Surgical artefacts in oral biopsy specimens: Punch biopsy compared to conventional scalpel biopsy

Artefacts: A Diagnostic Dilemma – A Review

“…This artefact is more common in incisional than in punch biopsies [9]. This is seen as a distorted tissue with scalloped serrations (produced by beaks of the forceps) and crushed cells, appear as dark chromatin strands and may give a false diagnosis of dysplastic lesions.…”

“…[ This can be prevented, if after the biopsy, the specimen is placed with its mucosal surface up on a piece of the sterile paper (usually that which held the suture material) and if it is allowed to remain unfixed for some time while the incision is being sutured [14,16] Since curling is seen in thin biopsy specimens, ensuring adequate depth of the specimens can prevent this artefact [9].…”

“…Several papers have reported that artefacts are common in oral mucosal biopsy specimens [1,3,7]. Some papers have also compared artefacts occurred due to different surgical techniques i.e., punch biopsy versus scalpel biopsy [8,9]. Therefore, this article highlights the different types of artefacts that occur right from the time the biopsy is surgically obtained, till all the histopathological procedures are performed.…”

How to Help the Oral Pathologist in Making an Accurate Diagnosis

“…A suture usually prevents unwanted movements of tissue, especially while a biopsy is being taken from the mobile structures such as the tongue. Suture traction with the subsequent use of a scalpel can result in crushing and fragmentation of the tissue [8]. In an excisional biopsy, the cut should slightly exceed the depth of the lesion.…”

“…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].…”