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Bladder mass - Medium Biopsy 1-3 cm

Biopsy
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Biopsy of medium-sized bladder mass.

₹370₹529

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Bladder Mass - Medium Biopsy 1-3 cm

  • Why is it done?
    • Tissue diagnosis of bladder lesions measuring 1-3 centimeters in diameter detected on cystoscopic examination
    • Differentiation between benign and malignant bladder lesions, including suspected urothelial carcinoma, papillomas, or inflammatory masses
    • Evaluation of persistent hematuria with visible bladder abnormalities on imaging or cystoscopy
    • Assessment of lesions that are too small for definitive visual diagnosis or when surveillance is needed
    • Staging and grading of known bladder cancer to guide treatment decisions
  • Normal Range
    • Normal/Negative Result: Histopathology shows benign bladder mucosa without malignancy, characterized by normal urothelium, lamina propria, and muscularis layers without dysplasia, carcinoma in situ, or invasive cancer
    • Benign findings include: chronic inflammation, cystitis, benign papillomas, polyps, or granulation tissue
    • No atypical cells, dysplasia, or malignant transformation present
    • Result presented as pathological diagnosis with grading system: Grade 1 (low-grade non-muscle invasive) to Grade 3 (high-grade muscle-invasive) for malignant findings
  • Interpretation
    • Negative/Benign Findings: Absence of malignancy; may indicate benign lesions such as cystitis glandularis, cystitis cystica, polyps, or inflammatory masses; suggests conservative management or close surveillance
    • Urothelial Carcinoma (Low-Grade/Grade 1): Non-muscle invasive bladder cancer confined to mucosa or lamina propria; generally favorable prognosis with 70-80% 5-year survival; may require transurethral resection with intravesical therapy
    • Urothelial Carcinoma (High-Grade/Grade 2-3): More aggressive disease with potential for muscle invasion; greater recurrence and progression risk; may require radical cystoprostatectomy or neoadjuvant chemotherapy depending on depth of invasion
    • Carcinoma In Situ (CIS): High-grade dysplasia of urothelium with 40-50% progression to muscle-invasive disease; requires aggressive treatment with BCG immunotherapy or cystectomy
    • Inadequate Specimen: Insufficient tissue for diagnosis; repeat biopsy may be necessary
    • Factors affecting interpretation: Sample quality, location of biopsy within lesion, presence of artifact, immunohistochemical staining results, patient history of prior bladder cancer or radiation
  • Associated Organs
    • Primary Organ: Urinary bladder (epithelial tissue and muscularis layers)
    • Associated Organ Systems: Urinary system (ureters, urethra, kidneys); potentially lymph nodes, prostate, and pelvic structures if advanced disease
    • Diseases commonly associated with abnormal results: Urothelial (transitional cell) carcinoma, squamous cell carcinoma, adenocarcinoma of bladder, bladder lymphoma, recurrent hematuria, chronic cystitis, upper urinary tract cancers (ureter, renal pelvis)
    • Risk factors associated with abnormalities: Smoking, occupational exposures (dyes, chemicals), chronic bladder irritation, history of schistosomiasis, previous pelvic radiation, chronic urinary catheterization, recurrent urinary tract infections
    • Potential complications of malignant findings: Invasion into muscle and perivesical tissues, regional and distant metastasis, obstruction of ureteral or urethral orifices, fistula formation, urinary obstruction, sepsis, metastatic disease to lungs, liver, and bone
  • Follow-up Tests
    • If benign/non-malignant findings: Urine cytology; repeat cystoscopy in 3-6 months if symptoms persist; imaging studies (CT/MRI pelvis) if clinical concern remains
    • If low-grade non-muscle invasive carcinoma: Repeat transurethral resection (re-TURBT) to assess for residual disease; bladder ultrasound or CT cystogram; urine cytology; cystoscopic surveillance every 3-6 months for 2 years, then annually
    • If high-grade non-muscle invasive or CIS: Urgent repeat TURBT with biopsies from normal-appearing areas; consider upper urinary tract imaging (CT urogram) to exclude upper tract involvement; intravesical BCG therapy or chemotherapy initiation
    • If muscle-invasive carcinoma: Staging imaging: CT chest/abdomen/pelvis, bone scan if indicated; lab work including creatinine and electrolytes; consultation with urology and oncology; consideration of radical cystoprostatectomy or neoadjuvant chemotherapy
    • Complementary tests: Urinalysis and culture, PSA level (if prostate involvement suspected), renal function tests, serum albumin, liver function tests for baseline assessment
  • Fasting Required?
    • Fasting: No fasting required for tissue biopsy procedure
    • Anesthesia preparation: If general or spinal anesthesia is planned, standard NPO (nothing by mouth) guidelines apply: typically 6 hours for solid food, 2 hours for clear liquids
    • Medications: Continue regular medications unless specifically instructed otherwise; anticoagulants (warfarin, dabigatran) may require temporary discontinuation; notify physician of all medications, especially antiplatelet agents and NSAIDs
    • Pre-procedure requirements: Urinalysis and urine culture to exclude active infection; void before procedure; informed consent; arrange transportation as you may not be able to drive after sedation
    • Post-procedure care: Mild dysuria and hematuria may occur for 24-48 hours; maintain adequate hydration; avoid strenuous activity for 1 week; avoid sexual intercourse for 1 week; report persistent bleeding, fever, or severe dysuria to physician

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