Buttock mass biopsy - Medium 1-3 cm

Biopsy

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Biopsy of medium buttock swelling.

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Buttock Mass Biopsy - Medium 1-3 cm

Why is it done?
- To obtain tissue samples from a palpable mass located in the buttock region measuring 1-3 cm in diameter for histopathological examination and definitive diagnosis
- To differentiate between benign lesions (lipomas, cysts, fibromas) and malignant neoplasms (sarcomas, melanoma, metastatic lesions)
- To evaluate subcutaneous or deep tissue masses with unclear etiology when clinical examination and imaging are inconclusive
- To identify infectious processes, inflammatory conditions, or reactive lesions that may present as buttock masses
- Typically performed when a mass has been present for more than 2-4 weeks, is enlarging, or shows concerning imaging features (heterogeneous enhancement, infiltrative borders)
Normal Range
- Normal Result: Benign tissue with no malignant cells identified; normal histological architecture; absence of atypia or abnormal mitotic activity
- Benign Findings Include: Lipoma (mature adipose tissue), sebaceous cyst, fibroma, ganglion cyst, or other non-malignant lesions
- Abnormal Result: Presence of malignant cells, atypical cellular features, or diagnostic findings consistent with specific disease entity (malignancy, infection, inflammatory process)
- Units of Measurement: Qualitative histopathological diagnosis; specimen size documented in centimeters; cellular mitotic rate expressed as mitoses per high-power field (HPF)
Interpretation
- Benign Lipoma: Mature fatty tissue without cellular atypia; most common benign soft tissue tumor; no follow-up required unless enlarging or symptomatic
- Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma: Presence of atypical stromal cells with nuclear enlargement; requires wide excision and close surveillance for recurrence or dedifferentiation
- High-Grade Sarcoma: Significant cellular atypia, increased mitotic activity (>10 mitoses/10 HPF), necrosis; requires urgent surgical resection with wide margins and consideration for adjuvant chemotherapy or radiation therapy
- Melanoma or Squamous Cell Carcinoma: Requires oncologic consultation; Breslow thickness documented for melanoma; depth of invasion important for staging and prognosis
- Infectious Process: Granulomas, abscess formation, or organisms identified; culture should be sent for appropriate antimicrobial therapy; may require drainage and antibiotics
- Factors Affecting Results: Specimen adequacy and size; proper fixation and processing; immunohistochemical studies may be necessary for precise classification; prior chemotherapy or radiation may alter cellular appearance
Associated Organs
- Primary Organ Systems: Integumentary system (skin and subcutaneous tissue); musculoskeletal system (muscle and fascia); lymphatic system (regional lymph nodes)
- Common Benign Conditions: Lipoma, epidermoid cyst, dermatofibroma, ganglion cyst, hemangioma, pilonidal cyst
- Malignant Conditions: Liposarcoma, fibrosarcoma, rhabdomyosarcoma, leiomyosarcoma, synovial sarcoma, melanoma, squamous cell carcinoma, metastatic disease
- Inflammatory/Infectious Conditions: Abscess, cellulitis, lymphadenitis, tuberculosis, fungal infections, pilonidal disease with infection
- Potential Complications: Local recurrence if malignancy inadequately excised; metastatic spread to regional lymph nodes, lungs, or liver with high-grade malignancies; infection at biopsy site (rare); hematoma formation
Follow-up Tests
- For Benign Lesions: No follow-up imaging required; clinical follow-up at 3-6 months if symptomatic; ultrasound if size change noted during surveillance
- For Low-Grade Malignancies: MRI for surgical planning and assessment of margins; CT chest to rule out pulmonary metastases; follow-up imaging every 3-6 months for 2 years, then annually
- For High-Grade Malignancies: Urgent staging with CT chest/abdomen/pelvis; MRI of primary site; PET-CT may be indicated; oncology consultation for systemic therapy; imaging follow-up every 2-3 months for first 2 years
- For Melanoma: Sentinel lymph node biopsy if appropriate; full body skin examination; periodic imaging based on stage; LDH level assessment
- For Infectious Process: Bacterial culture and sensitivities; tuberculosis testing if granulomas identified; imaging follow-up 4-6 weeks after treatment initiation; repeat ultrasound to confirm resolution
- Complementary Tests: Immunohistochemistry for tumor classification; FISH or cytogenetics for specific sarcoma subtypes; flow cytometry if lymphoma suspected; molecular testing for specific mutations
Fasting Required?
- Fasting: No
- Pre-Procedure Preparation: Patient may eat and drink normally before the procedure; no special dietary restrictions
- Medications to Avoid: Discontinue aspirin 3-5 days before procedure; discontinue NSAIDs 3-5 days prior; stop anticoagulants (warfarin, DOACs) per provider instructions; continue other chronic medications unless otherwise instructed
- General Preparation Instructions: Cleanse skin with soap and water on morning of procedure; wear comfortable, loose-fitting clothes allowing easy access to buttock region; avoid applying lotions or deodorants to biopsy area; arrange for transportation if conscious sedation used
- Post-Procedure Care: Keep wound clean and dry; apply antibiotic ointment as directed; avoid heavy lifting and strenuous activity for 1 week; monitor for signs of infection (fever, increasing pain, drainage); results typically available in 5-10 business days

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