Brain Tumor Biopsy/Pathology

If diagnostic tests suggest that you have a brain tumor, your care team may recommend obtaining a sample of this tissue either via a biopsy or resection of the abnormal tissue. This is important because the results directly impact your course of treatment.

At Northwestern Medicine, neuropathologists specializing in tumors of the central nervous system provide comprehensive evaluations for brain and spine tumors, including integrating clinical, radiologic, pathologic and molecular data to ensure the most accurate diagnoses possible.

Brain Tumor Biopsy

During a biopsy, your surgeon removes a sample of tissue or tumor from your body. His may be performed as a biopsy for diagnostic purposes or as a component of a resection which can provide diagnostic tissue but may also be therapeutic. Once the tissue is removed, the sample is analyzed by our renowned neuropathology team, in collaboration with your neuro-oncologist and neurosurgeon. A biopsy can show what type of brain tumor you have, provide information on prognosis, lend insight on how likely you may be to respond to specific therapies, and open up additional treatment options.

  • Stereotactic biopsy: A neurosurgeon uses a thin, hollow needle to remove a piece of your tumor. At the same time, they also use CT or MRI imaging to carefully guide the procedure.
  • Endoscopic biopsy: In some circumstance neurosurgeons can use a camera to guide the biopsy of some structures. They often approach tumor via the nose (endonasal approach).
  • Craniotomy: This procedure is done through an opening in your skull while you are sedated. During the procedure, your scalp is cut. Then, your surgeon removes a piece of skull bone to access the brain. In most cases, they put the bone back in place after the biopsy. Often, neurosurgeons can make a diagnosis while you are still in the operating room. This tells them how extensive the surgery will be. They can the resect tumor. This approach provides therapeutic benefit in addition to establishing a diagnosis.

Molecular Pathology

More recently, we can look at the tumor on the molecular level to improve diagnostic accuracy and determine how to best treat it. This is the most rapidly evolving aspect of neuropathology and requires a high level of expertise.

Molecular pathology is the study of disease at the molecular level. This includes molecules found in organs, bodily fluids and tissue samples. Looking at a brain tumor tissue sample from a molecular level can provide even more information about the tumor, including how aggressive the tumor may be. The information gathered from next generation sequencing, chromosomal analysis, and methylation profiling is a key aspect of the evaluation your tumor undergoes at Northwestern Medicine.

Our team includes neuropathologists with substantial expertise in the conduct and interpretation of the molecular neuropathologic characteristics of your tumor. We are able to conduct these analyses even on tissue which has been resected at other institutions.