Carcinoma of the penis biopsy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Biopsy
During a biopsy, tissues or cells are removed from the body so they can be tested in a laboratory. The pathology report from the laboratory will confirm whether or not cancer cells are present in the sample. The biopsies that could be used for penile cancer are:
excisional biopsy
- The surgeon removes the entire abnormal area.
- If the abnormal area is small or confined to the foreskin, it can often be completely removed by an excisional biopsy.
- Circumcision (removal of the foreskin) may be done if the abnormal area is on the foreskin.
incisional biopsy
- An incisional biopsy removes only a small piece of tissue from the abnormal area.
- An incisional biopsy may be done if the tumour on the penis is large, seems to be growing deeply into the tissue or is ulcerated (appears as an open sore on the skin).
fine needle aspiration (FNA)
- FNA may be used to take a biopsy of a growth on the penis.
- FNA may also be used on nearby enlarged lymph nodes to see if they contain cancer.
Lymph node biopsy
The most common place for penile cancer to spread is the lymph nodes in the groin that are closest to the penis. A lymph node biopsy removes lymph nodes or cells from lymph nodes during a surgical procedure so they can be examined under a microscope to find out if they contain cancer.
The doctor will examine the lymph nodes to check if they look or feel swollen.
- If the lymph nodes are large and firm to the touch, the doctor may do a lymph node biopsy to find out if they contain cancer.
- If the lymph nodes cannot be felt, the doctor may monitor the lymph nodes using ultrasound or may do a sentinel lymph node biopsy.
Fine needle aspiration (FNA) biopsy
Fine needle aspiration (FNA) biopsy may be used to remove some fluid from an enlarged lymph node to check for cancer cells. FNA is sometimes used instead of removing lymph nodes to see if they contain cancer. If the biopsy shows that there are cancer cells present, surgery may be done to remove all the lymph nodes in the area.
The doctor may use ultrasound or a computed tomography (CT) scan to guide the needle into the lymph node if it is too deep to be felt.
Sentinel lymph node biopsy
The sentinel node is the first lymph node or cluster of lymph nodes that receives fluid from the area around a tumour. Cancer cells will most likely spread to these lymph nodes first. Sentinel lymph node biopsy (SLNB) is the removal of the sentinel lymph node so it can be examined to see if contains cancer cells. There may be more than one sentinel lymph node, depending on the drainage route of the lymph vessels around the tumour.
- If the results of the SLNB are negative (cancer cells are not present), it is unlikely that other lymph nodes are affected and no additional surgery is necessary.
- If the results of the SLNB are positive (cancer cells are present), all of the lymph nodes in the area may be removed.
Surgical or excisional lymph node biopsy
Surgery may be done to remove an enlarged lymph node and check for cancer cells. An inguinal lymphadenectomy (groin lymph node dissection) removes lymph nodes in the groin and checks them for cancer.