Biopsy

A biopsy is a small sample of tissue taken from the body so it can be examined under a microscope and tested chemically in the laboratories. This page from Great Ormond Street Hospital (GOSH) explains about the procedure to take a biopsy in the Interventional Radiology department. Any area of the body can be biopsied. A biopsy may be suggested if your child has developed a new, undiagnosed lump or an abnormal area of tissue within an organ. The results are used to help make a diagnosis or assess the effects of certain treatments. Information sheets explaining specific biopsies, such as kidney, liver or skin, are also available.

You will already have received information about how to prepare your child for the procedure in your admission letter. You may need to come to GOSH before the procedure so that your child can have a pre-admission assessment to check that they are well enough. The appointment may involve taking blood samples and other tests. Sometimes a biopsy is suggested while your child is still in hospital.

The doctor will explain the procedure in more detail, discuss any worries you may have and ask you to sign a consent form giving permission for your child to have the procedure. If your child has any medical problems, please tell the doctors.

A few biopsies we carry out use x-ray or CT scan guidance. If x-ray or CT scan guidance is planned, legally, we are obliged to ask any girls over the age of 12 whether there is any chance they might be pregnant. We may ask for a urine or blood sample to carry out a pregnancy test. This is to protect babies in the womb from receiving unnecessary radiation.

Most children have a biopsy under general anaesthetic. It is important that your child does not eat or drink anything for a few hours before the anaesthetic. This is called ‘fasting’ or ‘nil by mouth’. Fasting reduces the risk of stomach contents entering the lungs during and after the procedure. You will be informed the night before the procedure of the time that your child should be ‘nil by mouth’ – in other words, have nothing to eat or drink before the anaesthetic.

It is equally important to keep giving your child food and drink until those times to ensure they remain well-hydrated and get adequate nutrition. This may involve waking your child in the night to give them a drink which we recommend.

Once your child is under general anaesthetic, the doctor will inject local anaesthetic around the area to be biopsied to make it numb for a few hours. Using a variety of imaging techniques, such as ultrasound, x-rays or a CT scan, the doctor will locate the precise area to be biopsied and make a small cut in the skin. They will then insert a biopsy needle through the skin incision into the tissue to be biopsied.

The needle has a hollow centre and is used to take a number of tissue samples. After the samples have been taken, they will ‘plug’ the track where the needle was inserted with a harmless substance that is absorbed by the body over the next few months. Finally, the area will be covered with a dressing.

Every anaesthetic carries a risk, although this is extremely small. There is a small risk of bleeding during and after the biopsy procedure, but ‘plugging’ the biopsy track reduces this greatly. Plugging the biopsy track also reduces the chance of cells spilling into surrounding tissues. This is particularly important if the abnormal tissue is cancerous. There is a chance that the biopsy procedure may have to be repeated if there is a problem with the tissue samples collected, such as too few samples being collected, or if the diagnosis is particularly complicated.

Your child will return to the ward after they have recovered from the general anaesthetic if they have had one. Some children feel sick and vomit after a general anaesthetic. Your child may have a headache or sore throat or feel dizzy, but these side effects are usually short-lived and not severe.

The area where the biopsy was taken will feel uncomfortable for a while afterwards but this soon passes. Your child can usually start eating and drinking as normal once they feel like it but please check with the nurse first. The dressing over the area should be kept clean and dry for the next few days.

If your child does not need to stay in hospital for treatment, you can return home once they have recovered from the anaesthetic or sedation.

You should call the hospital if:

• The biopsy site looks red, swollen and feels hotter than the surrounding skin
• The biopsy site is oozing
• Your child is in a lot of pain and pain relief does not seem to help
• Your child has a temperature of 38°C or higher

The initial results of the biopsy are usually available within a couple of days, but more complicated tests can take longer. All the biopsy results will be given to you at your child’s next outpatient appointment, but if there is a need to change your child’s treatment before this time, you will be contacted directly by your child’s doctor or via your family doctor (GP).