Pathology · patient case question
Which biopsy would be used if one were required?
Patient case: Two-year history of tongue discomfort with spicy foods
Scenario: A female patient has had discomfort in her tongue for TWO YEARS. Spicy foods and some cold drinks bother her.
Show answer and explanation
Correct answer: C. Incisional biopsy
- A. Excisional biopsy is for small discrete lesions that can be removed in their entirety; a migrating patch on the tongue dorsum is not such a lesion.
- B. Immunofluorescence is used for the autoimmune vesiculobullous diseases, not for erythema migrans.
- C. Correct. Erythema migrans is normally a CLINICAL diagnosis and biopsy is rarely required. If the presentation is atypical or persistent, an INCISIONAL biopsy taken at the ACTIVE WHITE BORDER is the appropriate technique, showing a psoriasiform pattern with Munro microabscesses.
- D. Brush biopsy is a screening adjunct for suspicious flat white or red lesions and cannot provide architectural detail.