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© Dirk Biddle
Often invasive biopsies are the only sure way to confirm a diagnosis of vasculitis. Many conditions can mimic vasculitis. These mimics have completely different treatments, for example, antibiotics for infections or surgery, radiation therapy or chemotherapy for tumours. Thus it is essential to rule out such diagnoses before embarking upon therapy for a vasculitis condition. A number of different biopsy procedures are available to physicians depending on the tissue to be examined. A strong caution must be noted however; because vasculitis is often segmental or focal, biopsy of clinically suspicious tissue may not always provide a definitive histologic diagnosis. Further, when large blood vessels are affected, a biopsy is often not practical because of the risks of surgery.
Before any biopsy is done, the patient’s blood will be assessed for its clotting potential, as some biopsy procedures cannot be performed if the patient bleeds too easily.
In certain cases a biopsy may be problematic. First, one must already have a firm diagnosis in mind, as a biopsy of an uninfected site will return negative results (and too often a biopsy conducted on an infected site will similarly return negative results). Second, one must be considerate of the damage a biopsy could do to an already inflamed and stressed system, particularly if aneurisms, the nervous system, or the brain are involved.
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