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Cervical biopsy

Biopsy
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Report in 240Hrs

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Details

Tissue biopsy from cervix.

₹296₹423

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Cervical Biopsy - Comprehensive Medical Test Guide

  • Why is it done?
    • Test Purpose: A cervical biopsy involves removing a small sample of tissue from the cervix for microscopic examination to detect precancerous changes, cervical cancer, or other cervical abnormalities.
    • Primary Indications: Abnormal Pap smear results; persistent HPV infection (high-risk types); visible cervical lesions or abnormalities; abnormal colposcopy findings; evaluation of cervical bleeding or persistent cervical pain.
    • Timing and Circumstances: Performed during colposcopy examination when abnormal areas are identified; typically scheduled 1-2 weeks after abnormal screening results; generally not performed during menstruation; may be performed in office or outpatient surgical setting.
    • Clinical Significance: Gold standard for confirming cervical pathology; allows definitive diagnosis when screening tests are abnormal; guides treatment decisions and management plans.
  • Normal Range
    • Normal Results: Reported as 'benign,' 'normal tissue,' or 'no dysplasia'; indicates healthy cervical tissue without malignancy or significant abnormality.
    • Result Classification System: Results are categorized using the CIN (Cervical Intraepithelial Neoplasia) grading system: Negative (no dysplasia); CIN 1 (mild dysplasia); CIN 2 (moderate dysplasia); CIN 3 (severe dysplasia/carcinoma in situ); Invasive squamous cell carcinoma; Adenocarcinoma; Other findings (inflammation, infection, benign lesions).
    • Interpretation of Negative Results: No cervical cancer or significant precancerous changes detected; tissue appears structurally and microscopically normal; patient can typically return to routine screening.
    • Units of Measurement: Histopathological analysis (microscopic cellular examination); results reported qualitatively with descriptive diagnosis; no numerical values; tissue graded by degree of dysplasia present.
    • Benign Findings: May include cervicitis (inflammation); polyps; fibroids; metaplasia; infection (viral, bacterial, fungal); hemorrhage; or normal squamous tissue.
  • Interpretation
    • Negative/Normal Results: No dysplasia or malignancy present; cervical tissue is healthy; continue routine screening (Pap smear every 3-5 years if appropriate); low immediate cancer risk.
    • CIN 1 (Mild Dysplasia): Abnormal cells present in lower third of epithelium; often associated with HPV infection; may regress spontaneously in young women; typically requires repeat colposcopy in 12 months or HPV testing; surveillance preferred over immediate treatment in selected cases.
    • CIN 2 (Moderate Dysplasia): Abnormal cells occupy approximately one-half to two-thirds of epithelial thickness; increased risk of progression to malignancy; treatment typically recommended (excisional or ablative procedures); follow-up colposcopy and cytology required after treatment.
    • CIN 3 (Severe Dysplasia/Carcinoma In Situ): Full-thickness involvement of epithelium without invasion into stroma; considered high-grade lesion; significant malignant potential; excisional treatment necessary; margins must be evaluated; close surveillance mandatory; higher recurrence risk.
    • Invasive Squamous Cell Carcinoma: Malignant cells breach basement membrane and invade stroma; indicates cervical cancer; requires staging studies (imaging, additional testing); oncology referral necessary; treatment may include surgery, radiation, chemotherapy, or combination approaches.
    • Adenocarcinoma: Glandular cervical cancer; often arises from endocervical columnar cells; accounts for 10-25% of cervical cancers; aggressive behavior in some cases; requires oncology evaluation and specialized treatment planning; poorer prognosis than squamous cell carcinoma.
    • Benign Findings (Cervicitis, Polyps, Infection): Non-malignant pathology; requires treatment directed at underlying cause; cervicitis responds to antimicrobials if infectious; polyps may require removal if symptomatic; generally favorable prognosis; routine follow-up based on specific diagnosis.
    • Factors Affecting Interpretation: Specimen adequacy and quality; tissue processing techniques; pathologist expertise; HPV status; patient age; immune status; smoking history; prior treatments; tissue margins (for excisional specimens); presence of inflammation or infection.
    • Specimen Adequacy: Pathologist comments on tissue adequacy; inadequate specimens may require repeat biopsy; architecture preservation important for accurate grading; fixation and staining quality affects diagnostic accuracy.
  • Associated Organs
    • Primary Organ: Cervix (lower portion of uterus); stratified squamous epithelium (ectocervix); columnar epithelium (endocervix); transformation zone where most cancers arise.
    • Related Organ Systems: Reproductive system (uterus, ovaries, fallopian tubes); pelvic lymph nodes; lower gastrointestinal tract (potential metastatic sites); urinary system (potential involvement in advanced disease).
    • Common Associated Conditions: Cervical cancer (squamous cell carcinoma, adenocarcinoma); cervical intraepithelial neoplasia (CIN); cervicitis (infectious or non-infectious); cervical polyps; fibroids; HPV infection; endometriosis; cervical stenosis.
    • Associated Diseases Detected: Cervical cancer; precancerous lesions; sexually transmitted infections (HPV, herpes simplex); bacterial infections; fungal infections; viral infections; immunosuppression-related conditions.
    • Potential Complications from Abnormal Results: Metastatic cancer (to lungs, liver, bones, brain); pelvic lymphadenopathy; fistula formation; vaginal bleeding; pelvic pain; reproductive dysfunction; need for hysterectomy; chemotherapy side effects; radiation complications; fertility impact.
    • Biopsy-Related Risks and Complications: Vaginal bleeding (usually minimal); cramping or pain; infection (rare); uterine perforation (uncommon); cervical stenosis (rare); vasovagal response; psychosocial impact of diagnosis.
  • Follow-up Tests
    • After Normal Biopsy: Return to routine screening (Pap smear every 3-5 years); HPV testing may be recommended; colposcopy surveillance based on prior cytology; annual gynecological examination.
    • After CIN 1 Diagnosis: HPV testing (if not already done); repeat colposcopy at 12 months; repeat Pap smear at 12 months; surveillance for 2-3 years; treatment only if persistence or progression; consider excisional procedure if margins unclear.
    • After CIN 2/3 Diagnosis: Excisional treatment (loop electrosurgical excision procedure [LEEP], cold knife conization, or laser conization); evaluation of surgical margins; Pap smear/colposcopy at 3-6 months post-treatment; HPV testing at 6-12 months; surveillance for 25 years; treatment failure requires further intervention.
    • After Invasive Cancer Diagnosis: Staging studies (CT/MRI pelvis and abdomen, chest imaging); PET scan; oncology consultation; pap smear/HPV testing not indicated; treatment planning (surgery vs. radiation/chemotherapy); tumor markers if applicable; regular oncology follow-up.
    • Complementary Tests: HPV genotyping; p16/Ki67 testing (immunohistochemistry); repeat cytology (Pap smear); colposcopy with directed biopsy; endocervical curettage; viral serologies if indicated.
    • Surveillance Schedule Post-Treatment: First follow-up at 3-6 months after treatment; Pap smear and colposcopy; repeat testing at 12 months; annual screening for 25 years minimum; lifelong monitoring recommended; persistent or recurrent disease requires re-evaluation.
    • Tests NOT Recommended: Routine HPV vaccination after cervical cancer diagnosis; routine imaging for surveillance of treated CIN (only for invasive cancer); screening colonoscopy unless clinically indicated for other reasons.
  • Fasting Required?
    • Fasting Requirement: NO - Fasting is NOT required for cervical biopsy.
    • Pre-Procedure Preparation: Normal meal and hydration acceptable on day of procedure; arrive with empty bladder or void before examination; remove all jewelry and metal objects; wear loose, comfortable clothing; arrange for someone to drive if sedation used.
    • Timing Considerations: Schedule during follicular phase of menstrual cycle (days 5-25); NOT during menstruation; NOT during pregnancy (unless medically urgent); consider scheduling when patient can be pain-free (avoid heavy exercise day of procedure).
    • Medications - Acceptable: Continue regular medications as prescribed; mild analgesics (acetaminophen, ibuprofen) may be taken before procedure with water; thyroid medications; antihypertensives; diabetes medications.
    • Medications - Use Caution/Discuss: Anticoagulants (warfarin, apixaban, dabigatran); antiplatelet agents (aspirin, clopidogrel); NSAIDs if high bleeding risk; discuss with provider before discontinuing; may need to continue if bleeding risk acceptable.
    • Pre-Procedure Hygiene: Bathe or shower before appointment; normal vaginal hygiene acceptable; NO douching for 24 hours prior; NO tampons for 24 hours prior; NO vaginal medications or creams for 24 hours prior; NO sexual intercourse for 24 hours prior.
    • Post-Procedure Instructions: Normal diet and hydration encouraged; pads recommended for 1-2 days (mild vaginal bleeding normal); NO tampons for 2 weeks; NO sexual intercourse for 1-2 weeks; NO douching for 2 weeks; NO heavy exercise/strenuous activity for 2 weeks; rest as needed; mild cramping normal.
    • When to Contact Provider: Heavy vaginal bleeding (soaking more than 1 pad per hour); severe or worsening pain not relieved by analgesics; fever above 101°F (38.3°C); foul-smelling vaginal discharge; signs of infection; chest pain; difficulty breathing; fainting; severe complications.

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