Introducción a la patología - Biopsia y tipos de biopsias

Summary

The script delves into the critical role of biopsies in modern pathology, explaining their significance in diagnosing and treating diseases. It traces the history of biopsies, their evolution from autopsies, and the shift towards live patient treatments. The video covers various biopsy techniques, including percutaneous and open biopsies, and their uses in diagnosing cancer and other conditions. It also highlights the differences between cytopathological and histopathological studies, emphasizing their complementary nature in diagnosis. The risks, such as cancer spread during biopsies, are discussed, along with specific procedures like punch biopsies, endoscopic biopsies, and bone marrow biopsies.

Takeaways

• 😀 The introduction of biopsy as a medical technique revolutionized the diagnosis and treatment of diseases, allowing for in-life analysis rather than relying solely on autopsies.
• 😀 The term 'biopsy' comes from two Greek words: 'bios' meaning life and 'opsis' meaning vision, signifying the study of living tissue.
• 😀 Biopsy plays a crucial role not only in diagnosing diseases but also in providing treatment, especially in cases where the lesion or tumor is removed as part of the biopsy process.
• 😀 There are different types of biopsies, categorized by their approach: percutaneous (through the skin) and open biopsy (exposing the organ directly).
• 😀 Percutaneous biopsies often utilize tools like ultrasound or fluoroscopy to guide the procedure without directly visualizing the tissue.
• 😀 Open biopsies involve directly exposing the lesion or organ, allowing for precise tissue removal and in some cases, complete excision of a tumor.
• 😀 Malignant tumors like melanoma pose a high risk of spreading during biopsy procedures, which is why some cancers are treated by excising the entire tumor rather than performing a biopsy.
• 😀 Biopsy procedures can be further classified by technique, including exfoliative cytology (e.g., Pap smears), fine-needle aspiration (FNA), incisional biopsy, and excisional biopsy.
• 😀 Cytopathology (cell study) and histopathology (tissue study) are the two main types of analysis following a biopsy, each with its advantages and limitations.
• 😀 Different biopsy techniques, such as punch biopsies, endoscopic biopsies, and razor biopsies, are used depending on the location and type of lesion, with the choice of technique influencing both the diagnosis and treatment process.

Q & A

What is the significance of the introduction of biopsy in medicine?

The introduction of biopsy revolutionized medicine by allowing doctors to diagnose diseases in living patients, providing the opportunity for early treatment and more accurate prognoses, which wasn't possible with autopsies alone.

What is the origin of the term 'biopsy'?

The term 'biopsy' is derived from two Greek words: 'bios' meaning life, and 'opsis' meaning vision, coined by the medical professional Ernest Henry Besnier in the 19th century to describe the process of examining living tissue.

What is the difference between a biopsy and an autopsy?

A biopsy is a procedure where a sample of tissue or cells is taken from a living patient for examination, while an autopsy is performed after death to determine the cause of death.

What types of biopsies exist, and how are they classified?

Biopsies are classified by the method of approach: percutaneous (through the skin) and open biopsies. Percutaneous biopsies involve the use of needles or small instruments to remove tissue or cells, while open biopsies require surgical intervention to expose and remove tissue.

Why is biopsy useful in determining cancer and its progression?

Biopsy is crucial in determining the type, biological behavior, and extent of a disease, particularly cancer. It allows for a detailed study of how the cells are arranged and if cancer has spread or is invasive.

What are the risks of performing a biopsy on certain types of cancer, like melanoma?

In cases like melanoma, biopsies are risky because the cancer can spread through the blood or lymphatic system during the procedure, potentially leading to further metastasis.

What is the difference between incisional and excisional biopsies?

An incisional biopsy removes only a small part of the lesion, while an excisional biopsy involves the complete removal of the lesion, including a margin of healthy tissue around it, to ensure all malignant cells are removed.

How are different biopsy techniques, like fine needle aspiration (FNA) and punch biopsy, utilized?

Fine needle aspiration (FNA) involves using a thin needle to extract cells, typically for small or superficial tumors. Punch biopsy removes a cylindrical sample of skin, often used for diagnosing skin conditions. These techniques vary depending on the lesion's location and size.

What is a histopathological study, and how is it different from a cytopathological study?

A histopathological study examines tissue samples to observe cell structure and arrangement within their natural context, while a cytopathological study analyzes individual cells, providing insights into cell morphology. Both are essential for diagnosing diseases, with histopathology offering a more comprehensive view of tissue architecture.

Why might a physician choose not to perform a biopsy on certain tumors, such as those in the kidney or melanoma?

In some cases, like melanoma or kidney tumors, biopsies are avoided due to the high risk of spreading cancerous cells. For these conditions, the entire tumor is typically removed surgically to minimize the risk of metastasis.