Which biopsy method should not be used for vascular lesions such as hemangioma?

Which biopsy method should not be used for vascular lesions such as hemangioma?

• A. Fine-needle aspiration
• B. Wedge biopsy
• C. Core needle biopsy
• D. Biopsy forceps

Answer: (C)

The main idea is that vascular lesions like hemangiomas are full of blood vessels, so any biopsy method that cuts through and removes a solid core of tissue can sever these vessels and cause heavy, hard-to-control bleeding. A core needle biopsy uses a relatively large bore needle to obtain a cylindrical piece of tissue from inside the lesion. This can transect multiple feeding vessels and lead to brisk hemorrhage, which can be difficult to control in a vascular lesion. Because of that bleeding risk, this method should not be used for vascular lesions. Smaller, less invasive sampling methods tend to be preferred when biopsy is necessary. Fine-needle aspiration uses a thinner needle and collects cells rather than a tissue core, reducing the risk of major bleeding and distortion from intralesional hemorrhage. Surgical wedge biopsy or forceps biopsy involve direct visualization and control of bleeding, and may be considered only if absolutely needed and under appropriate precautions. The key point is that the core needle approach carries the greatest risk in this context and is the one to avoid.

The main idea is that vascular lesions like hemangiomas are full of blood vessels, so any biopsy method that cuts through and removes a solid core of tissue can sever these vessels and cause heavy, hard-to-control bleeding. A core needle biopsy uses a relatively large bore needle to obtain a cylindrical piece of tissue from inside the lesion. This can transect multiple feeding vessels and lead to brisk hemorrhage, which can be difficult to control in a vascular lesion. Because of that bleeding risk, this method should not be used for vascular lesions.

Smaller, less invasive sampling methods tend to be preferred when biopsy is necessary. Fine-needle aspiration uses a thinner needle and collects cells rather than a tissue core, reducing the risk of major bleeding and distortion from intralesional hemorrhage. Surgical wedge biopsy or forceps biopsy involve direct visualization and control of bleeding, and may be considered only if absolutely needed and under appropriate precautions. The key point is that the core needle approach carries the greatest risk in this context and is the one to avoid.