Pathology · single question
A 58-year-old male with a white, erythematous ulcer on the postero-lateral border of the left tongue and history of alcohol and smoking — what type of biopsy should be performed?
Show answer and explanation
Correct answer: C. Incisional biopsy
A LARGE (>1 cm) suspicious lesion on the lateral tongue in a patient with significant risk factors (smoking, alcohol) requires an INCISIONAL biopsy — removal of a representative portion of the lesion for histological examination. Excisional biopsy (complete removal) is appropriate for SMALL lesions (<1 cm) expected to be benign. For a potentially malignant lesion, incisional biopsy allows diagnosis without potentially compromising subsequent surgical margins if cancer is confirmed.
- A. INCORRECT. Excisional biopsy is appropriate for SMALL (<1 cm) lesions likely to be benign. For a potentially malignant large lesion, excisional biopsy might compromise subsequent surgical margins.
- B. INCORRECT. Lymph node biopsy is performed when lymph node metastasis is suspected and the primary lesion has been identified — not the initial step for a mucosal lesion.
- C. CORRECT. INCISIONAL biopsy takes a representative sample from a LARGE suspicious lesion for histological diagnosis. This is the appropriate first step for a potentially malignant oral lesion in a high-risk patient.
- D. INCORRECT. Fine-needle aspiration is used for LYMPH NODES or deep masses — not for mucosal surface lesions.