Many medical conditions must be diagnosed by removing a sample of tissue from the patient and sending it to a pathologist for examination to assist in diagnosis. This procedure is called a biopsy, a Greek-derived word that may be loosely translated as "view of the living." Any organ in the body can be biopsied using a variety of techniques, some of which require major surgery (e.g., staging splenectomy for Hodgkin's disease), while others may not even require local anesthesia (e.g., fine needle aspiration biopsy of thyroid, breast, lung, liver, etc).
Fluid aspiration and drainage performed in the Radiology Department are procedures in which image guidance (ultrasound or x-ray) is used to place a needle into an abnormal fluid collection in order to remove the fluid.
After the biopsy or drainage specimen is obtained by the doctor, it is sent for examination to another doctor, the anatomical pathologist, who prepares a written report with information designed to help the primary doctor manage the patient's condition properly.
Biopsy or drainage procedures may be performed on various areas of the body, with the liver, lung, bone marrow and muscle being the most common ones.
Liver biopsy
A liver biopsy can be used to confirm diagnoses such as hepatitis, cirrhosis of the liver, or tumors.
The biopsy is usually performed with the patient lying on their left side with their right shoulder extended and their right hand under their head. It is important to remain in this position and to keep as still as possible. A local anesthetic will be given to numb the skin.
A needle is then guided between two ribs towards the surface of the liver, and the biopsy taken very quickly.
Bone marrow biopsy
A bone marrow biopsy may be necessary for many different diseases of the bone marrow, the blood and the lymphatic system. The biopsy will normally be taken from the upper part of the hip (a point called the iliac crest), but it can also be taken from the breastbone.
First, a local anesthetic is given. Then a strong needle is led through the skin and the outer part of the bone until it reaches the softer, central part of the bone (bone marrow). A syringe is put on the loose end of the needle and some bone marrow is sucked out. This sample is examined under a microscope.
