Artefacts created during oral biopsy procedures

How to Help the Oral Pathologist in Making an Accurate Diagnosis

“…This is referred to as a curling artefact. Curling and bending of the tissue makes the correct orientation difficult during the embedding procedure [7]. Since curling of the tissue is seen in the thin biopsy specimens, an adequate depth can help preventing this artefact [8].…”

“…Firm grasping of the tissue with a toothed forceps leaves puncture holes that can mimic mucosal pits or epidermoid cysts [6]. The incorrect use of the forceps produces the formation of pseudomicrocysts which are apparently lined with the surface epithelium, which is forced inwards by the teeth of the instrument [7]. To avoid this, small atraumatic forceps should be used.…”

“…If electrocautery is used, the heat which is generated by it can give rise to alterations such as tissue protein coagulation, resulting in an amorphous epithelial and connective tissue appearance [7]. In such situations, the epithelial cells become fusiform and hyperchromatic.…”

“…The resulting effect of a layer of carbonized tissue, a zone of thermal necrosis and a zone of tissue which exhibits thermal damage makes a histopathological interpretation more difficult [3]. To avoid the biopsy from becoming non-diagnostic, a wide incisional margin which is far away from the clinical boundary of the lesion is preferred [7].…”

Pseudodysplastic artefacts of the oral mucosa created by the electrotome

“…It was noticed that in places the epithelium of the basal and parabasal layers featured abnormal changes namely columnar cells with Oral mucosa biopsy may show numerous artefacts resulting from various causes such as surgical technique, inappropriate fixation, etc. [1][2][3]. Electrosurgical and laser devices, tools used by some surgeons to biopsy or remove oral mucosa lesions, may produce some thermal artefacts due to the energy released to the tissues during incision or excision techniques, including pseudodysplastic epithelial artefacts (dysplasialike) [4][5][6].…”