Biopsy in Histological Examination

Histological (or Histopathological) Examination: What is it?

Histological or histopathological examination is a crucial element in the diagnostic process of tumors, whether malignant or benign. Conducted under a microscope, this laboratory analysis involves inspecting samples of organic tissue exhibiting anomalies to precisely identify, through meticulous microscopic observation, the signs and alterations present in fragments of human tissue from any organ. This is how the physician obtains the necessary "proof" to refine their diagnosis.

In the presence of a solid tumor (such as breast, thyroid, or prostate cancer), a histological analysis of a tissue sample, generally obtained through biopsy, confirms any doubts raised during a paraclinical examination (such as a CT scan). This analysis also precisely determines the tumor type, as well as its aggressiveness and differentiation. This crucial information is essential for the oncologist to determine the best therapeutic approach based on the tumor stage.

Histological Examination: Some Examples

Histological Examination of a Nevus

The laboratory test is indispensable when faced with a suspected case of melanoma, a malignant skin tumor that often arises from a mole, or nevus, which already appears abnormal compared to a healthy nevus or to the same nevus in the past.

Indeed, nevi are atypical and benign moles that must be monitored over time because they are susceptible (although in rare cases) to degenerating into cancer. To guarantee a thorough analysis, it is common to completely remove a questionable nevus by biopsy before submitting it to the aforementioned techniques. The time required to obtain histological results for dysplastic nevi or lesions suspected of melanoma can range from one week for cases requiring immediate intervention to two weeks for others.

Histological Examination of a Colon Polyp

Histological examination is often performed after the polyp has been detected during a non-virtual colonoscopy and completely or partially removed by biopsy. It is established that the larger an intestinal polyp grows, the higher the probability that it will become a malignant tumor. Indeed, small polyps have a lower risk of turning cancerous than those measuring more than two centimeters in diameter.

For this reason, early histological analysis of colon polyp tissue is the preferred diagnostic examination and a crucial preventative measure, particularly from age 65 or if family members have had colorectal cancer, one of the most widespread malignant pathologies in both sexes worldwide.

Histological Examination of an Endometrial Polyp

Endometrial polyps are growths that appear inside the uterus. While they are not common and usually cause no symptoms, they can sometimes be precancerous lesions. Removal or biopsy of the endometrial polyp is performed through a small outpatient surgical procedure called operative hysteroscopy. Within one to ten days maximum, we receive the histological examination report of the sample and it is possible to understand whether it is a malignant neoplasm or not.

Histological Examination of the Breast

This is a required procedure in all cases where a breast biopsy has been necessary on a suspicious mass or lesion, in order to study its nature. In this case, the histological examination report includes different initials depending on the result (more or less favorable), which must be interpreted.

Histological Examination of the Placenta

This test, as mentioned above, is the only histological examination that is not performed for the diagnosis of a tumor.

An ultrasound is essential in cases of pregnancy problems such as miscarriage or fetal death in utero, as it helps to understand the reasons for these events. Placental analysis can reveal the causes of these sad situations, as well as any problems that occurred during the birth of a baby with anomalies. The information obtained can be valuable in preventing such complications in a future pregnancy.

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Biopsy and Puncture

In histology, most tissues to be examined are sampled from the organ or body part in question via a biopsy. This procedure can be performed during surgery to remove a suspicious formation, such as a mass, polyp, or cyst, which will then be entirely excised and analyzed individually.

To analyze a tissue, the pathologist may be satisfied with the smallest fragment, provided it is preserved. The performance of the biopsy may vary depending on the location, size, and type of tissue studied. Indeed, the professional has different methods to accomplish this task.

There are four main techniques for performing biopsy examination:

Excisional biopsy, when an entire area of damaged tissue (e.g., a lump) is removed;
Incisional biopsy, when only a small part of the abnormal tissue is removed;
Percutaneous biopsy involves removing a portion of subcutaneous tissue using a needle.
Needle aspiration: To facilitate understanding of the content, the method using a fine needle to aspirate questionable tissue after a radiographic or ultrasound examination is commonly used for breast or thyroid nodules. This procedure, although it may seem daunting, is actually minimally invasive, quick, painless, and requires neither anesthesia nor specific preparation. After sampling, the tissue is then analyzed under a microscope.

Before implementing these techniques, it is imperative to perform paraclinical examinations such as computed tomography, magnetic resonance imaging, ultrasound, or mammography, and other forms of analysis such as blood tests. Only after detecting anomalies and alterations should swift action be taken to examine them.

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