Unveiling Hidden Insights: The Significance of Deeper Tissue Sections in Aiding Small Biopsy Diagnosis

Introduction: Histopathology is the foremost diagnostic method for numerous lesions, utilising biopsies to pinpoint diseases precisely via microscopic scrutiny. It establishes the diagnostic benchmark, influencing prognosis and treatment planning. Initial incomplete sectioning leads to errors; deeper sections enhance minor biopsy diagnosis. Laboratories commonly adopt deeper sectioning to refine results, particularly with limited small biopsy specimens. Objectives: To evaluate the prevalence of deeper sections required for definitive diagnoses in small biopsies and to analyse which anatomical sites are associated with a higher frequency of these requests. Materials and Methods: In a 6-month study at a tertiary care hospital, 106 small biopsy cases were examined to compare initial histopathology with deeper sections, assessing their impact on final diagnoses. Results: Out of 106 cases, 36 biopsies (34%) were analyzed. Deeper sections were frequently requested from samples received from Obstetrics and Gynaecology (33%) and least from Pulmonology (5%). 4 cases (11.2%) needed deeper sections due to inadequate initial samples. In 28 cases (77%), deeper sections were used to confirm or clarify diagnoses; of these, 13 (46.4%) revealed new pathology, 13 (46.4%) upheld initial findings, and 2 cases (7.2%) required diagnosis changes. 4 cases (11.2%) remained inconclusive, and 2 (5.6%) had tissue loss. Conclusions: Deeper sections significantly impact the ultimate diagnosis. Therefore, regardless of the lesion's site, consistently employing deeper sections is universally advised. This practice serves to surmount the constraints posed by the initial histopathological characteristics of small biopsies. Balancing this need with additional time, cost, and patient care effects is crucial.