Biopsy “Dos” & “Dont’s”

• Do submit an accurate and complete history
• Do remove sufficient tissue to ensure having representative material
• Do submit x-rays of all bony lesions
• Do immerse the lesion immediately in sufficient volume of fixative
• Do perform periodic biopsies, if necessary, to check for recurrence or to following the course of a lesion
• Do handle the lesion gently — crushing the lesion may limit our ability to diagnose the lesion
• Do include adjacent normal tissue for specimens you suspect might be ulcerated, necrotic, or for biopsies for which you suspect a vesiculobullous process (pemphigus, pemphigoid)
• Do incise deep enough, especially if you are dealing with a raised leukoplakia – if the sample is not deep enough it may not include the bottom of the epithelium which may mean a diagnosis of dysplasia, or worse, is missed
• Don’t incise a small lesion — excise it instead
• Don’t inject local anesthetic solution into the immediate area — it can distort the tissue making microscopic examination difficult
• Don’t use cautery or lasers if you suspect dysplasia, cancer or inflammatory lesions — they cook tissues and we may not be able to provide an accurate diagnosis
• Don’t allow the tissue to dry out before fixation — place it in formalin immediately