Pathology · single question
For the papillary tongue lesion with koilocytes (consistent with HPV infection), what is the MOST appropriate type of biopsy?
Show answer and explanation
Correct answer: D. Excisional biopsy (complete removal)
- A. Brush biopsy is a screening tool for epithelial dysplasia detection (OralCDx) — it does not provide the tissue architecture information needed to distinguish among HPV lesion types.
- B. Incisional biopsy removes only a representative portion of a larger lesion. For a small papilloma that can be completely excised, incisional biopsy alone is inadequate treatment.
- C. Fine needle aspiration is used for solid masses or lymph nodes — not for exophytic mucosal lesions.
- D. CORRECT. Excisional biopsy (complete surgical removal of the entire lesion) is indicated for small, well-circumscribed lesions where complete removal is achievable and serves both diagnostic and therapeutic purposes simultaneously. An HPV-related papilloma on the tongue is typically small enough for excision, and complete removal is the treatment.