Biopsy is a commonly used term, often associated with cancer-related diseases. A negative biopsy result indicates a benign tumor, while a positive result suggests a malignant tumor. However, there are instances where the result is a false negative.
1. Understanding Biopsy
Imaging tests such as CT scans and X-rays can only identify areas that need further examination but cannot differentiate between normal cells and cancer cells. A biopsy is a medical procedure that involves taking a tissue sample. To distinguish between normal and cancerous cells, a biopsy is performed on a suspicious organ or mass. Biopsies are highly accurate in diagnosing most cancers.
A biopsy involves taking a sample of tissue from any part of the body, such as the skin, internal organs, or other structures. The sample is then examined under a microscope for a more accurate diagnosis. The purpose of this procedure is often to investigate the abnormal function of an organ or changes in cellular structure, such as a mass, swelling, tumor…
While biopsies are often associated with cancer, a doctor's request for a biopsy does not necessarily mean you have cancer. Doctors use this procedure to determine if abnormalities in the body are caused by cancer or other issues.
2. The purpose of biopsy
A biopsy helps diagnose the cellular nature of a body part by providing a tissue sample for examination when it cannot be accessed externally. Some of the purposes of a biopsy include:
- Cancer biopsy: If a patient has a mass or swelling somewhere in the body without a clear cause, the only way to determine if it is cancerous is through a biopsy.
- Stomach biopsy: This procedure can help doctors identify stomach conditions such as ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs).
- Small intestine biopsy: This can be used to evaluate patients with malabsorption, anemia, or celiac disease.
- Liver biopsy: This can help doctors diagnose tumors or cancer in the liver, diagnose cirrhosis, or hepatitis. Biopsies can also be used to assess how patients respond to treatment.
- Infection testing: A needle biopsy can help determine if a patient has an infection and what is causing it.
- Inflammation testing: By examining cells, such as through a needle biopsy, doctors can identify the cause of inflammation.
3. Why can biopsy results be false negative?
There are cases where a biopsy of a mass returns a result of inflamed tissue.
In the first case, although it is a malignant tumor, there are necrotic lesions (dead cells or inflamed cells) around the tumor. When a biopsy is performed, the needle may have been inserted into that exact location. The result is chronic inflammation and necrosis (but in reality, the mass is a malignant tumor). This is a false negative situation, meaning that the tumor is cancerous but the biopsy did not hit the malignant cells, instead hitting the benign lesion.
In the second case, after performing a biopsy on the patient's mass, the doctor sends half of the mass to the laboratory of one hospital and the other half to another hospital. The problem is that one half of the mass only shows inflamed cells without malignant cells, while the other half of the mass shows cancerous cells. The result of the first half of the mass with inflamed cells is negative, while the second half of the mass with malignant cells is positive.
Therefore, when performing a biopsy, it is advisable to choose a small mass or a lymph node and send the entire sample to only one laboratory so that the pathologist can cut the entire lesion and provide a more accurate answer.
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