Biopsy Specimens

Incisional biopsies in the upper aerodigestive tract are usually directed at a specific lesion located either by visualisation or by CT or MR imaging. "Blind" biopsies may be taken, particularly from the fossa of Rosenmuller, base of the tongue, pyriform fossa and palatine tonsil, in the search for an occult primary carcinoma. Superficial biopsies of tonsil may miss a small submucosal tumour; tonsillectomy is preferred. Biopsies of pharyngeal and laryngeal lesions are usually taken at endoscopy with punch or cup forceps. While usually sufficient, it is sometimes difficult to make a histological diagnosis of malignancy as the specimens tend to be superficial, and submucosal tumours or the invasive components of well-differentiated squamous carcinoma may not be represented.

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