. If your biopsy finds cancer cells, your report will include details about how fast the cancer cells are growing, how much they look like normal cells, and other information to help plan the most effective treatment for your type of cancer. Usually, a doctor who specializes in breast cancer will provide your care.
Breast Biopsy: MedlinePlus Medical Test [accessed on Mar 22, 2022]
Having a Breast Biopsy | Effective Health Care (EHC) Program [accessed on Mar 22, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (13)
PreOp® Breast Biopsy Wire Guide Patient Education - Patient Engagement
Video by PreOp.com Patient Engagement - Patient Education/YouTube
How a core breast biopsy is taken
Video by Bupa Health UK/YouTube
Stereotactic Biopsies for Breast Evaluation | UPMC Magee-Womens Hospital
Video by UPMC/YouTube
What It’s Like to Get a Breast Biopsy
Video by RAYUS Radiology™/YouTube
Ultrasound-guided core-needle breast biopsy
Video by Institute for Cancer Genetics and Informatics/YouTube
Having a breast biopsy. A review of the research for women and thier families (2016 report)
This information is right for you if: -- You are a woman. The information in this summary is from
research on women. -- Your doctor has found a breast lump or shadow on your mammogram and has recommended a breast biopsy.
Document by effectivehealthcare.ahrq.gov
Ultrasound Guided Breast Biopsy 1
Ultrasound image of possible breast tumor before biopsy. The procedure is performed by a radiologist and sonographer. A local anesthetic is injected into the breast. The transducer is pressed to the breast and the suspicious area is located. The biopsy needle is inserted in the breast and guided in realtime by watching its movement through the breast on a computer monitor. The tissue sample is taken and the needle is removed.
Image by TheVisualMD
Ultrasound Guided Breast Biopsy 2
Ultrasound image of possible breast tumor showing core needle penetrating suspicious breast lesion during biopsy. The procedure is performed by a radiologist and sonographer. A local anesthetic is injected into the breast. The transducer is pressed to the breast and the suspicious area is located. The biopsy needle is inserted in the breast and guided in realtime by watching its movement through the breast on a computer monitor. The tissue sample is taken and the needle is removed.
Image by TheVisualMD
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Needle Biopsy
Adult Black female breast visible. Physician's hands are seen performing a needle biopsy to determine nature of lump either fluid-filled cyst or solid tumor.
Image by National Cancer Institute / Linda Bartlett (Photographer)
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Biopsy
A Caucasian woman patient is being operated on. Her nipple is being incised by the surgeon. The male surgeon and an operating room attendant are visible. A surgical biopsy is being performed to determine exact nature of solid tumor.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Breast Biopsy
Image Caption : Needle Breast Biopsy
Image by BruceBlaus
Mammotome
Mammotome probe - biopsy
Image by Waglione/Wikimedia
This browser does not support the video element.
Breast Cancer Biopsy
If a woman has symptoms of breast cancer (such as a lump), or if a suspicious area is found in an imaging exam, the next step is to physically examine the breasts by noting any changes in their appearance and palpating the breast and the underarm region. A complete physical exam may be done as well. If symptoms or results of these exams suggest cancer might be present, then further tests will be done. (Note: The following diagnostic procedures are common to the US; procedures may vary in other countries.)
Video by TheVisualMD
2:22
PreOp® Breast Biopsy Wire Guide Patient Education - Patient Engagement
Stereotactic Biopsies for Breast Evaluation | UPMC Magee-Womens Hospital
UPMC/YouTube
3:57
What It’s Like to Get a Breast Biopsy
RAYUS Radiology™/YouTube
1:29
Ultrasound-guided core-needle breast biopsy
Institute for Cancer Genetics and Informatics/YouTube
Having a breast biopsy. A review of the research for women and thier families (2016 report)
effectivehealthcare.ahrq.gov
Ultrasound Guided Breast Biopsy 1
TheVisualMD
Ultrasound Guided Breast Biopsy 2
TheVisualMD
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Needle Biopsy
National Cancer Institute / Linda Bartlett (Photographer)
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Biopsy
National Cancer Institute / Linda Bartlett (Photographer)
Breast Biopsy
BruceBlaus
Mammotome
Waglione/Wikimedia
0:56
Breast Cancer Biopsy
TheVisualMD
Kidney Biopsy
Kidney Biopsy
Also called: Renal Biopsy, Biopsy - Kidney
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. The tissue is examined for signs of kidney disease or infection. It can also be used to check for cancer or other abnormalities.
Kidney Biopsy
Also called: Renal Biopsy, Biopsy - Kidney
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. The tissue is examined for signs of kidney disease or infection. It can also be used to check for cancer or other abnormalities.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result is when the kidney tissue shows normal structure.
Related conditions
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. A pathologist—a doctor who specializes in diagnosing diseases—examines the kidney tissue sample in a lab. The pathologist looks for signs of kidney disease or infection. If the kidney has been transplanted and is not working, a kidney biopsy may help identify the cause.
A health care provider will perform a kidney biopsy to evaluate any of the following conditions:
hematuria—blood in the urine, which can be a sign of kidney disease or other urinary problems.
albuminuria—a condition in which the urine has more-than-normal amounts of a protein called albumin. Albuminuria may be a sign of kidney disease.
changes in kidney function, which can cause the buildup of waste products in the blood.
Health care providers may use a kidney biopsy to diagnose cancer. If cancer is present, there is a small chance that the biopsy needle will spread the cancer. In addition, the biopsy specimen is very small and may miss the cancer and, therefore, may not provide the right diagnosis.
A kidney biopsy is usually done in a hospital. An overnight stay may be needed to watch for any problems. You may be awake with only light sedation, or asleep under general anesthesia. You will be lying face down with a pillow under your rib cage. If the biopsy is done on a transplanted kidney, you will be lying on your back.
To prepare for a kidney biopsy talk with your doctor, have blood and imaging tests if needed, arrange for a ride home after the procedure, and follow your doctor’s instructions about about food or medication restrictions.
The risks of a kidney biopsy include
bleeding—the most common complication of a kidney biopsy. Bleeding may come from the kidney or the puncture site. Bleeding from the kidney rarely requires a blood transfusion.
infection—a rare complication of a kidney biopsy. Health care providers prescribe bacteria-fighting medications called antibiotics to treat infections.
The kidney tissue sample can show inflammation, scarring, infection, or unusual deposits of a protein called immunoglobulin. If a person has chronic kidney disease—any condition that causes reduced kidney function over a period of time—the biopsy may show how quickly the disease is advancing. A biopsy can also help explain why a transplanted kidney is not working properly.
https://www.niddk.nih.gov/health-information/diagnostic-tests/kidney-biopsy [accessed on Feb 19, 2019]
https://medlineplus.gov/ency/article/003907.htm [accessed on Feb 19, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (17)
Pyelonephritis (Kidney Infection)
Pain caused by Pyelonephritis
Image by Grook Da Oger
Drawing of the urinary tract showing simple kidney cysts (male figure)
Drawing of the urinary tract in the outline of a male figure. The kidneys, ureters, and bladder are labeled. An inset image from one of the kidneys shows simple cysts as raised bumps on the kidney. The simple cysts and ureter are labeled. Simple kidney cysts are abnormal, fluid-filled sacs that form in the kidneys.
Image by NIDDK Image Library
Kidney with ACKD
Drawing of a male torso with kidneys, ureters, bladder, and urethra labeled, and a drawing below of a kidney with sacs of fluid labeled as cysts. Acquired cystic kidney disease happens when a person's kidneys develop fluid-filled sacs called cysts.
Image by National Institute of Diabetes and Digestive and Kidney Diseases
Diagram of two kidneys (healthy vs polycystic)
The healthy kidney on the lower right is smooth. The polycystic kidney on the upper left has many fluid-filled sacs on the surface. Labels point to the ureter and cysts on the polycystic kidney. The polycystic kidney roughly retains the same shape as the healthy kidney.
Image by NIDDK Image Library
Peritoneal dialysis
Outline of a male figure receiving peritoneal dialysis. Labels point to the dialysis solution, catheter, space inside the belly, lining of the belly and tube to drain bag.
Image by NIDDK Image Library
Kidneys and urinary tract within the outline of a young boy
Drawing of the kidneys and urinary tract within the outline of a young boy. The kidneys, ureters, and bladder are labeled. The kidneys remove wastes and extra water from the blood to form urine.Urine flows from the kidneys to the bladder through the ureters.
Image by NIDDK Image Library
Front-view drawing of a normal urinary tract in an infant
Front-view drawing of a normal urinary tract in an infant. The kidneys, ureters, bladder, and urethra are labeled. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra.
Image by NIDDK Image Library
Drawing of a pelvic ectopic kidney labeled
Drawing of a pelvic ectopic kidney labeled, showing the pelvis, bladder, ureters, and kidneys. The kidney on the right is in the normal position, several inches above the bladder. The kidney on the left is an ectopic kidney, just a couple of inches above the bladder. An ectopic kidney may remain in the pelvis, near the bladder.
Image by NIDDK Image Library
Drawing of a fused ectopic kidney, labeled
Drawing of a fused ectopic kidney, showing the pelvis, bladder, ureters, and fused kidneys. The kidney that would normally be on the left has crossed over and fused with the kidney on the right. An ectopic kidney may cross over and become fused with the other kidney.
Image by NIDDK Image Library
Drawing of pelvic ectopic kidney
An ectopic kidney may remain in the pelvis, close to the bladder.
Image by NIDDK Image Library
Drawing of urinary tract in an outline of the top half of a human body. Inset of one kidney and the bladder and one kidney, nonworking kidney, and the bladder
When a person has only one kidney or one working kidney, this kidney is called a solitary kidney. People born with kidney dysplasia have both kidneys; however, one kidney does not function (top right). When a kidney is removed surgically due to disease or for donation, both the kidney and ureter are removed (bottom right).
Image by NIDDK Image Library
Solitary Kidney
Drawing of one kidney and the bladder.
Image by NIDDK Image Library
Healthy vs Damaged Kidney
A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
Urine Test for Albumin
If you are at risk for kidney disease, your provider may check your urine for albumin.
Albumin is a protein found in your blood. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better. Having albumin in the urine is called albuminuria.
A diagram showing a healthy kidney with albumin only found in blood, and a damaged kidney that has albumin in both blood and urine.
A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
A health care provider can check for albumin in your urine in two ways:
Dipstick test for albumin. A provider uses a urine sample to look for albumin in your urine. You collect the urine sample in a container in a health care provider’s office or lab. For the test, a provider places a strip of chemically treated paper, called a dipstick, into the urine. The dipstick changes color if albumin is present in the urine.
Urine albumin-to-creatinine ratio (UACR). This test measures and compares the amount of albumin with the amount of creatinine in your urine sample. Providers use your UACR to estimate how much albumin would pass into your urine over 24 hours. A urine albumin result of
30 mg/g or less is normal
more than 30 mg/g may be a sign of kidney disease
If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. Talk with your provider about what your specific numbers mean for you.
If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you. A urine albumin level that stays the same or goes down may mean that treatments are working.
Image by The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Kidney and Urinary System
3D visualization reconstructed from scanned human data of the urinary system revealing anterior view of the kidneys, ureters and bladder. The urinary system is responsible for fluid balance and waste excretion. Blood enters the kidneys where waste products are excreted to form a fluid called filtrate. Filtrate continues to collect additional waste products and minerals as it travels through the winding tubules of the kidney. Eventually the filtrate becomes urine as it is channeled out of the kidney, into the ureters, down to the bladder and eventually out through the urethra to the external body.
Image by TheVisualMD
Right Kidney and Ureter
3D visualization based on scanned human data of the right kidney.
Image by TheVisualMD
Kidney with Blood Vessel
This 3D visualization reveals the vasculature of a kidney. Kidneys help to remove excess water and salts from the body and lower the volume of blood by producing the waste product, urine.
Image by TheVisualMD
Drawing of a kidney with an inset of a nephron
The glomeruli are sets of looping blood vessels in nephrons--the tiny working units of the kidneys that filter wastes and remove extra fluid from the blood.
Image by NIDDK Image Library
Pyelonephritis (Kidney Infection)
Grook Da Oger
Drawing of the urinary tract showing simple kidney cysts (male figure)
NIDDK Image Library
Kidney with ACKD
National Institute of Diabetes and Digestive and Kidney Diseases
Diagram of two kidneys (healthy vs polycystic)
NIDDK Image Library
Peritoneal dialysis
NIDDK Image Library
Kidneys and urinary tract within the outline of a young boy
NIDDK Image Library
Front-view drawing of a normal urinary tract in an infant
NIDDK Image Library
Drawing of a pelvic ectopic kidney labeled
NIDDK Image Library
Drawing of a fused ectopic kidney, labeled
NIDDK Image Library
Drawing of pelvic ectopic kidney
NIDDK Image Library
Drawing of urinary tract in an outline of the top half of a human body. Inset of one kidney and the bladder and one kidney, nonworking kidney, and the bladder
NIDDK Image Library
Solitary Kidney
NIDDK Image Library
Healthy vs Damaged Kidney
The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Kidney and Urinary System
TheVisualMD
Right Kidney and Ureter
TheVisualMD
Kidney with Blood Vessel
TheVisualMD
Drawing of a kidney with an inset of a nephron
NIDDK Image Library
Liver Biopsy
Liver Biopsy
Also called: Biopsy of the Liver
A liver biopsy is a procedure that removes a small sample of liver tissue for testing. The tissue is looked at under a microscope to check for signs of damage or disease.
Liver Biopsy
Also called: Biopsy of the Liver
A liver biopsy is a procedure that removes a small sample of liver tissue for testing. The tissue is looked at under a microscope to check for signs of damage or disease.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
The liver tissue is normal.
Related conditions
A liver biopsy is a procedure in which a doctor takes a small piece of tissue from your liver. A pathologist will examine the tissue with a microscope to look for signs of damage or disease. A biopsy can be done in different ways.
Doctors use liver biopsy to
diagnose liver diseases when doctors can’t confirm a diagnosis with blood or imaging tests
find out how severe the liver damage or disease is
help determine the best treatment for liver damage or disease
find out how a treatment for liver disease is working
Doctors perform a liver biopsy at a hospital or outpatient center. Depending on the liver biopsy type, doctors take the sample of liver tissue in a different way.
Procedures used to collect the sample of cells or tissues include:
Percutaneous liver biopsy: A procedure in which a long needle is introduced through the skin of your chest or abdomen. The needle removes 2 or 3 small samples of liver tissue. This procedure is usually performed on an outpatient basis. If you have a history of bleeding problems your doctor may want to perform a transjugular biopsy.
Transjugular liver biopsy: A transjugular liver biopsy is often advised for people who have a problem with blood clotting or a large amount of fluid in their abdomen. It is done by an interventional radiologist, a doctor who specializes in this type of procedure. During a transjugular biopsy your doctor will insert a small tube into your jugular (neck) vein. X-rays will help guide the tube into a large vein in your liver. A small needle is inserted through the tube and into your liver. The needle removes 2 or 3 small samples of tissue.
Laparoscopic liver biopsy: This is where a special instrument known as a laparoscope, which allows doctors to view the liver (done in the OR by a surgeon), is inserted through a small cut in your abdomen. The laparoscope is a small tube with a camera on the end. The doctor will use instruments attached to the laparoscope to remove tissue samples from your liver. This technique is useful when the doctor wants to take a biopsy from a specific part of the liver. This is the least common type of liver biopsy.
To prepare for a liver biopsy talk with your doctor, have blood and imaging tests if needed, arrange for a ride home after the procedure, and follow your doctor’s instructions about fasting before the procedure.
The risks of liver biopsy include complications such as the following:
Internal bleeding
Pain
Infection
Collapsed lung
Complications from the sedation
Injury to the gallbladder or kidney
A liver biopsy shows how much scarring your liver has and will help your health care provider figure out what is causing the damage and how best to treat it.
Liver Biopsy | NIDDK [accessed on Jan 08, 2019]
Liver biopsy: MedlinePlus Medical Encyclopedia [accessed on Jan 08, 2019]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=92&contentid=P07696 [accessed on Jan 08, 2019]
https://www.hepatitis.va.gov/basics/liver-damage-tests.asp [accessed on Jan 08, 2019]
https://www.ncbi.nlm.nih.gov/books/NBK470567/ [accessed on Sep 19, 2019]
https://www.mayoclinic.org/tests-procedures/liver-biopsy/about/pac-20394576 [accessed on Sep 19, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (18)
Living with Hepatitis B
Video by Health Science Channel/YouTube
LIVER BIOPSY by Dr. Robert Gish
Video by Robert Gish/YouTube
Healthy liver (left) versus alcoholic liver disease (right)
Image by TheVisualMD
Gallbladder, Liver, and Pancreas
Gallbladder, Liver, and Pancreas
Image by Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436
Drawing of a liver biopsy procedure
Liver biopsy
Image by NIDDK Image Library
Drawing of a percutaneous liver biopsy, showing a liver within an outline of a male body, a needle pricking the liver tissue, and a slide with the tissue sample
Percutaneous liver biopsy is the most common type of liver biopsy.
Image by NIDDK Image Library
Drawing of a liver biopsy procedure and a slide with tissue sample, with the text- A small, slender core of tissue is removed with a biopsy needle and looked at through a microscope
Liver biopsy
Image by NIDDK Image Library
Nonalcoholic Fatty Liver Disease (NAFLD)
A comparison of a healthy liver (top) and an unhealthy, fatty liver (bottom). The liver is a large organ, about the size of a football, located in the upper right abdomen underneath the ribs. It plays a major part in many core bodily functions such as metabolism, digestion, and detoxification. However, consuming excess calories, especially in the form of refined sugars, can cause fat to be stored in the liver--leading to a condition known as nonalcoholic fatty liver (NAFLD). The excess fat can lead to inflammation of the liver, which can become scarred and hardened.
Image by TheVisualMD
Alkaline Phosphatase (ALP): Liver
Many types of liver damage, including cancer and blocked bile ducts, can elevate ALP levels. Among the factors that raise an individual's risk of liver damage are: obesity, alcoholism, exposure to hepatitis viruses, and medications toxic to the liver.
Image by TheVisualMD
Bilirubin, Direct: Liver
If bilirubin is not being attached to sugars (conjugated) in the liver and/or is not being adequately removed from the blood, it can mean that there is damage to your liver. Testing for bilirubin in the blood is therefore a good test of damage to your liver.
Image by TheVisualMD
Liver Cross Section Hepatocytes and vascularization
Liver Cross Section Hepatocytes and vascularization
Image by TheVisualMD
Hepatocytes (Liver Cells)
Most of the cells in the liver (80%) are hepatocytes, which operate like microscopic chemical factories. The liver is responsible for removing toxins, converting and storing sugars and lipids, regulating metabolism, and manufacturing key enzymes, hormones, and proteins, including those involved in blood clotting, as well as producing bile, which aids digestion, and most of body's supply of cholesterol (the rest comes from food).
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Female Digestive System Including Liver
Female Digestive System Including Liver
Image by TheVisualMD
Bone, Kidney, Liver
Bone, Kidney, Liver
Image by TheVisualMD
Liver and Lipoproteins
Liver and Lipoproteins
Image by TheVisualMD
Enlarged Liver, a Sign of Hemochromatosis
Enlarged Liver, a Sign of Hemochromatosis : Hemochromatosis is a genetic disease that causes the body to absorb too much iron. Because the body can't use or eliminate this extra iron, it's stored in organs, especially the liver, but also the heart and pancreas. Eventually, up to 20 times as much iron as normal can accumulate, which can lead to organ failure. Symptoms can include irregular heartbeat, cirrhosis, chronic fatigue, confusion, and hepatomegaly, the enlargement of the liver.
Image by TheVisualMD
Liver Biopsy
Document by National Digestive Diseases Information Clearinghouse
Healthy Liver / Fatty Liver
Normal Liver vs Fatty Liver
In nonalcoholic fatty liver disease (NAFLD) fat accumulates in the liver cells. NAFLD is most often found in people who are middle-aged and overweight or obese. About half of all obese kids are also thought to have nonalcoholic fatty liver disease.
Interactive by TheVisualMD
3:51
Living with Hepatitis B
Health Science Channel/YouTube
6:55
LIVER BIOPSY by Dr. Robert Gish
Robert Gish/YouTube
Healthy liver (left) versus alcoholic liver disease (right)
TheVisualMD
Gallbladder, Liver, and Pancreas
Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436
Drawing of a liver biopsy procedure
NIDDK Image Library
Drawing of a percutaneous liver biopsy, showing a liver within an outline of a male body, a needle pricking the liver tissue, and a slide with the tissue sample
NIDDK Image Library
Drawing of a liver biopsy procedure and a slide with tissue sample, with the text- A small, slender core of tissue is removed with a biopsy needle and looked at through a microscope
NIDDK Image Library
Nonalcoholic Fatty Liver Disease (NAFLD)
TheVisualMD
Alkaline Phosphatase (ALP): Liver
TheVisualMD
Bilirubin, Direct: Liver
TheVisualMD
Liver Cross Section Hepatocytes and vascularization
TheVisualMD
Hepatocytes (Liver Cells)
TheVisualMD
Sensitive content
This media may include sensitive content
Female Digestive System Including Liver
TheVisualMD
Bone, Kidney, Liver
TheVisualMD
Liver and Lipoproteins
TheVisualMD
Enlarged Liver, a Sign of Hemochromatosis
TheVisualMD
Liver Biopsy
National Digestive Diseases Information Clearinghouse
Normal Liver vs Fatty Liver
TheVisualMD
Skin Biopsy
Skin Biopsy
Also called: Skin Lesion Biopsy
A skin biopsy is a procedure that removes a small sample of skin for testing. Skin biopsies are used to check for skin cancer, skin infections, or skin disorders, such as psoriasis.
Skin Biopsy
Also called: Skin Lesion Biopsy
A skin biopsy is a procedure that removes a small sample of skin for testing. Skin biopsies are used to check for skin cancer, skin infections, or skin disorders, such as psoriasis.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
If your results are normal, it means no cancer or skin disease was found. If a skin lesion is benign (not cancer), you may not need any further treatment.
Related conditions
A skin biopsy is a procedure that removes a small sample of skin for testing. The procedure can help diagnose a skin lesion (an abnormal area of skin). The skin sample is looked at under a microscope to check for skin cancer, a variety of skin conditions, or skin infections. Only certain skin lesions need a biopsy. Your provider may be able to diagnose many types of lesions just by looking at them.
There are three main ways to do a skin biopsy. The type of biopsy you have depends on the location, size, and depth of the skin lesion:
A shave biopsy removes a sample from the top layers of skin with a razor blade or scalpel (a small cutting blade used for surgery). Your provider will do a shave biopsy if your condition appears to involve only the top layers of skin.
A punch biopsy uses a special tool with a round blade to remove the skin sample. Your provider will do a punch biopsy if your condition appears to involve the deep layers of skin.
An excisional biopsy uses a scalpel to remove all of the skin lesion, usually with some normal skin around it. The sample may include the full thickness of the skin along with fat below the skin.
Most skin biopsies can be done in a health care provider's office or other outpatient facility.
A skin biopsy is used to help diagnose a variety of skin conditions including:
Skin disorders such as psoriasis, eczema, actinic keratosis ("precancers"), and warts.
Bacterial or fungal infections of the skin.
Skin cancer. A biopsy can confirm or rule out whether a suspicious mole or other growth is cancer. If the result is cancer, the biopsy can show what type of skin cancer it is.
Skin cancer is the most common type of cancer in the United States. The two most common types of skin cancer are basal cell and squamous cell cancers. These cancers rarely spread to other parts of the body and can usually be cured with treatment. In many cases, the biopsy removes all the cancer, and no other treatment is needed.
The most serious type of skin cancer is melanoma. It's more likely than other skin cancers to spread to other parts of your body, including to your organs. Most deaths from skin cancer are caused by melanoma.
A skin biopsy can help diagnose skin cancer in the early stages, when it's easier to treat.
You may need a skin biopsy if you have certain skin symptoms, such as:
A rash that doesn't go away
Scaly or rough skin
Open sores that won't heal
A mole or skin growth that has changed in its shape, color, or size
A mole or new growth that has the "A-B-C-D-Es" of melanoma:
Asymmetrical - the shape is not regular
Border - the edge is jagged
Color - the color is uneven
Diameter - the size is larger than a pea
Evolving - the mole or growth has changed in the past few weeks or months
Blistering skin, which may be a sign of pemphigus, an autoimmune disease
A provider will clean the site and give you an injection (shot) to numb your skin so you won't feel any pain.
For a punch biopsy:
A provider uses a special tool with a hollow, round blade. The blade is placed over the abnormal skin area (lesion) and rotated to remove a small piece of skin about the size of a pencil eraser.
The sample is lifted out with another tool.
If a larger skin sample is taken, you may need one or two stitches to close the wound.
Pressure will be applied to the wound until the bleeding stops.
The wound will be covered with a bandage.
A punch biopsy is often used to diagnose rashes.
For a shave biopsy:
A provider will use a razor or a scalpel to remove a sample from the top layer of your skin.
To help stop the bleeding, pressure will be applied to the wound, or medicine may be spread over the wound.
The wound will be covered with a bandage.
A shave biopsy is often used if your provider thinks you may have basal cell or squamous cell skin cancer or if you have a rash appears to affect only the top layer of your skin.
For an excisional biopsy:
A doctor will use a scalpel to remove the entire skin lesion, usually with some normal skin around it called "a margin." If the skin lesion is large, your provider may remove only a piece of it. This is called an incisional biopsy.
The doctor will close the wound with stitches.
Pressure will be applied to wound until the bleeding stops.
The wound will be covered with a bandage.
An excisional biopsy is often used if your provider thinks you may have melanoma, the most serious type of skin cancer. It may also be used for basal cell and squamous cell skin cancer.
After the biopsy, keep the area covered with a bandage until you've healed or until your stitches come out. If you had stitches, they will be taken out 3-14 days after the biopsy.
You don't need any special preparations for a skin biopsy.
You may have a little bruising, bleeding, or soreness at the biopsy site. If these symptoms last longer than a few days or they get worse, tell your provider.
Infection is possible, so it's important to keep the wound clean until it heals. Your provider will tell you how to care for your wound. You may have a scar after healing.
A normal biopsy result means no cancer or skin disease was found.
An abnormal biopsy result may diagnose a specific skin condition. But sometimes abnormal results aren't clear, and you may need more tests to find out exactly what condition you have. Your provider can explain what your results mean.
If your provider thinks you may have a basal cell or squamous cell cancer, the entire lesion may be removed during the biopsy. Often, the biopsy removes the entire cancer and no other treatment is needed.
If you are diagnosed with melanoma, you will need more tests to see if the cancer has spread. Then you and your health care provider can develop a treatment plan that's right for you.
Skin Biopsy: MedlinePlus Lab Test Information [accessed on Oct 05, 2022]
Skin lesion biopsy: MedlinePlus Medical Encyclopedia [accessed on Dec 20, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (14)
Punch Biopsy
Empty pilar cyst removed from the scalp of a woman through a small punch biopsy hole through the scalp.
Image by Northerncedar (talk)
Hyperkeratosis
Low magnification micrograph of lichen simplex chronicus. Skin biopsy.
Image by Nephron
Lichen simplex chronicus
Very low magnification micrograph of lichen simplex chronicus, abbreviated LSC. H&E stain. Skin biopsy.Features:
Image by Nephron
Stevens-Johnson syndrome
Very high magnification micrograph of confluent epidermal necrosis. Skin biopsy. H&E stain.
Image by Nephron
Under a medium magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the appearance of the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.
Kaposi sarcoma, is a malignant tumor of the lymphatic endothelium caused by the Human herpesvirus 8 (HHV8), i.e., Kaposi’s sarcoma-associated herpesvirus (KSHV), and arises from a cancer of the lymphatic endotheial lining. It is characterized by bluish-red cutaneous nodules. Kaposi’s sarcoma is thought of as an opportunistic infection, affecting patients whose immune systems have been compromised, as in the case of patients with HIV/AIDS.
Image by CDC/ Dr. Peter Drotman
Under a low magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the normal appearance of the most superficial epidermal layer on the far left, which was overlying the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.
Kaposi sarcoma, is a malignant tumor of the lymphatic endothelium caused by the Human herpesvirus 8 (HHV8), i.e., Kaposi’s sarcoma-associated herpesvirus (KSHV), and arises from a cancer of the lymphatic endotheial lining. It is characterized by bluish-red cutaneous nodules. Kaposi’s sarcoma is thought of as an opportunistic infection, affecting patients whose immune systems have been compromised, as in the case of patients with HIV/AIDS.
Image by CDC/Dr. Peter Drotman
This photomicrograph of a skin biopsy reveals some cytoarchitectural signs that are indicative of Kaposi's sarcoma.
The dermis contains a dense cellular infiltrate, and narrow slit-like vascular spaces that are characteristic in these KS lesions. KS is a cancer that is common in those who’ve developed the human immunodeficiency virus (HIV), or an AIDS infection.
Image by CDC/ Dr. Steve Kraus
Under medium magnification, this micrograph of a skin biopsy shows the cytoarchitectural changes found in Kaposi's sarcoma.
Note the thinning of the skin layers, most appreciably the dermis, which is reduced in thickness, and flattened due to the presence of a cellular subdermal infiltrate.
Image by CDC/ Dr. Steve Kraus
An illustration depicting the skin punch biopsy.
An illustration depicting the skin punch biopsy.
Image by BruceBlaus
Having a punch biopsy
Video by University Hospitals Birmingham NHS Foundation Trust/YouTube
Biopsy - What You Need To Know
Video by Rehealthify/YouTube
Study examines accuracy of melanoma biopsy findings
Video by UW Medicine/YouTube
What happens to your biopsy?
Video by Sunnybrook Hospital/YouTube
Skin Biopsy for Skin Cancer
Video by Dermatology Office of Dr. Ellen Turner/YouTube
Punch Biopsy
Northerncedar (talk)
Hyperkeratosis
Nephron
Lichen simplex chronicus
Nephron
Stevens-Johnson syndrome
Nephron
Under a medium magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the appearance of the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.
CDC/ Dr. Peter Drotman
Under a low magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the normal appearance of the most superficial epidermal layer on the far left, which was overlying the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.
CDC/Dr. Peter Drotman
This photomicrograph of a skin biopsy reveals some cytoarchitectural signs that are indicative of Kaposi's sarcoma.
CDC/ Dr. Steve Kraus
Under medium magnification, this micrograph of a skin biopsy shows the cytoarchitectural changes found in Kaposi's sarcoma.
CDC/ Dr. Steve Kraus
An illustration depicting the skin punch biopsy.
BruceBlaus
1:36
Having a punch biopsy
University Hospitals Birmingham NHS Foundation Trust/YouTube
0:47
Biopsy - What You Need To Know
Rehealthify/YouTube
3:13
Study examines accuracy of melanoma biopsy findings
UW Medicine/YouTube
3:26
What happens to your biopsy?
Sunnybrook Hospital/YouTube
0:26
Skin Biopsy for Skin Cancer
Dermatology Office of Dr. Ellen Turner/YouTube
Testicular Biopsy
Testicular Biopsy
Also called: Biopsy of the Testicle
A testicular biopsy is a procedure in which a small tissue sample from one or both testicles is taken and then sent to a specialist for its evaluation. This test can be used to help find the cause of male infertility or to diagnose testicular cancer.
Testicular Biopsy
Also called: Biopsy of the Testicle
A testicular biopsy is a procedure in which a small tissue sample from one or both testicles is taken and then sent to a specialist for its evaluation. This test can be used to help find the cause of male infertility or to diagnose testicular cancer.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal biopsy result means that no cancer or abnormal cells were found and sperm development appears to be normal.
Related conditions
A testicular biopsy is a test in which a small piece of tissue from one or both testicles is taken and then sent to a pathologist for evaluation.
Your doctor may want to order this test to help find the cause of male infertility in the following situations:
When a semen analysis shows abnormalities in the sperm and other tests (such as blood and hormone tests) have not found the cause
To distinguish between obstructive and nonobstructive causes of azoospermia (absence of sperm)
To retrieve sperm for in vitro fertilization (IVF)
A testicular biopsy may also be done if an abnormal mass has been found during testicular examination. In this case, the biopsy is more frequently performed intraoperatively (during the surgery) to determine whether the mass is cancerous or noncancerous. If cancer is found, the entire testicle is removed (orchidectomy).
There are several approaches to take the testicular tissue sample, which are by performing an open biopsy (doing a small incision in the testicle) or a percutaneous biopsy (inserting a thin biopsy needle through the scrotum).
The kind of biopsy you have depends on the reason for the test.
Open Biopsy
For the open biopsy you will be put under local or general anesthesia, then the scrotum is cleaned with a germ-killing (antiseptic) solution, and your doctor makes a small cut in the skin and testicle. Then a small sample of the testicle tissue is removed, and stitches are used to close both cuts.
Percutaneous Biopsy
For the percutaneous biopsy you will be put under local anesthesia, then the scrotum is cleaned with a germ-killing (antiseptic) solution, and your doctor will insert a thin biopsy needle into the testicle. Then a small sample of the testicle tissue is aspirated. This procedure does not require an incision or stitches.
No special preparations are usually necessary. Inform your healthcare practitioner if you are taking any over-the-counter or prescription medications.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, hematomas, and infection. You may also present a bad reaction to the anesthesia.
After the biopsy is common for the area to be sore, this usually goes away within two or three days.
You may also be required to avoid any sexual activity for one or two weeks after the test.
A testicular biopsy is normal when no cancerous cells are found, and sperm development appears to be normal.
Results are considered abnormal when any of the following findings are present:
Spermatocele (a lump filled with fluid and dead sperm cells)
Orchitis (inflammation of the testicles, usually caused by an infection)
Testicular cancer
If your testicular biopsy result is normal, but your semen analysis shows azoospermia (absence of sperm) or oligozoospermia (low sperm count), this may indicate a blockage of the vans deferens (the tube through which the sperm passes from the testes to the urethra). Blockages can usually be repaired with surgery.
DIAGNOSTIC PROCEDURES | Stony Brook Medicine [accessed on Dec 27, 2018]
Testicular biopsy Information | Mount Sinai - New York [accessed on Dec 27, 2018]
Testicular biopsy and vasography in the evaluation of male infertility. - PubMed - NCBI [accessed on Dec 27, 2018]
https://www.researchgate.net/publication/265934322_Diagnostic_Surgery_Vasography_Seminal_Vesicle_Aspiration_and_Testis_Biopsy [accessed on Dec 27, 2018]
Testicle Biopsy: Purpose, Procedure & Recovery [accessed on Dec 27, 2018]
Testicular biopsy: clinical practice and interpretation [accessed on Dec 27, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Prostate Biopsy
Prostate Biopsy
Also called: Biopsy of the Prostate
A prostate biopsy is a procedure in which a small sample of the prostate tissue is taken and then sent to a specialist to see if there are any cancerous cells present in it.
Prostate Biopsy
Also called: Biopsy of the Prostate
A prostate biopsy is a procedure in which a small sample of the prostate tissue is taken and then sent to a specialist to see if there are any cancerous cells present in it.
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Use the slider below to see how your results affect your
health.
{score}
7
8
Your result is Low risk.
Gleason score of 6 or less = Grade Group 1
Related conditions
Low-risk prostate cancer
The prostate is a small gland that can be found deep inside the groin, located between the rectum and the base of the penis. This gland forms part of the male reproductive system, and it’s in charge of producing seminal fluid, which is of utmost importance for sperm survival.
A prostate biopsy is a test in which a small piece of the prostate is taken and then sent to a pathologist for evaluation.
There are two main approaches to take the prostate sample, which are by performing a transrectal biopsy (through the rectum) or a template biopsy (through the perineum, which is the portion of skin between the anus and the penis).
The prostate biopsy is usually performed under ultrasound guidance. However, under certain circumstances, you might have a special type of magnetic resonance imaging (MRI) scan before having the prostate biopsy. The MRI images provide more detailed information of the prostate than is possible with ultrasound, and it helps to pinpoint specific areas that may require further evaluation.
Your doctor may want to order this test to diagnose prostate cancer in the following situations:
If you have a nodule or other prostate abnormality that was found during your digital rectal examination (DRE), which is a common prostate cancer screening test.
If you have elevated levels of prostate-specific antigen (PSA) in the blood.
The MRI-guided prostate biopsy may be useful in men who have a rising PSA level along with a normal ultrasound-guided biopsy
This test can also be used to differentiate between cancer and a common condition in elderly men that is called benign prostatic hyperplasia.
First, the physician will perform a DRE. Then, for an ultrasound-guided transrectal biopsy, you will be asked to lie down and onto your left side with your legs bent towards your chest. At this point, a finger-sized ultrasound probe (which has been previously lubricated and covered with a condom) will be carefully inserted into your rectum. The images that appear on the ultrasound machine screen are used to guide a very fine needle into your prostate so a biopsy sample can be taken
For an MRI-guided transrectal biopsy, you will be asked to lie down on your stomach on a cushioned table and the biopsy guide will be gently inserted into your rectum, the biopsy needle will be guided with the help of the MRI images, and the biopsy sample will be taken.
For an MRI-guided transperineal biopsy, you will be asked to lie down on your back and a guidance grid will be placed against your peritoneum, between your legs. The biopsy needle will be guided with the help of the MRI images, and the biopsy sample will be taken.
In either method, the biopsy sampling is repeated to ensure coverage of all the possible affected areas of the prostate, and to ensure that there are no areas left behind where cancer could be hiding. Therefore, during the biopsy procedure, up to 14 individual samples will be taken and then sent to a laboratory for analysis by the pathologist.
You will be asked to fast, or to eat light meals for at least 8 to 12 hours before the procedure. In most cases, you will be given antibiotic pills for a day or two before the biopsy to help prevent infection.
Inform your healthcare practitioner if you are taking any over-the-counter or prescription medications.
For the MRI-guided biopsy, you must remove any chains, rings, watches, dentures, or other metals, and wear comfortable clothing for the test.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, and infection. You may also present a bad reaction to the anesthesia.
During the transrectal biopsy, you will feel pressure and discomfort in the rectal area, which can last for a day or two after the biopsy, especially when you are seated.
After the biopsy, is common for small amounts of blood to appear in the urine, sperm, and feces. This usually goes away within one or two weeks.
The prostate biopsy results are expressed by using the Gleason score, which is obtained by adding the two most common cancerous grades that were found in the prostate tissue.
This happens because prostate tumors are often made up of cancerous cells that have different grades of malignancy. Then, the first grade describes the most common cells that were found in the tumor; and the second grade describes the second most common cells.
For example, if the Gleason score is written as 4+5=9, it means that the most common grade in all the tumor samples is 4 and the next common grade of the tumor is 5, when added together these grades make up the total Gleason score, which would be 9.
The higher your Gleason score, the more aggressive the cancer and the more likely it is to metastasize (grow and spread outside the prostate to surrounding tissue).
Nevertheless, besides taking your Gleason score into consideration, your doctor will also consider other factors such as your age, overall health, and PSA (prostate-specific antigen) levels to determine the prostate cancer stage, risk level, and prognosis (outcome).
A biopsy can only show if there are cancerous cells in the samples taken; therefore, it is possible that cancer in unsampled areas of the prostate might be missed.
How Is Prostate Cancer Diagnosed? [accessed on Nov 24, 2018]
Understanding Your Pathology Report: Prostate Cancer [accessed on Nov 24, 2018]
https://www.prostateconditions.org/about-prostate-conditions/prostate-cancer/newly-diagnosed/gleason-score [accessed on Nov 24, 2018]
Understanding Prostate Cancer: The Gleason Scale [accessed on Nov 24, 2018]
Prostate biopsy | Prostate Cancer UK [accessed on Nov 24, 2018]
Ultrasound- and MRI-Guided Prostate Biopsy [accessed on Nov 24, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Transrectal ultrasound with prostate biopsy
Drawing of a transrectal ultrasound with prostate biopsy, showing a needle and needle guide inserted in the rectum. The bladder, transducer, and needle guide are labeled. Inset of enlarged view of prostate with needle inserted.
Image by NIDDK Image Library
Cross-section diagram of transrectal prostate biopsy with ultrasound probe guiding the needle to the prostate. An inset shows a close-up of a needle entering the prostate
Transrectal ultrasound and prostate biopsy
Image by NIDDK Image Library
Drawing of a transrectal ultrasound with prostate biopsy, showing a needle and needle guide inserted in the rectum. The bladder, transducer, and needle guide are labeled. Inset of enlarged view of prostate with needle inserted. The prostate and needle are labeled
Transrectal ultrasound with prostate biopsy.
Image by NIDDK Image Library
Cross-section diagram of a transrectal prostate biopsy with an untrasound probe guiding the needle to the prostate
Tranrectal ultrasound and prostate biopsy
Image by NIDDK Image Library
Sensitive content
This media may include sensitive content
Transperineal Prostate biopsy - Image 2
Diagram showing a transperineal prostate biopsy
Image by Cancer Research UK uploader
Sensitive content
This media may include sensitive content
transperineal prostate biopsy - Image 1
Diagram showing a transperineal prostate biopsy
Image by Cancer Research UK uploader
Deeper Dive on PSA Screening
Video by DocMikeEvans/YouTube
What is prostate cancer? | Cancer Research UK
Video by Cancer Research UK/YouTube
Prostate Cancer Treatment | Cancer Research UK
Video by Cancer Research UK/YouTube
What are the Signs and Symptoms of Prostate Cancer? | Cancer Research UK
Video by Cancer Research UK/YouTube
NHS Prostate Cancer Screening Module 2
Video by AS&K Communications - Visual Science/YouTube
Video by AS&K Communications - Visual Science/YouTube
NHS Prostate Cancer Screening Module 1
Video by AS&K Communications - Visual Science/YouTube
NHS Prostate Cancer Screening Module 3
Video by AS&K Communications - Visual Science/YouTube
PSA Test: Prostate Cancer Screening Harmful to Men?
Video by ABC News/YouTube
Stage 1: Cancer is confined to a small area of the prostate.
Stage 2: Cancer is confined to the prostate but has spread within it, patient had a high Gleason score, had a high PSA level, or can be felt.
Stage 3: Cancer has spread outside the prostate and may have spread to the seminal vesicles, but has not spread anywhere else.
Stage 4: Cancer has spread to nearby tissues (other than the seminal vesicles), or to the lymph nodes, or to distant sites in the body.
1
2
3
4
Prostate Cancer Summary Staging
Cancer staging helps in estimating the patient's prognosis and in deciding on treatment. If tests show the cancer is likely to have spread, imaging and other tests are done to see the extent of the cancer and to assign it a stage.
Interactive by TheVisualMD
Pelvis, Prostate and Tumor
Prostate and Tumor
Prostate Only
1
2
3
Prostate Cancer
About 80-95% of all cases of prostate cancer are carcinomas that develop in the glandular tissue of the prostate.Most cases of prostatic adenocarcinoma grow more slowly than most other types of cancer. In fact, some prostate tumors grow so slowly that they never require treatment.
Interactive by TheVisualMD
Central zone
Transition zone
Peripheral zone
1
2
3
1) Central Zone 2) Transition Zone 3) Peripheral Zone
The interactive shows prostate gland zones in several layers: (1) central zone, (2) transition zone and (3) peripheral zone. Prostate cancer usually starts in certain zones of the prostate. Knowing these different zones helps the doctor to decide where to biopsy tissue and where to look for cancer spread. Percentage of cancer origin in prostate zones: peripheral zone 70-75%, transition zone 10-15%, central zone 15-20%.
Interactive by TheVisualMD
CT
PET/CT
PET
1
2
3
Prostate Cancer PET/CT 1) CT Scan 2) CT/Pet Scan 3) Pet Scan
Positron emission tomography (PET) scans produce pictures of the body's metabolic functions, such as where glucose is concentrated in cancerous tumors. Computed tomography (CT) scans use X-rays to create images of the body's anatomical structures. PET/CT scans combine PET with CT to show both metabolic functions and anatomical structures. PET/CT is the best imaging technology for detecting cancer recurrence.
Interactive by TheVisualMD
Transrectal ultrasound with prostate biopsy
NIDDK Image Library
Cross-section diagram of transrectal prostate biopsy with ultrasound probe guiding the needle to the prostate. An inset shows a close-up of a needle entering the prostate
NIDDK Image Library
Drawing of a transrectal ultrasound with prostate biopsy, showing a needle and needle guide inserted in the rectum. The bladder, transducer, and needle guide are labeled. Inset of enlarged view of prostate with needle inserted. The prostate and needle are labeled
NIDDK Image Library
Cross-section diagram of a transrectal prostate biopsy with an untrasound probe guiding the needle to the prostate
NIDDK Image Library
Sensitive content
This media may include sensitive content
Transperineal Prostate biopsy - Image 2
Cancer Research UK uploader
Sensitive content
This media may include sensitive content
transperineal prostate biopsy - Image 1
Cancer Research UK uploader
1:57
Deeper Dive on PSA Screening
DocMikeEvans/YouTube
2:35
What is prostate cancer? | Cancer Research UK
Cancer Research UK/YouTube
2:35
Prostate Cancer Treatment | Cancer Research UK
Cancer Research UK/YouTube
2:34
What are the Signs and Symptoms of Prostate Cancer? | Cancer Research UK
PSA Test: Prostate Cancer Screening Harmful to Men?
ABC News/YouTube
Prostate Cancer Summary Staging
TheVisualMD
Prostate Cancer
TheVisualMD
1) Central Zone 2) Transition Zone 3) Peripheral Zone
TheVisualMD
Prostate Cancer PET/CT 1) CT Scan 2) CT/Pet Scan 3) Pet Scan
TheVisualMD
Cervical Biopsy
Cervical Biopsy
Also called: Biopsy - Cervix
A cervical biopsy is a medical procedure in which a small sample of the cervix (the uppermost portion of the vagina that connects with the uterus) is taken and then sent to a specialist to see if there are any cancerous cells or other abnormalities present in it.
Cervical Biopsy
Also called: Biopsy - Cervix
A cervical biopsy is a medical procedure in which a small sample of the cervix (the uppermost portion of the vagina that connects with the uterus) is taken and then sent to a specialist to see if there are any cancerous cells or other abnormalities present in it.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that no cancerous cells or other abnormal cells were found and you don't need any immediate treatment.
Related conditions
The cervix is the uppermost portion of the vagina that is connected with the uterus. The outer surface of the cervix is covered with a layer of skin-like cells (epithelial cells), and it’s called ectocervix. While, the lining of the cervical canal is covered with glandular cells that produce mucus, and it’s known as endocervix.
A cervical biopsy is a procedure in which a small sample of tissue from the cervix (usually from both the ectocervix and endocervix) is taken and then sent to a pathologist to see if there are any cancerous cells or other abnormalities present in it.
This procedure is often done as part of a colposcopy, which is a diagnostic test where a special device known as colposcope is used to examine the cervix, vagina, and vulva to look for microscopic signs of disease.
Your doctor may want to order a cervical biopsy in the following situations:
If your Pap results were abnormal. A Pap test screens for any cell changes on your cervix
If your cervix looks abnormal during a routine pelvic exam
If you have been diagnosed with human papillomavirus (HPV)
This test may also be used to diagnose and help treat certain conditions, such as cervical polyps (benign growths on the cervix) and cervical warts.
A healthcare practitioner will ask you to lie on your back on an exam table; then a sterile speculum will be inserted in your vagina to visualize your cervix, and the colposcope will be used to observe your cervical cells.
Next, a cotton swab will be used to apply a solution of vinegar or iodine on your cervix. This will make any potentially abnormal tissue visible. A local anesthetic will be injected into your cervix, and the biopsy will be taken.
The type of biopsy that your healthcare professional choose to perform will depend on the size, shape, and location of the abnormal cells. Types of cervical biopsies include:
Punch biopsy: in this procedure, a circular blade is used to remove the tissue samples. It is somewhat similar to a paper hole puncher.
Cone biopsy: in this procedure, a large cone-shaped piece of cervical tissue is removed by using a laser or blade.
Endocervical curettage (ECC): in this procedure, a narrow instrument called a curette is used to scrape cells from the endocervix.
After the biopsy is taken, your healthcare practitioner will apply a paste-like topical medicine on your cervix to stop the bleeding.
You will be asked to empty your bladder before the procedure. Tell your doctor if there is any chance that you may be pregnant. If there is any uncertainty, you will need to take a pregnancy test beforehand.
Do not use vaginal medicines, douche, tampons, or have sex for at least 48 hours before the procedure. Make sure to inform your healthcare practitioner if you are allergic to iodine or latex.
You may be asked to take an over-the-counter pain reliever 30 minutes before the procedure to minimize any potential discomfort.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, and infection. You may also present a bad reaction to the anesthesia.
You may feel some cramping, discomfort, and vaginal spotting during and after the procedure.
Do not insert anything on your vagina or have sex after a cone biopsy procedure until your doctor tells you otherwise. Cone biopsies may increase the risk for infertility and miscarriage.
A cervical biopsy is normal when no cancerous cells or other abnormal cells are found.
An abnormal result can be reported using different systems to describe dysplasia, which is the technical word used to describe abnormal cell changes:
Mild dysplasia: this means that your cervical cells look slightly different from normal cells.
Moderate dysplasia: this means that your cervical cells look quite different from normal cells.
Severe dysplasia: this means that your cervical cells look very different from normal cells, which indicates a higher risk for cancer.
Cervical intraepithelial neoplasia (CIN)
Another way to describe abnormal cell changes in the cervix is the cervical intraepithelial neoplasia (CIN) grading system.
CIN is the name given to cellular changes to the ectocervix; while, cervical glandular intraepithelial neoplasia (CGIN) refers to abnormal changes to the endocervix. CGIN less common than CIN, but it is treated similarly.
CIN 1: is used for low-grade changes in the cervical cells. It’s the least severe, and it compares to mild dysplasia.
CIN 2: is used for moderate changes in the cervical cells. It’s moderately severe, and it compares to moderate dysplasia.
CIN 3: is used for high-grade changes in the cervical cells. It’s the most severe, and it describes both severe dysplasia and carcinoma in situ (very early stage of cancer)
Squamous intraepithelial lesion (SIL)
The most common way to describe abnormal squamous cell changes in the cervix is the squamous intraepithelial lesion (SIL) grading system. SIL is described as low grade or high grade.
Low-grade SIL (LSIL): compares to mild dysplasia and CIN 1.
High-grade SIL (HSIL): compares to moderate and severe dysplasia and to CIN 2 and CIN 3.
https://www.acog.org/Patients/FAQs/Abnormal-Cervical-Cancer-Screening-Test-Results [accessed on Dec 27, 2018]
Cervical Biopsy - Health Encyclopedia - University of Rochester Medical Center [accessed on Dec 27, 2018]
Canadian Cancer Society [accessed on Dec 27, 2018]
Abnormal Cervical Cells: CIN & CGIN | Jo's Cervical Cancer Trust [accessed on Dec 27, 2018]
Types and Stages of Cervical Cancer | Jo's Cervical Cancer Trust [accessed on Jan 03, 2019]
Reporting For Cervical Biopsy Specimens [accessed on Jan 03, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Endometrial Biopsy
Endometrial Biopsy
Also called: Biopsy - Endometrium
An endometrial biopsy is a procedure that removes a small sample of endometrium tissue (the lining of the uterus) for testing. The tissue is looked at under a microscope to check for abnormal cells.
Endometrial Biopsy
Also called: Biopsy - Endometrium
An endometrial biopsy is a procedure that removes a small sample of endometrium tissue (the lining of the uterus) for testing. The tissue is looked at under a microscope to check for abnormal cells.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
This means that no cancerous cells or other abnormal cells are found.
Related conditions
The endometrium is the layer of the uterus that sheds during the normal menstrual cycle, and it’s where the embryo implantation takes place during pregnancy.
An endometrial biopsy is a procedure in which a small sample of tissue from the endometrium is taken and then sent to a pathologist to see if there are any cancerous cells or other abnormalities present in it.
Your doctor may want to order this test is the following situations:
To help assess the cause of infertility
If you have heavy or unusually long menstrual periods
If your menstrual cycle is irregular
If you have vaginal bleeding after the menopause
If a pelvic ultrasound has shown that you have a thickened uterine lining
After applying a mild sedative, or giving you an over-the-counter medication to minimize any potential discomfort, a healthcare practitioner will ask you to lie on your back on an exam table; then a sterile speculum will be inserted in your vagina to visualize your cervix (the uppermost portion of your vagina).
After cleaning and numbing your cervix, a thin rod-like instrument, known as a uterine sound, is carefully inserted through it to measure the length of your uterus and find the location for biopsy.
The uterine sound is removed, and then a very thin and flexible tool called catheter is inserted through the cervix to gently suction out a tissue sample from the endometrium.
This procedure usually lasts no more than 20 minutes, after which you are cleared to go home.
You will be asked to empty your bladder before the procedure. Tell your doctor if there is any chance that you may be pregnant. If there is any uncertainty, you will need to take a pregnancy test beforehand.
Inform your healthcare practitioner about any over-the-counter or prescription medications that you are taking, as well of any chronic pelvic infection or untreated sexually transmitted infection that you may have.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, and infection. You may also present a bad reaction to the anesthesia.
You may feel some cramping, discomfort, and vaginal spotting during and after the procedure.
An endometrial biopsy is normal when no cancerous cells or other abnormal cells are found.
Results are considered abnormal when any of the following findings are present:
Benign (noncancerous) growths, such as polyps or fibroids
A uterine infection, like endometritis
Endometrial hyperplasia, which is a thickening of the endometrium
Endometrial cancer
Your results might also come back as inconclusive. In this case, further testing, such as dilation and curettage (D&C), may be required.
Endometrial biopsy cannot be performed on pregnant women or those who are suffering from untreated vaginal, cervical, or tubal infection.
Endometrial Biopsy Test Details | Cleveland Clinic [accessed on Dec 27, 2018]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=92&contentid=P07773 [accessed on Dec 27, 2018]
Endometrial Biopsy: Purpose, Procedure, and Risks [accessed on Dec 27, 2018]
Endometrial Biopsy | Johns Hopkins Medicine Health Library [accessed on Dec 27, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (16)
Dilation and Curettage
An illustration of the dilation and curettage medical procedure
Image by Fred the Oyster
Symptoms, Causes, Risk of pregnancy loss/miscarriage
A 13-week fetus without cardiac activity located in the uterus (delayed or missed miscarriage)
Image by Mikael Haggstrom
Endometrial Cancer | Did You Know?
Video by National Cancer Institute/YouTube
Mayo researchers developing new way to screen for endometrial cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Dilation and Curettage D & C Surgery PreOp® Patient Engagement and Education
Video by PreOp.com Patient Engagement - Patient Education/YouTube
Pelvic Diseases: Uterine Cancer
Video by AFMSCEMMTube/YouTube
The Facts on Miscarriages (Getting Pregnant #6)
Video by Healthguru/YouTube
How to Recover from a Miscarriage
Video by Howcast/YouTube
What Causes Miscarriage | Parents
Video by Parents/YouTube
What is endometrial cancer? | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Uterus
Uterus and Nearby Organs Description The uterus and nearby organs in the female reproductive tract (ovaries, fallopian tubes, cervix, and vagina). An inset provides a close-up view of the layers of the tissue in the uterus (myometrium and endometrium).
Image by BruceBlaus
Sensitive content
This media may include sensitive content
Uterus
Uterus and Nearby Organs Description The uterus and nearby organs in the female reproductive tract (ovaries, fallopian tubes, cervix, and vagina). An inset provides a close-up view of the layers of the tissue in the uterus (myometrium and endometrium).
Image by National Cancer Institute
Human female reproductive system
Uterus and Nearby Organs Description The uterus and nearby organs in the female reproductive tract (ovaries, fallopian tubes, cervix, and vagina). An inset provides a close-up view of the layers of the tissue in the uterus (myometrium and endometrium).
Image by Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436
Implantation
During implantation, the trophoblast cells of the blastocyst adhere to the endometrium and digest endometrial cells until it is attached securely.
Image by CNX Openstax
Uterus with Uterine Cancer
Medical visualization of an anterior cross-sectional view of a uterus with advanced uterine cancer, the most common gynecologic cancer. The most common form of uterine cancer is endometrial cancer (90%+), which originates from the lining of the uterus (endometrium.) Far less common is uterine sarcoma, which originates from the outer layer of muscle (myometrium.)
Image by TheVisualMD
Estrogen Molecule
Medical visualization of an estrogen molecule. Estrogen, as with all of the other main sex hormones, is a steroid hormone derived from cholesterol. Along with progesterone, estrogen is one of the most important female sex hormones. Estrogen production is primarily located in the developing follicles in the ovaries, called the corpus luteum, and the placenta. Another main site of estrogen production is fatty tissue, making weight a contributing factor to the timing of puberty. Smaller amounts are produced by other tissues such as the the breasts, liver, and adrenal glands. Estrogen is responsible for female secondary sexual characteristics such as breast growth, as well as aspects of menstrual cycle regulation, such as the thickening of the endometrium. As with all sex hormones, the effects of estrogen aren't limited to reproduction; estrogen affects bone growth and is involved with learning and memory. Both men and women have all of the main sex hormones, but in very different amounts. Women have much more estrogen than men, but some research suggests that estrogen may be essential for maintenance of the male libido, or sex drive.
Image by TheVisualMD
Dilation and Curettage
Fred the Oyster
Symptoms, Causes, Risk of pregnancy loss/miscarriage
Mikael Haggstrom
2:53
Endometrial Cancer | Did You Know?
National Cancer Institute/YouTube
1:43
Mayo researchers developing new way to screen for endometrial cancer - Mayo Clinic
Mayo Clinic/YouTube
3:12
Dilation and Curettage D & C Surgery PreOp® Patient Engagement and Education
What is endometrial cancer? | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
Uterus
BruceBlaus
Sensitive content
This media may include sensitive content
Uterus
National Cancer Institute
Human female reproductive system
Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436
Implantation
CNX Openstax
Uterus with Uterine Cancer
TheVisualMD
Estrogen Molecule
TheVisualMD
Sentinel Lymph Node Biopsy
Sentinel Lymph Node Biopsy
Also called: SLNB, Biopsy of the Sentinel Lymph Node, Lymph Node Biopsy, Sentinel Node Biopsy, Sentinel Lymph Node Mapping and Biopsy
A sentinel lymph node biopsy is a test that checks lymph nodes for cancer cells. Some cancers, such as breast cancer and melanoma, can spread through the lymphatic system. The sentinel lymph node is the first node where a cancer usually spreads. The test can show whether your cancer is likely to spread.
Sentinel Lymph Node Biopsy
Also called: SLNB, Biopsy of the Sentinel Lymph Node, Lymph Node Biopsy, Sentinel Node Biopsy, Sentinel Lymph Node Mapping and Biopsy
A sentinel lymph node biopsy is a test that checks lymph nodes for cancer cells. Some cancers, such as breast cancer and melanoma, can spread through the lymphatic system. The sentinel lymph node is the first node where a cancer usually spreads. The test can show whether your cancer is likely to spread.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
If your results are negative, it means no cancer cells were found, and it's unlikely that the cancer has spread. You will not need to have any more lymph nodes removed.
Related conditions
Breast cancer
Melanoma
Penile cancer
Endometrial cancer
A sentinel lymph node biopsy is a test that checks lymph nodes for cancer cells. Lymph nodes are part of the lymphatic system, a network of organs and vessels that help the body fight infections and other diseases. Lymph nodes are located throughout the body, including the underarms, neck, chest, abdomen, and groin.
Certain cancers, such as breast cancer and melanoma (the most dangerous form of skin cancer), can spread through the lymphatic system. Cancers spread when cells break off from the original tumor and are carried to other parts of the body. The sentinel lymph node is the first node where these types of cancers are most likely to spread. The node is usually located near the site of the original tumor. Sometimes there is more than one sentinel lymph node.
A sentinel lymph node biopsy can show how likely it is that your cancer is spreading (metastasizing).
Other names: lymph node biopsy, sentinel node biopsy, sentinel lymph node mapping and biopsy
A sentinel lymph node biopsy is used to find out whether an early-stage cancer has spread through the lymphatic system. It's most often used for people who have breast cancer or melanoma.
You may need this test if you've been diagnosed with breast cancer, melanoma, or certain other types of cancer. It can show whether your cancer is spreading.
A sentinel lymph node biopsy may be done in a hospital or an outpatient surgical center. The procedure usually includes a special type of imaging test called lymphoscintigraphy. Lymphoscintigraphy takes pictures of the lymphatic system and is used to locate the sentinel lymph node. The procedure includes the following steps:
A health care provider will apply medicine to numb the skin over the procedure area.
You will be injected with a small amount of a radioactive substance called a tracer near the tumor. The tracer will travel and collect in the sentinel lymph node, or nodes. You may also be injected with a blue dye that stains the lymph node, making it easier to see.
You will be given general anesthesia. General anesthesia is a medicine that makes you unconscious. It makes sure you won't feel any pain during the surgery. A specially trained doctor called an anesthesiologist will give you this medicine.
Once you're unconscious, a camera will take images of the area. The camera finds and records the location of the tracer, which will have settled in the sentinel node.
The node will be removed and sent to a lab, where it will be checked for cancer cells. This part of the test is known as a biopsy.
The original tumor is also usually removed during the procedure.
You will probably need to fast (not eat or drink) for several hours before the test. You may also need to stop taking blood thinners, such as aspirin, for a certain time before your test. Your provider will let you know when you need to stop taking your medicine and anything else you need to do to prepare for the test.
In addition, be sure to arrange for someone to drive you home. You may be groggy and confused after you wake up from the procedure.
You may have a little bleeding, pain, or bruising at the biopsy site. There is also a small risk of infection, which can be treated with antibiotics. Allergic reactions to the tracer are rare and usually mild.
There is very little exposure to radiation in a sentinel lymph node biopsy. While radiation exposure from the tracer in a sentinel lymph node biopsy is safe for most adults, it can be harmful to an unborn baby. So be sure to tell your provider if you are pregnant or think you may be pregnant.
The results will be given as positive or negative.
If your results are positive, it means cancer was found and may have spread to nearby lymph nodes and/or other organs. Your provider may recommend removing and testing more lymph nodes to check for cancer cells.
If your results are negative, it means no cancer cells were found, and it's unlikely that the cancer has spread. You will not need to have any more lymph nodes removed.
If you have questions about your results, talk to your health care provider.
While sentinel lymph node biopsies are mostly used for people with breast cancer or melanoma, it is currently being studied for use with other types of cancer, including:
Colon cancer
Stomach cancer
Thyroid cancer
Non-small cell lung cancer
Sentinel Lymph Node Biopsy: MedlinePlus Medical Test [accessed on Feb 03, 2024]
Sentinel Lymph Node Biopsy - NCI. National Cancer Institute. Jun 25, 2019 [accessed on Feb 03, 2024]
Melanoma: Tests After Diagnosis - Health Encyclopedia - University of Rochester Medical Center [accessed on Feb 03, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (50)
Sentinel Lymph Node Biopsy of the Breast
Sentinel lymph node biopsy of the breast. The first of three panels shows a radioactive substance and/or blue dye injected near the tumor; the middle panel shows that the injected material is followed visually and/or with a probe that detects radioactivity to find the sentinel nodes (the first lymph nodes to take up the material); the third panel shows the removal of the tumor and the sentinel nodes to check for cancer cells.
Sentinel lymph node biopsy of the breast. A radioactive substance and/or blue dye is injected near the tumor (first panel). The injected material is detected visually and/or with a probe that detects radioactivity (middle panel). The sentinel nodes (the first lymph nodes to take up the material) are removed and checked for cancer cells (last panel).
Sentinel Lymph Node & Axillary Lymph Node Procedures for Breast Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Surgery for Melanoma Patients: Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection
Video by American Cancer Society/YouTube
Sentinel Node Biopsy: Breast Cancer Lymph Node Surgery
Video by Breast Cancer School for Patients/YouTube
Sentinel Lymph Node Mapping for Gynecologic Cancers
Video by Memorial Sloan Kettering/YouTube
Introduction to the Lymphatic System
Video by Osmosis/YouTube
Lymphatic System, Part 2
Video by Tammy Moore/YouTube
The Lymphatic System, Part 1
Video by Tammy Moore/YouTube
The lymphatic system's role in immunity | Lymphatic system physiology | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
lymphatic system
Diagram of the lymphatic system.
Image by Cancer Research UK / Wikimedia Commons
Lymphatic System
Lymphatic System
Image by NIH
Lymph Node of Head and Neck
3D visualization reconstructed from scanned human data of male revealing lymphatic structures (lacrimal glands, tonsils, salivary glands, thymus, subclavian veins axillary nodes, stomach, cisterna chyli). The lymphatic system works in concert with the immune system. It can be described as an extensive network of vessels that shuttle molecular waste-filled fluid (lymph) through purifiying centers called lymph nodes.
Image by TheVisualMD
Lymphatic, circulatory and nervous systems
The systems of the human body consist of: circulatory, digestive, endocrine, immune/lymphatic, integumentary, muscular, reproductive, skeletal, urinary. This image depicts the circulatory, endocrine, immune/lymphatic, nervous
Image by TheVisualMD
Babies Sitting Showing Respiratory Lymphatic Circulatory and Skeletal Systems
One of the most obvious ways that we notice the overall immune health of a baby is through the presence or absence of respiratory infections. Respiratory illness is the leading cause of hospitalization among young children. Lymph nodes and vessels are a direct component of the immune system. Lymph nodes are encapsulated bundles of lymph tissue found throughout the body especially in the neck, axillae, groin, and thoracic regions. Lymph tissue aids the immune system by collecting and breaking down toxins and other waste products of the body. Lymph vessels transport lymph, a clear fluid derived from intercellular spaces around the body, eventually back into the blood. An infant's circulatory system will face an olympian job over the course of the individual's lifetime; the heart will beat 2.5 billion times and pump millions of gallons of blood through the body's vast network of arteries and veins. An infant's heart doubles in size the first year of life. Nutrition plays a key role in the development and maintenance of a healthy circulatory system by providing building blocks such as iron needed for red blood cell production.
Image by TheVisualMD
Lymphatic System
Lymphatic Trunks and Ducts System
Image by OpenStax College
Babies Sitting Showing Respiratory Lymphatic Circulatory and Skeletal Systems
One of the most obvious ways that we notice the overall immune health of a baby is through the presence or absence of respiratory infections. Respiratory illness is the leading cause of hospitalization among young children. Lymph nodes and vessels are a direct component of the immune system. Lymph nodes are encapsulated bundles of lymph tissue found throughout the body especially in the neck, axillae, groin, and thoracic regions. Lymph tissue aids the immune system by collecting and breaking down toxins and other waste products of the body. Lymph vessels transport lymph, a clear fluid derived from intercellular spaces around the body, eventually back into the blood. An infant's circulatory system will face an olympian job over the course of the individual's lifetime; the heart will beat 2.5 billion times and pump millions of gallons of blood through the body's vast network of arteries and veins. An infant's heart doubles in size the first year of life. Nutrition plays a key role in the development and maintenance of a healthy circulatory system by providing building blocks such as iron, needed for red blood cell production.
Image by TheVisualMD
In Defense of You: Your Immune System
Image by TheVisualMD
Lymph Node and Lymph interstitial fluid
Lymph Node and Vasculature: The image shows a human lymph node and its vasculature (blood vessels). Lymph nodes are encapsulated bundles of lymph tissue found throughout the body, especially in the neck, armpit, groin, lung, and aortic areas. These aggregations of lymph tissue aid the immunological system by collecting and breaking down toxins and other waste products of the body.
Image by TheVisualMD
Lymph Node with Vasculature
Computer generated illustration of a human lymph node and its vasculature. Lymph nodes are encapsulated bundles of lymph tissue found throughout the body especially in the neck, axillae, groin, lung and aortic areas. These aggregations of lymph tissue aid the immunological system by collecting and breaking down toxins and other waste products of the body.
Image by TheVisualMD
Immune System and Autoimmune Diseases
Normally, an individual's immune system learns to identify and ignore all of the distinctive little structures found on that individual's own cells. Sometimes, however, it will make a mistake and identify its own body as foreign. If that happens, the immune system produces antibodies that attempt to destroy the body's own cells in the same way it would try to destroy a foreign invader.
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Image by TheVisualMD
Lymph Node Biopsy
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Image by TheVisualMD
Lymph Node Biopsy
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Image by TheVisualMD
Sentinel Lymph Node Biopsy
This is a picture of the first radio-guided sentinel lymph node biopsy using real-time imaging by means of a portable gamma camera (Sentinella) in a patient with colon cancer
The lobes and ducts of the breast, and nearby lymph nodes (above) are areas that cancer can attack. The temporary inconvenience of a mammogram can save you from troublesome and costly treatment and surgery by catching breast cancer early, when it is easiest to treat.
Image by NIH
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Breast Cancer Surgery
Breast surgeon Dr. Nora Jaskowiak of The University of Chicago Medical Center explains how far mastectomies and other breast surgeries have come and the impact on the patient's life.
Image by TheVisualMD
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Mastectomy (Simple)
Title Mastectomy (Simple) Description Treatment for breast cancer - removal of breast and a sample of underarm lymph nodes.
Image by National Cancer Institute / Linda Bartlett (Photographer)
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Mastectomy
Total (simple) Mastectomy Description Total (simple) mastectomy; drawing shows removal of the breast and lymph nodes. The dotted line shows where the entire breast is removed. Some lymph nodes under the arm may also be removed.
Image by National Cancer Institute
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Radical Mastectomy
Mastectomy (Radical) Description Halsted radical mastectomy. Removal of the entire breast and chest muscles, as well as lymph nodes in underarm area for the treatment of breast cancer.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Front view of the breast
Diagram showing the front view of the breast.
Image by Centers for Disease Control and Prevention (CDC)
Side view of the breast
Diagram showing the side view of the breast.
Image by Centers for Disease Control and Prevention (CDC)
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Breast and adjacent lymph nodes
Illustration of Breast and Adjacent Lymph Nodes Description: The female breast along with lymph nodes and vessels. An inset shows a close-up view of the breast with the following parts labeled: lobules, lobe, ducts, nipple, areola, and fat.
Image by National Cancer Institute, Don Bliss (Illustrator)
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Breast and Adjacent Lymph Nodes
The female breast (nipple, areola, ducts, lobes, lobules, and fatty tissue) and adjacent lymph nodes and lymph vessels (no labels appear in the illustration).
Image by National Cancer Institute (NCI) / Don Bliss (Illustrator)
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Human Epidermal Growth Factor Receptor 2 (HER2): Aggressive Breast Cancers
Most breast cancers begin in the lobules or ducts of the breast, which produce breast milk and carry it to the nipples after pregnancy. Invasive cancers spread outside of the lobules and ducts and penetrate into the surrounding breast tissue. From there, cancer cells may travel to lymph nodes in the armpit area. In stage IV breast cancer, cancer cells have spread into other parts of the body, such as the lungs or bones. HER2-positive breast cancer is aggressive and is likely to spread quickly. It is also resistant to hormone therapy. However, treatment with the drugs trastuzumab and/or lapatinib may help women who test positive for HER2.
Image by TheVisualMD
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Metastatic Breast Cancer in Pleural Fluid
Image by Ed Uthman/Flickr
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Diagram showing the network of lymph nodes in and around the breast.
Diagram showing the network of lymph nodes in and around the breast.
Image by Cancer Research UK / Wikimedia Commons
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Breast lobes and ducts
Diagram showing the lobes and ducts of a breast.
Image by Cancer Research UK / Wikimedia Commons
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Breast
Breast and Adjacent Lymph Nodes Description The female breast along with lymph nodes and vessels. An inset shows a close-up view of the breast with the following parts labeled: lobules, lobe, ducts, nipple, areola, and fat.
Image by National Cancer Institute
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Breast Anatomy
Breast Anatomy; observe lobes, lobules, ducts, areola, nipple, fat, lymph nodes and lymphatic vessels.
Image by National Cancer Institute / Don Bliss (Illustrator)
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External and Internal Anatomy of Breast
The breast is made up of a variety of tissues and structures, including fat, blood vessels, lymph vessels, ligaments, and nerves. The mammary gland is embedded in the breast's fatty tissue and contains 15-20 lobes, each of which is subdivided into smaller lobules. The breast milk that is produced drains from the lobes into the nipple via the lactiferous ducts.
Image by TheVisualMD
Lymph Nodes
Lymph Nodes
Lymph Nodes
Lymph Nodes
1
2
3
4
Breast Lymph Nodes
Lymph vessels form a network in each breast, draining into lymph nodes in the underarm and along the breast bone. Cancer cells may break away from the main tumor and spread to other parts of the body through the lymphatic system.
Interactive by TheVisualMD
Sentinel Lymph Node Biopsy of the Breast
Sentinel lymph node biopsy of the breast. The first of three panels shows a radioactive substance and/or blue dye injected near the tumor; the middle panel shows that the injected material is followed visually and/or with a probe that detects radioactivity to find the sentinel nodes (the first lymph nodes to take up the material); the third panel shows the removal of the tumor and the sentinel nodes to check for cancer cells.
Sentinel lymph node biopsy of the breast. A radioactive substance and/or blue dye is injected near the tumor (first panel). The injected material is detected visually and/or with a probe that detects radioactivity (middle panel). The sentinel nodes (the first lymph nodes to take up the material) are removed and checked for cancer cells (last panel).
A brain biopsy is typically performed after an imaging test confirmed the presence of a brain tumor or mass. The test is used to confirm or rule out brain cancer.
Brain Biopsy
Also called: Biopsy - Brain
A brain biopsy is typically performed after an imaging test confirmed the presence of a brain tumor or mass. The test is used to confirm or rule out brain cancer.
If imaging tests show there may be a brain tumor, a biopsy is usually done. One of the following types of biopsies may be used:
Stereotactic biopsy: When imaging tests show there may be a tumor deep in the brain in a hard to reach place, a stereotactic brain biopsy may be done. This kind of biopsy uses a computer and a 3-dimensional (3-D) scanning device to find the tumor and guide the needle used to remove the tissue. A small incision is made in the scalp and a small hole is drilled through the skull. A biopsy needle is inserted through the hole to remove cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.
Open biopsy: When imaging tests show that there may be a tumor that can be removed by surgery, an open biopsy may be done. A part of the skull is removed in an operation called a craniotomy. A sample of brain tissue is removed and viewed under a microscope by a pathologist. If cancer cells are found, some or all of the tumor may be removed during the same surgery. Tests are done before surgery to find the areas around the tumor that are important for normal brain function. There are also ways to test brain function during surgery. The doctor will use the results of these tests to remove as much of the tumor as possible with the least damage to normal tissue in the brain.
Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain.Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain.
The pathologist checks the biopsy sample to find out the type and grade of brain tumor. The grade of the tumor is based on how the tumor cells look under a microscope and how quickly the tumor is likely to grow and spread.
The following tests may be done on the tumor tissue that is removed:
Immunohistochemistry: A laboratory test that uses antibodies to check for certain antigens (markers) in a sample of a patient’s tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.
Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a sample of brain tissue are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes may be a sign of cancer. Cytogenetic analysis is used to help diagnose cancer, plan treatment, or find out how well treatment is working.
For some tumors, a biopsy or surgery cannot be done safely because of where the tumor formed in the brain or spinal cord. These tumors are diagnosed and treated based on the results of imaging tests and other procedures.
Sometimes the results of imaging tests and other procedures show that the tumor is very likely to be benign and a biopsy is not done.
https://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq [accessed on Sep 19, 2019]
https://www.cancer.gov/rare-brain-spine-tumor/blog/2019/understanding-brain-tumors [accessed on Sep 19, 2019]
https://www.healthline.com/health/brain-biopsy [accessed on Sep 19, 2019]
https://www.dana-farber.org/brain-tumors/diagnosis/ [accessed on Sep 19, 2019]
https://www.mercy.com/health-care-services/cancer-care-oncology/specialties/brain-tumor-treatment/treatments/brain-biopsy [accessed on Sep 19, 2019]
Additional Materials (7)
Brain biopsy under stereotaxy.
Brain biopsy under stereotaxy. A small part of the tumor is taken via a needle with a vacuum system. The frame around the patient's head ensures a correct axis towards the target (max. error : ~1 mm)
Image by Dake~commonswiki
What to know about a brain tumor diagnosis
Video by Mayo Clinic/YouTube
How Liquid Biopsies Can Improve Brain Tumor Diagnoses
Video by MassGeneralHospital/YouTube
Stereotactic brain biopsy
Video by Institute for Cancer Genetics and Informatics/YouTube
Brain Tumor Diagnosis and Treatment - Mayo Clinic
Video by Mayo Clinic/YouTube
Brain Tumour facts: 10 things you should know about brain tumours | Cancer Research UK
Video by Cancer Research UK/YouTube
Distinguishing Brain Tumors
Video by Lee Health/YouTube
Brain biopsy under stereotaxy.
Dake~commonswiki
1:43
What to know about a brain tumor diagnosis
Mayo Clinic/YouTube
3:24
How Liquid Biopsies Can Improve Brain Tumor Diagnoses
MassGeneralHospital/YouTube
2:20
Stereotactic brain biopsy
Institute for Cancer Genetics and Informatics/YouTube
7:02
Brain Tumor Diagnosis and Treatment - Mayo Clinic
Mayo Clinic/YouTube
1:08
Brain Tumour facts: 10 things you should know about brain tumours | Cancer Research UK
Cancer Research UK/YouTube
1:49
Distinguishing Brain Tumors
Lee Health/YouTube
Bone Marrow Tests
Bone Marrow Tests
Also called: Bone Marrow Examination, Bone Marrow Aspiration and Biopsy
Bone marrow tests are used to diagnose and monitor bone marrow diseases, blood disorders, and certain types of cancer. There are two types of bone marrow tests: bone marrow aspiration and bone marrow biopsy, tests usually performed at the same time.
Bone Marrow Tests
Also called: Bone Marrow Examination, Bone Marrow Aspiration and Biopsy
Bone marrow tests are used to diagnose and monitor bone marrow diseases, blood disorders, and certain types of cancer. There are two types of bone marrow tests: bone marrow aspiration and bone marrow biopsy, tests usually performed at the same time.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative bone marrow biopsy results indicates that the bone marrow didn’t have any significant findings with all of the testing that was done. This may mean that certain diseases were not found. It may also mean that the bone marrow is functioning normally.
Related conditions
Bone marrow is a soft, spongy tissue found in the center of most bones. Bone marrow makes different types of blood cells, including:
Red blood cells (also called erythrocytes), which carry oxygen from your lungs to every cell in your body
White blood cells (also called leukocytes), which help you fight infections
Platelets, which help with blood clotting
Bone marrow tests check to see if your bone marrow is working correctly and making normal amounts of blood cells. The tests can help diagnose and monitor bone marrow disorders, blood disorders, and certain types of cancer.
There are two types of procedures used to collect bone marrow samples for testing:
Bone marrow aspiration removes a small amount of bone marrow fluid and cells
Bone marrow biopsy removes a small piece of bone and bone marrow
Bone marrow aspiration and bone marrow biopsy are usually done at the same time.
Other names: bone marrow examination
Bone marrow tests are used to:
Find out the cause of problems with red blood cells, white blood cells, or platelets
Diagnose and monitor blood disorders, such as:
Anemia (when the cause is unknown)
Polycythemia vera
Thrombocytopenia
Diagnose bone marrow disorders
Diagnose and monitor treatment for certain types of cancers, including leukemia, multiple myeloma, and lymphoma
Diagnose the cause of an unexplained fever, which could be from an infection in the bone marrow
Your health care provider may order a bone marrow aspiration and a bone marrow biopsy if other blood tests show your levels of red blood cells, white blood cells, or platelets are not normal.
Too many or too few blood cells may mean you have a medical condition, such as cancer that starts in your blood or bone marrow. If you are being treated for another type of cancer, these tests can find out if the cancer has spread to your bone marrow.
Bone marrow tests may also be used to see how well cancer treatment is working.
Bone marrow aspiration and bone marrow biopsy procedures are usually done at the same time. A health care provider will collect the marrow samples for testing. Usually, the samples can be collected in about ten minutes.
Before the procedure, you may be asked to put on a hospital gown. Your blood pressure, heart rate, and temperature will be checked.
You may choose to have a mild sedative, which is medicine to help you relax. You may also have the choice to use stronger medicine that will make you sleep. Your provider can help you decide which option is best for you.
During the procedure:
You'll lie down on your side or your stomach, depending on which bone will be used to get the samples. Most bone marrow samples are taken from the back of the hip bone, called the iliac crest. But other bones may be used.
An area of skin over the bone will be cleaned with an antiseptic.
You will get an injection (shot) of medicine to numb the skin and the bone underneath. It may sting.
When the area is numb, the provider will make a very small incision (cut) in your skin and insert a hollow needle. You will need to lie very still during the procedure:
The bone marrow aspiration is usually done first. The provider will push the needle into the bone and use a syringe attached to the needle to pull out bone marrow fluid and cells. You may feel a brief, sharp pain. The aspiration takes only a few minutes.
The bone marrow biopsy uses a special hollow biopsy needle inserted through the same skin opening. The provider will twist the needle into the bone to take out a small piece, or core, of bone marrow tissue. You may feel some pressure or brief pain while the sample is being taken.
After the test, the health care provider will cover your skin with a bandage.
If you didn't use medicine to relax or sleep, you'll usually need to stay lying down for about 15 minutes to make sure that the bleeding has stopped. Afterwards, you can do your usual activities as soon as you are able. If you used medicine to relax or sleep, you'll need to stay longer before you can go home. You may also need to rest the next day.
Your provider will tell you whether you need to fast (not eat or drink) for a few hours before the procedure.
Plan to have someone take you home after the test, because you may be drowsy if you are given medicine to help you relax or sleep during the procedure.
You'll receive instructions for how to prepare, but be sure to ask your provider any questions you have about the procedure.
After a bone marrow aspiration and bone marrow biopsy you may feel stiff or sore where the sample was taken. This usually goes away in a few days.
Your provider may recommend or prescribe a pain reliever to help. Don't take any pain medicine your provider hasn't approved. Certain pain relievers, such as aspirin, could increase your risk of bleeding.
Serious symptoms are very rare, but may include:
Increased pain or discomfort where the sample was taken
Redness, swelling, bleeding, or other fluids leaking from at the site
Fever
If you have any of these symptoms, call your provider.
It may take several days or even weeks to get your bone marrow test results. Your provider may have ordered many different types of tests on your marrow sample, so the results often include a lot of complex information. Your provider can explain what your results mean.
In certain cases, if your test results are not normal, you may need to have more tests to confirm a diagnosis or to decide which treatment would be best.
If you have cancer that affects your bones and marrow, your test results may provide information about your cancer stage, which is how much cancer you have in your body and how fast it may be growing.
If you are already being treated for cancer, your test results may show:
How well your treatment is working
Whether your treatment is affecting your bone marrow
Bone Marrow Tests: MedlinePlus Medical Test [accessed on Feb 16, 2024]
Additional Materials (22)
Bone marrow: location and labeled histology (preview) | Kenhub
Video by Kenhub - Learn Human Anatomy/YouTube
What to expect when you have a Bone Marrow Test | Cancer Research UK
Video by Cancer Research UK/YouTube
Having a bone marrow test
Video by Design Science/YouTube
Bone Marrow Transplant - Mayo Clinic
Video by Mayo Clinic/YouTube
Bone Marrow Diseases - What You Need To Know
Video by Rehealthify/YouTube
What Does Bone Marrow Actually Do?
Video by Seeker/YouTube
Aplastic Anemia-Bone Marrow
Image by doctorssupport.org
Bone Marrow Procedure Site
A 3D medical animation still showing preferred Sites for Bone Marrow Aspiration. The preferred sites for the procedure.
Image by Scientific Animations, Inc.
Image of a bone marrow harvest
Georgetown University Hospital, Washington, D.C. -- Surgeon Dr. Hans Janovich performs a bone marrow harvest operation on Aviation Electronics Technician 1st Class Michael Griffioen. The procedure consists of inserting a large-gauge syringe into an area of the hip and extracting the bone marrow. It is transfused into the recipient, and helps to recreate and replenish T-cells and the white and red blood cells killed while undergoing chemotherapy. Griffioen is assigned to the Pre-commissioning Unit Ronald Reagan (CVN 76) and was matched with an anonymous cancer patient through the Department of Defense Marrow Donor Program.
Image by Photographers Mate 2nd Class Chad McNeeley
Diagram showing the process of red blood cell production in the body with healthy and diseased kidneys. On the top half of the diagram, on the left side, a kidney labeled “Healthy kidney” starts the process by producing EPO. Six drops represent “Normal EPO.” An arrow beneath the EPO drops points from the kidney to a cross-section of a bone. Several cells labeled “Normal red blood cells” emerge from the bone marrow. Above the red blood cells, the label “Normal oxygen,” with three arrows pointing
Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to make red blood cells needed to carry oxygen throughout the body. Diseased kidneys don’t make enough EPO, and bone marrow then makes fewer red blood cells.
Image by NIDDK Image Library
Red Blood Cells, Bone Marrow
A skeleton may have a dry and lifeless Halloween image, but bone is actually dynamic, living tissue. Bone is not uniformly solid; within its interior is a network of cavities that house blood vessels and marrow. Bone marrow, particularly in larger bones, is where stem cells give rise to red blood cells (erythrocytes) as well as white blood cells (leukocytes) and blood clotting agents (platelets). As the source of blood cells, the bone marrow is critical to health. Disease or damage to bone marrow can result in either too many or too few blood cells.
Image by TheVisualMD
Erythropoiesis in Bone Marrow
Bone is dynamic, living tissue; within its interior is a network of cavities that house blood vessels and marrow. Bone marrow, particularly in larger bones, is where stem cells give rise to red blood cells (erythrocytes) as well as white blood cells (leukocytes) and blood clotting agents (platelets). Specialized cells in the kidney, which are sensitive to low oxygen levels, produce a hormone called erythropoietin (EPO), which in turn promotes the production of red blood cells. The boost in red blood cell production (erythropoiesis) in turn increases the oxygen-carrying capacity of the blood.
Image by TheVisualMD
Bone Marrow
Red bone marrow fills the head of the femur, and a spot of yellow bone marrow is visible in the center. The white reference bar is 1 cm.
Image by CNX Openstax
This browser does not support the video element.
Femur Bone Marrow Revealing Lacunae and Trabeculae
Camera descending into bone marrow dataset. Within the bone matrix that is shown one can see the spaces in the matrix which are called lacunae and the trabeculae which is a the mesh work of bone tissue
Video by TheVisualMD
Hematopoietic System of Bone Marrow
Hemopoiesis is the proliferation and differentiation of the formed elements of blood.
Image by CNX Openstax
Bone Marrow Biopsy
Bone Marrow Biopsy
Image by Blausen Medical Communications, Inc.
White Blood Cell Count: Bone
White blood cells (WBCs) and red blood cells (RBCs), as well as the cell fragments called platelets, are constantly being produced by bone marrow. Disease, cancer and genetic disorders of bone marrow can, in turn, affect the production of blood cells.
Image by TheVisualMD
Bone marrow core biopsy microscopy panorama
Section of bone marrow core biopsy as seen under the microscope.
Image by Gabriel Caponetti
Bone Marrow Biopsy
Bone Marrow Biopsy
Image by John Doe
Bone Marrow Biopsy
Diagram showing a bone marrow biopsy.
Image by Cancer Research UK / Wikimedia Commons
White Blood Cell Count: Bone Marrow
Disease or damage to the bone marrow, caused by infection, cancer, radiation treatment, or chemotherapy can lower white blood cell count by impairing the marrow's ability to produce new white blood cells.
Image by TheVisualMD
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Blood Cells
This is a scanning electron microscope image from normal circulating human blood. One can see red blood cells, several white blood cells including lymphocytes, amonocyte, a neutrophil, and many small disc-shaped platelets. Red cells are nonnucleated and contain hemoglobin, an important protein that contains iron and allows the cell to carry oxygen to other parts of the body. They also carry carbon dioxide away from peripheral tissue to the lungs where it can be exhaled. The infection-fighting white blood cells are classified in two main groups: granular and agranular. All blood cells are formed in the bone marrow. There are two types of agranulocytes: lymphocytes, which fight disease by producing antibodies and thus destroying foreign material, and monocytes. Platelets are tiny cells formed in bone marrow and are necessary for blood clotting.
Image by Bruce Wetzel (photographer). Harry Schaefer (photographer), National Cancer Institute
3:24
Bone marrow: location and labeled histology (preview) | Kenhub
Kenhub - Learn Human Anatomy/YouTube
2:12
What to expect when you have a Bone Marrow Test | Cancer Research UK
Cancer Research UK/YouTube
5:56
Having a bone marrow test
Design Science/YouTube
2:20
Bone Marrow Transplant - Mayo Clinic
Mayo Clinic/YouTube
1:38
Bone Marrow Diseases - What You Need To Know
Rehealthify/YouTube
4:03
What Does Bone Marrow Actually Do?
Seeker/YouTube
Aplastic Anemia-Bone Marrow
doctorssupport.org
Bone Marrow Procedure Site
Scientific Animations, Inc.
Image of a bone marrow harvest
Photographers Mate 2nd Class Chad McNeeley
Diagram showing the process of red blood cell production in the body with healthy and diseased kidneys. On the top half of the diagram, on the left side, a kidney labeled “Healthy kidney” starts the process by producing EPO. Six drops represent “Normal EPO.” An arrow beneath the EPO drops points from the kidney to a cross-section of a bone. Several cells labeled “Normal red blood cells” emerge from the bone marrow. Above the red blood cells, the label “Normal oxygen,” with three arrows pointing
NIDDK Image Library
Red Blood Cells, Bone Marrow
TheVisualMD
Erythropoiesis in Bone Marrow
TheVisualMD
Bone Marrow
CNX Openstax
0:06
Femur Bone Marrow Revealing Lacunae and Trabeculae
TheVisualMD
Hematopoietic System of Bone Marrow
CNX Openstax
Bone Marrow Biopsy
Blausen Medical Communications, Inc.
White Blood Cell Count: Bone
TheVisualMD
Bone marrow core biopsy microscopy panorama
Gabriel Caponetti
Bone Marrow Biopsy
John Doe
Bone Marrow Biopsy
Cancer Research UK / Wikimedia Commons
White Blood Cell Count: Bone Marrow
TheVisualMD
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Blood Cells
Bruce Wetzel (photographer). Harry Schaefer (photographer), National Cancer Institute
What Happens During a Biopsy?
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Biopsy
Image by National Cancer Institute / Linda Bartlett (Photographer)
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Biopsy
A Caucasian woman patient is being prepared for surgery. Her left breast is visible and anesthesia is being administered. The male physician has his hand extended and is examining the patient. Several operative attendants are also visible. A surgical biopsy is being performed to determine exact nature of solid tumor.
Image by National Cancer Institute / Linda Bartlett (Photographer)
What Happens During a Biopsy?
A biopsy (taking a tissue sample) is one of the most commonly used medical tests. Tissue samples can be analyzed in order to find out, for instance, whether a suspicious lump is harmless or dangerous. The doctor removes a small sample of tissue and sends it to a laboratory to be examined under a microscope. The tissue sample can often be removed in an outpatient setting.
Humna skin tissue: A human skin sample with full-thickness punch biopsies removed for experimentation
Image by Zpuckr200/Wikimedia
Biopsy, Fine Needle Aspiration (FNA), Lung
Fine-needle aspiration biopsy of the lung. The patient lies on a table that slides through the computed tomography (CT) machine, which takes x-ray pictures of the inside of the body. The x-ray pictures help the doctor see where the abnormal tissue is in the lung. A biopsy needle is inserted through the chest wall and into the area of abnormal lung tissue. A small piece of tissue is removed through the needle and checked under the microscope for signs of cancer.
Institute for Cancer Genetics and Informatics/YouTube
1:05
Biopsy - What It Is, What It Is Used For, and More
Rehealthify/YouTube
1:37
CHEST Foundation - Learn About Lung Biopsies
ACCP CHEST/YouTube
3:26
What happens to your biopsy?
Sunnybrook Hospital/YouTube
2:30
Preparing for your thyroid biopsy - UF Health Endocrinology in Jacksonville
UF Health Jacksonville/YouTube
8:31
Kidney Biopsy
UW Health/YouTube
4:37
Bone marrow aspiration and biopsy from the iliac crest • Oncolex
Institute for Cancer Genetics and Informatics/YouTube
0:51
How do I prepare for a skin biopsy?
MassGeneralHospital/YouTube
1:58
Results of Thyroid Biopsy | UCLA Endocrine Center
UCLA Health/YouTube
5:02
From Biopsy to Diagnosis
Michigan Medicine/YouTube
5:11
CT-guided lung biopsy
MD Anderson Cancer Center/YouTube
2:10
Breast Biopsy - What to Expect (Center for Diagnostic Imaging)
Froedtert & the Medical College of Wisconsin/YouTube
2:12
What is a liquid biopsy? Can cancer cells be detected in the blood?
Mount Sinai Health System/YouTube
0:41
What is a biopsy?
Bladder Cancer Advocacy Network/YouTube
1:02
When Do You Need a Kidney Cancer Biopsy?
Roswell Park Comprehensive Cancer Center/YouTube
1:09
Stereotactic Biopsy
CHI Health/YouTube
1:18
How a Throat Biopsy is Performed to Check for Throat Cancer
Fauquier ENT/YouTube
1:52
How is a prostate biopsy carried out?
Top Doctors UK/YouTube
2:37
Bone Marrow Biopsy & Aspiration (BMBx)
Leukemia & Lymphoma Society/YouTube
1:52
Noninvasive brain tumor biopsy | Inside the Research | Washington University
Washington University in St. Louis/YouTube
5:27
MR Fusion Biopsy at Mayo Clinic
Mayo Clinic/YouTube
2:44
Lymph Node Biopsy
Leukemia & Lymphoma Society/YouTube
0:47
Thyroid Cancer Q&A: Understanding Nodule Biopsy Results | Boston Children's Hospital
Boston Children's Hospital/YouTube
When Are Biopsies Necessary?
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Brain Biopsy
Image by Cancer Research UK / Wikimedia Commons
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Brain Biopsy
Diagram showing a burr hole biopsy.
Image by Cancer Research UK / Wikimedia Commons
When Are Biopsies Necessary?
If a doctor feels something unusual during a physical examination (palpation), analyzing a sample of tissue can help find out what it is. Biopsies might also be necessary for further clarification if imaging techniques such as ultrasounds or x-rays reveal abnormal areas of tissue. Then chronically inflamed tissue can be detected or cancer ruled out, for example. Samples of tissue can be taken from easily accessible parts of the body as well as from many internal organs.
Common biopsies include breast, prostate gland, skin and cervical biopsies. But tissue samples may also be taken from the liver, thyroid, stomach or muscles.
Sentinel lymph node biopsy of the breast. The first of three panels shows a radioactive substance and/or blue dye injected near the tumor; the middle panel shows that the injected material is followed visually and/or with a probe that detects radioactivity to find the sentinel nodes (the first lymph nodes to take up the material); the third panel shows the removal of the tumor and the sentinel nodes to check for cancer cells.
Sentinel lymph node biopsy of the breast. A radioactive substance and/or blue dye is injected near the tumor (first panel). The injected material is detected visually and/or with a probe that detects radioactivity (middle panel). The sentinel nodes (the first lymph nodes to take up the material) are removed and checked for cancer cells (last panel).
Biopsies are relatively simple procedures that can often be done without having to stay overnight in hospital. Exactly how long the procedure takes and what kind of doctor carries it out will depend on the part of the body or organ in question and which technique is chosen.
The doctor will first decide which exact area of the body the tissue should be taken from. For internal organs, this is done with the help of imaging techniques such as ultrasound, magnetic resonance imaging or computed tomography scans. Endoscopy can be used to view the tissue as the sample is being taken - for example, from the stomach, large bowel or lungs.
Non-internal tissue samples are taken after the skin has been disinfected. Usually just a local anesthetic is needed for a biopsy, depending on the size of the instrument to be used. After an outpatient biopsy has been completed, the wound is covered with a wound dressing. Antibiotics are sometimes prescribed to prevent infection, as is the case following a prostate biopsy.
If the procedure involves an internal organ, such as the liver or kidney, or if the person has poor general health, a hospital stay is often required. Multiple biopsies may be needed if the disease is at an advanced stage or if the organ is difficult to access, such as the prostate gland.
Biopsy wrap, biopsy sponge, tissue processing cassette and biopsy bag
Items used for submitting specimens from gross examination in surgical pathology: (Biopsy) wrap, (biopsy) sponge, (tissue processing) cassette and (biopsy) bag.
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D./Wikimedia
Biopsy, Fine Needle Aspiration (FNA), Lung
Fine-needle aspiration biopsy of the lung. The patient lies on a table that slides through the computed tomography (CT) machine, which takes x-ray pictures of the inside of the body. The x-ray pictures help the doctor see where the abnormal tissue is in the lung. A biopsy needle is inserted through the chest wall and into the area of abnormal lung tissue. A small piece of tissue is removed through the needle and checked under the microscope for signs of cancer.
Endoscopic ultrasound-guided fine-needle aspiration biopsy; drawing shows an endoscope with an ultrasound probe and biopsy needle inserted through the mouth and into the esophagus. Also shown are the lymph nodes near the esophagus and cancer in one lung. An inset shows the ultrasound probe locating the lymph nodes with cancer and the biopsy needle removing tissue from one of the lymph nodes near the esophagus.
Endoscopic ultrasound-guided fine-needle aspiration biopsy. An endoscope that has an ultrasound probe and a biopsy needle is inserted through the mouth and into the esophagus. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the lymph nodes near the esophagus. The sonogram helps the doctor see where to place the biopsy needle to remove tissue from the lymph nodes. This tissue is checked under a microscope for signs of cancer.
Sentinel lymph node biopsy of the breast. The first of three panels shows a radioactive substance and/or blue dye injected near the tumor; the middle panel shows that the injected material is followed visually and/or with a probe that detects radioactivity to find the sentinel nodes (the first lymph nodes to take up the material); the third panel shows the removal of the tumor and the sentinel nodes to check for cancer cells.
Sentinel lymph node biopsy of the breast. A radioactive substance and/or blue dye is injected near the tumor (first panel). The injected material is detected visually and/or with a probe that detects radioactivity (middle panel). The sentinel nodes (the first lymph nodes to take up the material) are removed and checked for cancer cells (last panel).
Bone marrow aspiration and biopsy; drawing shows a patient lying face down on a table and a bone marrow needle being inserted into the hip bone. Inset shows the bone marrow needle being inserted through the skin into the bone marrow of the hip bone.
Bone marrow aspiration and biopsy. After a small area of skin is numbed, a bone marrow needle is inserted into the patient's hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope.
Sentinel lymph node biopsy of the breast. The first of three panels shows a radioactive substance and/or blue dye injected near the tumor; the middle panel shows that the injected material is followed visually and/or with a probe that detects radioactivity to find the sentinel nodes (the first lymph nodes to take up the material); the third panel shows the removal of the tumor and the sentinel nodes to check for cancer cells.
Sentinel lymph node biopsy of the breast. A radioactive substance and/or blue dye is injected near the tumor (first panel). The injected material is detected visually and/or with a probe that detects radioactivity (middle panel). The sentinel nodes (the first lymph nodes to take up the material) are removed and checked for cancer cells (last panel).
Tissue selection from skin excision with lesion less than 4 mm with benign appearance
Tissue selection from skin excision with lesion 4-8 mm with benign appearance
Tissue selection from skin excision with lesion 9-15 mm with benign appearance
1
2
3
Skin Excisions - Benign appearance
Interactive by Mikael Häggström
Tissue selection from skin excision with lesion less than 4 mm with benign appearance
Tissue selection from skin excision with lesion 4-8 mm with benign appearance
Tissue selection from skin excision with lesion 9-15 mm with benign appearance
1
2
3
Skin Excisions - Benign appearance
Interactive by Mikael Häggström
What Different Types of Biopsies Are There?
A general difference is made between biopsies that involve removing only a part of the tissue believed to be abnormal (incisional biopsy) and those where the entire abnormal area is cut out (excisional biopsy). The latter is used mostly in the case of suspected skin cancer or colon polyps, a possible precancerous condition of the bowel. The amount of tissue sampled depends on the organ in question, the size of the possibly abnormal area and the type of tissue.
A needle biopsy is typically used if only a small sample is needed. The doctor puts a very thin hollow needle into the tissue to be examined. Depending on the diameter of the needle, samples of either individual cells (fine needle biopsies) or small pieces of tissue (core needle biopsies) can be taken. An open biopsy, by contrast, is done by exposing and removing the tissue.
Endoscopic ultrasound-guided fine-needle aspiration biopsy; drawing shows an endoscope with an ultrasound probe and biopsy needle inserted through the mouth and into the esophagus. Also shown are the lymph nodes near the esophagus and cancer in one lung. An inset shows the ultrasound probe locating the lymph nodes with cancer and the biopsy needle removing tissue from one of the lymph nodes near the esophagus.
Endoscopic ultrasound-guided fine-needle aspiration biopsy. An endoscope that has an ultrasound probe and a biopsy needle is inserted through the mouth and into the esophagus. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the lymph nodes near the esophagus. The sonogram helps the doctor see where to place the biopsy needle to remove tissue from the lymph nodes. This tissue is checked under a microscope for signs of cancer.
The tissue sample is then examined in a laboratory using a microscope. Dyes can be used to see certain cells or enzymes that may be signs of disease. If cancer is found, the tissue sample may also be used to tell what type of tumor was discovered and how much it has spread through the tissue.
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Interactive by TheVisualMD
Ultrasound Guided Breast Biopsy 1 / Ultrasound Guided Breast Biopsy 2
Breast Cancer - Ultrasound Guided Breast Biopsy
Ultrasound image of possible breast tumor before biopsy. The procedure is performed by a radiologist and sonographer. A local anesthetic is injected into the breast. The transducer is pressed to the breast and the suspicious area is located. The biopsy needle is inserted in the breast and guided in realtime by watching its movement through the breast on a computer monitor. The tissue sample is taken and the needle is removed.
Interactive by TheVisualMD
Central zone
Transition zone
Peripheral zone
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2
3
1) Central Zone 2) Transition Zone 3) Peripheral Zone
The interactive shows prostate gland zones in several layers: (1) central zone, (2) transition zone and (3) peripheral zone. Prostate cancer usually starts in certain zones of the prostate. Knowing these different zones helps the doctor to decide where to biopsy tissue and where to look for cancer spread. Percentage of cancer origin in prostate zones: peripheral zone 70-75%, transition zone 10-15%, central zone 15-20%.
Interactive by TheVisualMD
Breast Cancer - Lymph Node Biopsy
TheVisualMD
Breast Cancer - Ultrasound Guided Breast Biopsy
TheVisualMD
1) Central Zone 2) Transition Zone 3) Peripheral Zone
TheVisualMD
What Possible Complications Are There?
Pancreatic biopsy - Colestipol (49214539926)
Image by Atlas of Medical Foreign Bodies/Wikimedia
Pancreatic biopsy - Colestipol (49214539926)
Colestipol was found in a pancreatic biopsy that was obtained endoscopically via the stomach. It originated from the stomach and contaminated the pancreatic biopsy specimen. Colestipol is the generic form of Colestid® and others; a micronized form of bile acid sequestrant, which is used to treat elevated cholesterol. It is also sometimes given to treat chronic diarrhea after certain intestinal surgeries, and to relieve itching associated with liver disease. This patient was taking the medication for treatment of hyperlipidemia.
Images contributed by Dr. Michael Feely - @MFeelyDO
Image by Atlas of Medical Foreign Bodies/Wikimedia
What Possible Complications Are There?
Bleeding or bruising may follow a biopsy. Infection of the wound or damage to neighboring tissue are also possible.
Some people worry that the biopsy may accidentally allow cancer cells to move to healthy tissue and develop new tumors there, but this is unlikely according to the current state of medical knowledge.
Pap test. A speculum is inserted into the vagina to widen it. Then, a brush is inserted into the vagina to collect cells from the cervix. The cells are checked under a microscope for signs of disease.
A procedure in which a cone-shaped piece of abnormal tissue is removed from the cervix. A scalpel, a laser knife, or a thin wire loop heated by an electric current may be used to remove the tissue. The tissue is then checked under a microscope for signs of disease. Cone biopsy may be used to check for cervical cancer or to treat certain cervical conditions. Types of cone biopsy are LEEP (loop electrosurgical excision procedure) and cold knife conization (cold knife cone biopsy). Also called conization.
Source: National Cancer Institute (NCI)
Additional Materials (7)
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Trachelectomy
Diagram showing the parts removed with trachelectomy surgery.
Image by Cancer Research UK / Wikimedia Commons
Cervix Infected with Cancer
Human papillomavirus (HPV) is a large group of related viruses that are often sexually transmitted (half of all sexually active men and women are infected with HPV at some point in their lives). Most infections clear up quickly and cause few problems, though HPV can cause genital warts. Infection by certain types of HPV, however, can lead to cervical cancer. More than a dozen HPV types are considered \"high risk\" for cervical cancer, two of them are responsible for 70% of cervical cancers; genetic and environmental risk factors also play roles. The human papillomavirus (HPV) test is like a Pap test in that it involves the collection of cells from the cervix for analysis; the cell sample is taken with a special swab or brush during a pelvic examination. But while a Pap test is designed to spot abnormal cells, which often indicate an HPV infection, it cannot distinguish among different HPV types. An HPV test uses DNA techniques to determine whether an HPV infection has been caused by one of the viral types that lead to an increased risk of cervical cancer.
Image by TheVisualMD
Healthy Cervix
Healthy Cervix: The cervix is the lower portion of the uterus where it joins with the top of the vagina. The opening of the the cervix into the vagina is called the external os, and can vary in appearance from a small, circular opening in women who have not given birth, to a wider, more slit-like opening in women who have had children. Human papillomavirus (HPV) is associated with an increased risk of cervical cancer. Women should be screened for cellular changes of the cervix with a pap smear as part of a regular pelvic exam. Human papillomavirus (HPV) is a large group of related viruses that are often sexually transmitted. Most infections clear up quickly and cause few problems, though HPV can cause genital warts. Infection by certain types of HPV, however, can lead to cervical cancer. In 2006, the FDA approved an HPV vaccine (Gardisil) that protects against viral types that cause most cases of cervical cancer as well as genital warts. Public health experts recommend routine vaccination for girls ages 11-12 to ensure vaccine effectiveness.
Image by TheVisualMD
Can Cervical Scraping Destroy a Woman’s Sex Life?
Video by The Doctors/YouTube
LEEP Cone Biopsy (Gynecology - Pap Smear)
Video by Med Twice/YouTube
Cone Biopsy (Conization)
Very scant endocervical curettage (ECC) specimen from 28-year-old woman with Pap (from another lab) called high-grade squamous intraepithelial lesion. There was also a cervical biopsy specimen that had benign columnar epithelium only.
Image by Ed Uthman from Houston, TX, USA
What Is A Cone Biopsy?
Video by streamingwell/YouTube
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Trachelectomy
Cancer Research UK / Wikimedia Commons
Cervix Infected with Cancer
TheVisualMD
Healthy Cervix
TheVisualMD
5:09
Can Cervical Scraping Destroy a Woman’s Sex Life?
The Doctors/YouTube
5:21
LEEP Cone Biopsy (Gynecology - Pap Smear)
Med Twice/YouTube
Cone Biopsy (Conization)
Ed Uthman from Houston, TX, USA
2:12
What Is A Cone Biopsy?
streamingwell/YouTube
CT-Guided Biopsy
Lung biopsy guided by computertomography: Lung cancer
Image by Hellerhoff
Lung biopsy guided by computertomography: Lung cancer
Lung biopsy guided by computertomography: Lung cancer
Image by Hellerhoff
CT-Guided Biopsy
A biopsy procedure that uses a CT scan (a special type of x-ray linked to a computer) to find an abnormal area in the body and help guide the removal of a sample of tissue from that area. A needle is usually used to remove the sample, which is then checked under a microscope for signs of disease. A CT-guided biopsy may be done when the abnormal area is deep inside the body or when the doctor cannot feel a lump or mass.
Source: National Cancer Institute (NCI)
Additional Materials (1)
CT Lung Biopsy
Video by Mayo Clinic Health System/YouTube
7:47
CT Lung Biopsy
Mayo Clinic Health System/YouTube
Needle Biopsy
Breast Biopsy
Image by BruceBlaus
Breast Biopsy
Image Caption : Needle Breast Biopsy
Image by BruceBlaus
Needle Biopsy
The removal of tissue or fluid with a needle for examination under a microscope. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.
Source: National Cancer Institute (NCI)
Additional Materials (2)
Transthoracic Needle Biopsy
Video by Covenant Health/YouTube
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Needle Biopsy
Adult Black female breast visible. Physician's hands are seen performing a needle biopsy to determine nature of lump either fluid-filled cyst or solid tumor.
Image by National Cancer Institute / Linda Bartlett (Photographer)
2:25
Transthoracic Needle Biopsy
Covenant Health/YouTube
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Needle Biopsy
National Cancer Institute / Linda Bartlett (Photographer)
HeLa Cells
Henrietta Lacks (HeLa) Timeline
Image by NHGRI Image Gallery
Henrietta Lacks (HeLa) Timeline
Henrietta Lacks was an African-American woman whose cells were removed during a biopsy in 1951 and used for research without her knowledge or approval. Her cells (commonly known as HeLa cells) have revolutionized the field of medicine and have been used for decades in biomedical research - to study cancer, the effects of radiation, and AIDS among other areas. This timeline includes events from 1920 (when Lacks was born) to 2013 (when NIH announced an agreement with the Lacks family to allow biomedical researchers controlled access to the whole genome data of HeLa cells.
Image by NHGRI Image Gallery
Henrietta Lacks (HeLa)
Henrietta Lacks was an African-American woman whose cells were removed during a biopsy in 1951 and used for research without her knowledge or approval. Her cells (commonly known as HeLa cells) have revolutionized the field of medicine and have been used for decades in biomedical research - to study cancer, the effects of radiation, and AIDS among other areas. This timeline includes events from 1920 (when Lacks was born) to 2013 (when NIH announced an agreement with the Lacks family to allow biomedical researchers controlled access to the whole genome data of HeLa cells.
Source: National Human Genome Research Institute (NHGRI)
Additional Materials (8)
Just-Divided HeLa Cells
Scanning electron micrograph of just-divided HeLa cells, a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken in 1951 from Henrietta Lacks, a patient who eventually died of her cancer.
Image by National Institutes of Health / National Center for Microscopy and Imaging Research, NIH
A panorama view of cells
This photograph shows a panoramic view of HeLa cells, a cell line many researchers use to study a large variety of important research questions. The cells' nuclei containing the DNA are stained in blue and the cells' cytoskeletons in gray. HeLa cells are a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken in 1951 from Henrietta Lacks, a patient who eventually died of her cancer.
Image by NIGMS/Tom Deerinck, National Center for Microscopy and Imaging Research
HeLa cells
Scanning electron micrograph of an apoptotic HeLa cell. Zeiss Merlin HR-SEM. HeLa cells are a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken in 1951 from Henrietta Lacks, a patient who eventually died of her cancer.
Image by NIGMS/Tom Deerinck, National Center for Microscopy and Imaging Research
HeLa cells
Multiphoton fluorescence image of HeLa cells with cytoskeletal microtubules (magenta) and DNA (cyan). Nikon RTS2000MP custom laser scanning microscope. HeLa cells are a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken in 1951 from Henrietta Lacks, a patient who eventually died of her cancer.
Image by NIGMS/Tom Deerinck, National Center for Microscopy and Imaging Research
HeLa cells
Multiphoton fluorescence image of HeLa cells stained with the actin binding toxin phalloidin (red), microtubules (cyan) and cell nuclei (blue). Nikon RTS2000MP custom laser scanning microscope. HeLa cells are a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken in 1951 from Henrietta Lacks, a patient who eventually died of her cancer.
Image by NIGMS/Tom Deerinck, National Center for Microscopy and Imaging Research
HeLa cells
Multiphoton fluorescence image of cultured HeLa cells with a fluorescent protein targeted to the Golgi apparatus (orange), microtubules (green) and counterstained for DNA (cyan). HeLa cells are a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken in 1951 from Henrietta Lacks, a patient who eventually died of her cancer.
Image by NIGMS/Tom Deerinck, National Center for Microscopy and Imaging Research
HeLa cell undergoing division into two daughter cells
Here, a human HeLa cell (a type of immortal cell line used in laboratory experiments) is undergoing cell division. They come from cervical cancer cells that were obtained in 1951 from Henrietta Lacks, a patient at the Johns Hopkins Hospital. The final stage of division, called cytokinesis, occurs after the genomes—shown in yellow—have split into two new daughter cells. The myosin II is a motor protein shown in blue, and the actin filaments, which are types of protein that support cell structure, are shown in red. Read more about NIH and the Lacks family.
Image by Dylan T. Burnette, Ph.D., Vanderbilt University School of Medicine.
The immortal cells of Henrietta Lacks - Robin Bulleri
Video by TED-Ed/YouTube
Just-Divided HeLa Cells
National Institutes of Health / National Center for Microscopy and Imaging Research, NIH
A panorama view of cells
NIGMS/Tom Deerinck, National Center for Microscopy and Imaging Research
HeLa cells
NIGMS/Tom Deerinck, National Center for Microscopy and Imaging Research
HeLa cells
NIGMS/Tom Deerinck, National Center for Microscopy and Imaging Research
HeLa cells
NIGMS/Tom Deerinck, National Center for Microscopy and Imaging Research
HeLa cells
NIGMS/Tom Deerinck, National Center for Microscopy and Imaging Research
HeLa cell undergoing division into two daughter cells
Dylan T. Burnette, Ph.D., Vanderbilt University School of Medicine.
4:27
The immortal cells of Henrietta Lacks - Robin Bulleri
TED-Ed/YouTube
Biopsy (NINDS/NIH)
Brain biopsy under stereotaxy.
Image by Dake~commonswiki
Brain biopsy under stereotaxy.
Brain biopsy under stereotaxy. A small part of the tumor is taken via a needle with a vacuum system. The frame around the patient's head ensures a correct axis towards the target (max. error : ~1 mm)
Image by Dake~commonswiki
Biopsy (NINDS/NIH)
Biopsy involves the removal and examination of a small piece of tissue from the body. Muscle or nerve biopsies are used to diagnose neuromuscular disorders. A small sample of muscle or nerve is removed under local anesthetic (pain-relieving medication) and studied under a microscope. The muscle sample may be removed either surgically, through a slit made in the skin, or by needle biopsy, in which a thin hollow needle is inserted through the skin and into the muscle. A piece of the nerve may be removed through a small surgical incision near the ankle, or occasionally near the wrist. Muscle and nerve biopsies are usually performed in an outpatient testing facility. A skin biopsy can be used to measure small nerve fibers or to test for certain metabolic disorders. A small piece of skin is removed under local anesthesia, usually in an office setting. A brain biopsy, used to determine tumor type or certain infections, requires surgery to remove a small piece of the brain or tumor. A brain biopsy is an invasive procedure that carries its own risks.
Source: National Institute of Neurological Disorders and Stroke (NINDS)
Additional Materials (5)
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Brain Biopsy
Diagram showing a burr hole biopsy.
Image by Cancer Research UK / Wikimedia Commons
Stereotactic brain biopsy
Simplistic representation of a stereotactic brain biopsy.
Image by SimplisticReps
Artificial Intelligence, 'Virtual Biopsies' May Be The Future Of Understanding Brain Tumors
Video by CBS Boston/YouTube
Noninvasive brain tumor biopsy | Inside the Research | Washington University
Video by Washington University in St. Louis/YouTube
Safer Brain Biopsies
Video by University of Adelaide/YouTube
Sensitive content
This media may include sensitive content
Brain Biopsy
Cancer Research UK / Wikimedia Commons
Stereotactic brain biopsy
SimplisticReps
2:42
Artificial Intelligence, 'Virtual Biopsies' May Be The Future Of Understanding Brain Tumors
CBS Boston/YouTube
1:52
Noninvasive brain tumor biopsy | Inside the Research | Washington University
Washington University in St. Louis/YouTube
2:21
Safer Brain Biopsies
University of Adelaide/YouTube
Laparoscopic Biopsy
Kidney Biopsy
Image by NIDDK/NIH
Kidney Biopsy
Health care professionals use imaging techniques, such as ultrasound, to guide the biopsy needle into the kidney.
Image by NIDDK/NIH
Laparoscopic Biopsy
Laparoscopic biopsy involves inserting a laparoscope, a thin tube with a tiny video camera attached, through a small incision to look inside the body to view the surface of organs. The health care provider will insert a needle through a plastic, tubelike instrument called a cannula to remove the tissue sample.
Source: PubMed Health Glossary (Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases)
Additional Materials (4)
Surgeon Performing Laparoscopic Kidney Transplant
This photograph shows the posterior view of two surgeons performing laparoscopic kidney transplant surgery with a view of the patient's abdomen on the monitor. Laparoscopy is a a minimally invasive procedure which requires only small incisions and has replaced conventional operations for kidney removal that used to require a larger opening and therefore longer recovery time. The procedure for living donors involves inserting a special needle into the abdominal cavity to fill it up with gas and create space. A metal tube with a camera, called a laparoscope, is inserted through a two-inch incision in the skin. Surgical instruments can be inserted through the laparoscope, and the surgeon can watch his progress in removing the kidney on a video monitor above the patient. With laparoscopic surgery, donors feel less pain after the transplant, and are able to return to their daily routine sooner.
Image by TheVisualMD
Laparoscopy
Laparoscopy - "minimally invasive" surgery; has transformed traditional open surgery into a modern procedure that incorporates minimum risks, smaller scars, and a better treatment.
Image by Dr. Ashvind Bawa/Wikimedia
Gallbladder Removal Laparoscopic Surgery PreOp® Patient Engagement and Education
Video by PreOp.com Patient Engagement - Patient Education/YouTube
Drawing of a liver biopsy procedure
Liver biopsy
Image by NIDDK Image Library
Surgeon Performing Laparoscopic Kidney Transplant
TheVisualMD
Laparoscopy
Dr. Ashvind Bawa/Wikimedia
2:24
Gallbladder Removal Laparoscopic Surgery PreOp® Patient Engagement and Education
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Interactive by TheVisualMD
Lymph Node Biopsy
A procedure in which all or part of a lymph node is removed and checked under a microscope for signs of infection or disease, such as cancer. There are several types of lymph node biopsies, including excisional biopsy (removal of entire lymph node), incisional biopsy (removal of part of a lymph node), core needle biopsy (removal of tissue from a lymph node using a wide needle), and fine-needle aspiration biopsy (removal of tissue from a lymph node using a thin needle).
Source: National Cancer Institute (NCI)
Additional Materials (5)
Lymph Nodes
Lymph Nodes
Lymph Nodes
Lymph Nodes
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Breast Lymph Nodes
Lymph vessels form a network in each breast, draining into lymph nodes in the underarm and along the breast bone. Cancer cells may break away from the main tumor and spread to other parts of the body through the lymphatic system.
Interactive by TheVisualMD
Diagram showing the scar line after lymph node dissection in the neck CRUK 368
Diagram showing the scar line after lymph node dissection in the neck.
Image by Cancer Research UK/Wikimedia
Having a lymph node biopsy
Video by Design Science/YouTube
Lymph Node Biopsy
Video by Leukemia & Lymphoma Society/YouTube
Having a lymph node biopsy
Video by London Cancer/YouTube
Breast Lymph Nodes
TheVisualMD
Diagram showing the scar line after lymph node dissection in the neck CRUK 368
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Biopsy
A biopsy is a procedure that removes cells or tissue from your body. If your doctor suspects you may have cancer or another disease, she may order a biopsy for you. Learn about the types of biopsies and more.