Tissues

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TYPES OF BIOPSIES and

EXAMINATION OF TISSUES
JOSHUA KING V. GEDA, RMT

Faculty, Medical Technology
COLLEGE OF MEDICAL TECHNOLOGY
Calayan Educational Foundation, Inc.
Histology is the microscopic study of normal tissues.

Histopathology is the microscopic study of tissues affected by a
disease.
The procedures used to prepare these tissues are termed as
histologic or histopathologic techniques and it starts with the
collection of samples.
How do we acquire these samples?
Through surgery, biopsy, or autopsy.
From large sizes of samples or whole organs to tiny fragments of
tissues.
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What is a Biopsy?
Bio- means life
Psy- to see, appearance
A process of excision or examination of tissue sample
coming from a living person.
The gold standard in diagnosing malignant disease.
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Types of biopsies
• Fine needle aspiration biopsy
• Core needle biopsy
• Incisional biopsy
• Excisional biopsy
• Punch biopsy
• Shave biopsy
• Cutaneous biopsy
• Wedge biopsy
• Curettings
• Exfoliative cytology
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Fine needle aspiration biopsy (FNAB)- least invasive,

only uses the smallest needle to aspirate cells from the
area of abnormality.
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Core needle biopsy- removes not only cells but also a

small amount of surrounding tissue.
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• Incisional biopsy- takes only a small part of an organ,

tissue, or tumor.
If the organ, tissue, or tumor is found to be cancerous,
additional surgery is needed to remove the whole tumor.
• Excisional biopsy- generally removes the whole tumor.
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Punch biopsy- used for obtaining diagnostic full-

thickness of skin specimens. The procedure uses a
circular blade that is rotated down to epidermis, dermis,
and into the subcutaneous fats forming a 3-4mm
cylindrical core of skin tissue sample.
Cutaneous biopsy- also used for skin biopsy. For

diagnosing melanoma
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• Shave biopsy- usually done in the skin. Fragments are

“shaved” from the surface.
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Wedge biopsy- an incision from a solid organ “wedge”

shaped.
Curettings- uses scoops or spoon-like apparatus to
remove tissue growths from the body cavity such as
endometrium or cervical canal
Exfoliative cytology- a microscopic study of
desquamated cells from epithelial surfaces. Used to
diagnose cervical cancer.
An example is Pap smear.
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Tissue samples usually come in the laboratory in fixative

such as formalin or sometimes they arrive fresh and
must be immediately fixed.
They arrive in the lab together with the patient’s basic
information, clinical history, sample description and its
site of origin.
Upon receiving, they are then accessioned or assigned by
a number as an identifier- an important step in pre-
analytical phase to avoid the risk of mislabeling
misidentification.
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Some of the steps in accessioning a sample.

Surgery
S22- 0001
Autopsy
A22- 0001
Cytology
C22- 0001
Where “22” is for the year the procedure was done and
0001 for the number of the specimen.
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Histologic or Histopathologic techniques are done in either

fresh or preserved tissues.
Difference is that fresh tissues are temporary and is only
observed for a shorter period of time, prone to lysis and
rapid changes in cell structure.
Only done when there’s a need for immediate evaluation.
While preserved tissues are permanent, better, more
effective means of studying tissues and for long time
keeping, stained and mounted in glass slides with coverslips.
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Methods for Fresh Tissue Examination

1. Teasing or Dissociation
2. Squash preparation
3. Smear preparation
• Streaking
• Spreading
• Pull-apart
4. Touch preparation (impression smear)
5. Frozen section
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Teasing or Dissociation
- The selected tissue is immersed in NSS or Ringer’s
solution in a watch glass or petri dish, dissected with a
needle. Pieces of tissues are viewed in a microscope in
a wet preparation underneath a coverslip
- Cells are examined in a living state allowing movement
and mitotic division to be observed
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Squash preparation (Crushing)

- A process where a small tissue is crushed or forcibly
compressed between two slides or a coverslip.
- If necessary, Supravital stain may be used by allowing
to be absorbed by the cells or tissue.
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Smear preparation
- General rule is smears are made by spreading portion
of specimen over the surface of the slide using a
platinum loop.
- Alternatively making a smear using a second slide to
obtain a uniform distribution of secretion or sample.
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Three ways of Smear preparation:

1. Streaking- using an applicator stick or platinum loop, the
sample (body fluid) is rapidly and gently applied in direct or
zigzag line throughout the slide.
2. Spreading- a selected portion of a sample is transferred to a
clean slide teasing the mucous strands apart with an
applicator stick. More tedious than streaking. Commonly
done with sputum, mucoid secretions, bronchial aspirates.
3. Pull-apart- done by dropping a sample into a clean slide and
facing it to another slide allowing to first to disperse evenly
in both slides. Pulling both slides in opposite directions.
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Touch preparation
- Smear preparation whereby the surface of a freshly cut
tissue is brought into contact and pressed on the
surface of a clean glass slide allowing cells to be
transferred into the slide.
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Frozen section
- Used for rapid diagnosis.
- the surgeon need to know if his/her tissue section is
adequate before closing
- Usually done on muscle or nerve biopsies as well as on
surgically removed tumors.
- Morphological detail is inferior than waxed tissue
section.
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How it’s done:

- Fresh tissue is frozen on a microtome with CO2 or on a
cryostat with a temperature of -10deg cel to -20deg
cel.
- Frozen sections are mounted on a slide , fixed
immediately, stained using similar techniques used in
waxed tissue sections.
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Other advantages of frozen section:

- Less ventilation in needed
- Less equipment is used
Disadvantage:
- Poor quality of morphological detail
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Histopathologic technique for preserved tissue:
1. Numbering
2. Fixation
3. Decalcification (optional)
4. Dehydration
5. Clearing
6. Infiltration (impregnation)
7. Embedding
8. Trimming
9. Section-cutting (microtomy)
10.Staining
11.Mounting
12.(Labelling)
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--End--
Thank you for listening.
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Evolve.

TYPES OF BIOPSIES and

JOSHUA KING V. GEDA, RMT

Histology is the microscopic study of normal tissues.

The gold standard in diagnosing malignant disease.

Fine needle aspiration biopsy (FNAB)- least invasive,

Core needle biopsy- removes not only cells but also a

• Incisional biopsy- takes only a small part of an organ,

• Excisional biopsy- generally removes the whole tumor.

Punch biopsy- used for obtaining diagnostic full-

Cutaneous biopsy- also used for skin biopsy. For

• Shave biopsy- usually done in the skin. Fragments are

Wedge biopsy- an incision from a solid organ “wedge”

Tissue samples usually come in the laboratory in fixative

Some of the steps in accessioning a sample.

Histologic or Histopathologic techniques are done in either

Methods for Fresh Tissue Examination

Squash preparation (Crushing)

Three ways of Smear preparation:

How it’s done:

Other advantages of frozen section:

Histopathologic technique for preserved tissue:

Thank you for listening.

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