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Cervix biopsy - Medium 1-3 cm

Biopsy
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Report in 288Hrs

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No Fasting Required

Details

Evaluation of abnormal Pap smear, diagnosis of precancerous or cancerous lesions

₹399₹1,000

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Cervix Biopsy - Medium 1-3 cm

  • Why is it done?
    • Purpose: To obtain tissue samples from suspicious lesions or abnormal areas of the cervix for histopathological examination to diagnose precancerous or cancerous conditions.
    • Primary Indications: Abnormal Pap smear results, visible cervical lesions, persistent HPV infection, abnormal colposcopic findings, or grossly apparent cervical masses.
    • Typical Timing: Performed during colposcopy examination when abnormal areas are identified. Usually scheduled 1-2 weeks after abnormal screening results or when cervical pathology is suspected.
    • Clinical Context: Medium biopsies (1-3 cm) are taken when lesions are larger than minimal sampling but smaller than requiring extensive excision, allowing adequate tissue for diagnosis while preserving cervical anatomy.
  • Normal Range
    • Normal Finding: Benign cervical tissue with normal squamous epithelium, normal maturation, absence of dysplasia, and no malignancy.
    • Reference Values (Bethesda System): Negative for intraepithelial lesion or malignancy (NILM) - represents normal cervical tissue with normal histology.
    • Associated Normal Features: Intact basement membrane, normal cellular architecture, appropriate cellular differentiation, absence of mitotic figures in superficial layers, and normal inflammatory response.
    • Possible Benign Findings: Chronic inflammation, benign polyps, metaplasia, HPV changes without dysplasia, or infectious processes (candidiasis, bacterial vaginosis).
    • Interpretation Terminology: Negative (Normal) indicates absence of precancerous or cancerous changes; Positive/Abnormal indicates presence of dysplasia, neoplasia, or malignancy.
  • Interpretation
    • Negative for Intraepithelial Lesion or Malignancy (NILM): Normal cervical tissue without dysplasia or malignancy. May include benign findings such as inflammation, infection, or normal variants. Continuation of routine screening recommended.
    • Cervical Intraepithelial Neoplasia Grade 1 (CIN 1/Low-grade SIL): Mild dysplasia affecting lower third of epithelium. Indicates HPV-related changes with low risk of progression. Many regress spontaneously; close follow-up with repeat cytology or HPV testing in 12-24 months recommended.
    • Cervical Intraepithelial Neoplasia Grade 2 (CIN 2/High-grade SIL): Moderate dysplasia affecting lower two-thirds of epithelium. Significant risk of progression to invasive cancer if untreated. Requires excisional procedures (LEEP/cone biopsy) with margins assessment.
    • Cervical Intraepithelial Neoplasia Grade 3 (CIN 3/High-grade SIL): Severe dysplasia or carcinoma in situ affecting full thickness of epithelium. High risk for progression to invasive cancer. Mandatory excisional treatment with negative margin confirmation required.
    • Adenocarcinoma in Situ (AIS): Dysplasia of glandular epithelium with high malignant potential. Aggressive lesion requiring immediate excisional treatment with careful margin assessment and close follow-up.
    • Invasive Squamous Cell Carcinoma: Malignant neoplasm with invasion through basement membrane. Indicates advanced disease requiring staging, oncologic consultation, and multimodal treatment planning (surgery, radiation, chemotherapy).
    • Adenocarcinoma (Other Types): Malignant glandular neoplasms including endocervical, mucinous, or clear cell types. Requires immediate oncologic evaluation and aggressive treatment approach.
    • Factors Affecting Interpretation: HPV type (high-risk vs. low-risk), adequacy of biopsy sampling, presence of margin involvement in excisional specimens, patient age, immune status, smoking history, and concurrent inflammatory conditions.
    • Clinical Significance: Results guide management decisions including need for treatment, type and extent of intervention, surveillance intervals, and assessment of treatment efficacy.
  • Associated Organs
    • Primary Organ System: Female reproductive system, specifically the cervix (lower portion of uterus). Composed of stratified squamous epithelium and endocervical glandular epithelium at the transformation zone.
    • Related Anatomical Structures: Uterus, vagina, parametrial tissues, pelvic lymph nodes, and surrounding pelvic structures may be involved in advanced cervical disease.
    • Common Associated Conditions with Abnormal Results: Persistent HPV infection (types 16, 18, 31, 33, 45), cervical dysplasia, cervical cancer, genital warts (benign HPV), cervicitis, and inflammatory conditions.
    • Diseases Diagnosed/Monitored: Cervical intraepithelial neoplasia (CIN 1, 2, 3), cervical cancer (squamous cell carcinoma, adenocarcinoma), adenocarcinoma in situ, and HPV-related pathology.
    • Potential Complications/Associated Risks: Progression to invasive cancer if dysplasia untreated, metastatic disease (to lymph nodes, liver, lungs, bone), vaginal bleeding or excessive menstrual bleeding, infertility from cervical scarring post-treatment, and impaired reproductive function.
    • Systemic Implications: HPV infection is systemic; high-risk HPV types also associated with other cancers (anal, oropharyngeal, vulvar, penile). Cervical cancer may cause distant metastases affecting multiple organ systems.
  • Follow-up Tests
    • For CIN 1 Findings: Repeat cervical cytology at 12 and 24 months, or HPV reflex testing. Colposcopy may be repeated if cytology remains abnormal. Return to routine screening if results normalize.
    • For CIN 2/3 or AIS: Loop Electrosurgical Excision Procedure (LEEP) or cone biopsy with margin assessment. Excisional biopsy preferred to allow evaluation of lateral and deep margins. Repeat cytology at 6 months and 12 months post-treatment.
    • For Invasive Carcinoma: Imaging studies (MRI pelvis, CT chest/abdomen/pelvis, PET-CT) for staging. Oncology consultation. Possible additional testing: lymph node assessment, parametrial involvement evaluation. Tumor markers and circulating HPV DNA may be considered.
    • Surveillance Schedule: CIN 1: 3-4 years of surveillance with cytology or HPV testing. CIN 2/3 post-treatment: 3 years of surveillance with enhanced monitoring. Invasive cancer: Ongoing surveillance based on treatment type and stage, with imaging and clinical exams per oncology protocol.
    • Complementary Tests: HPV genotyping, HPV mRNA testing, p16/Ki-67 immunohistochemistry, repeat colposcopy, endocervical curettage, and testing for other sexually transmitted infections.
    • HPV Vaccination Status: Catch-up HPV vaccination may be recommended for appropriate age groups if not previously vaccinated, especially after treatment of HPV-related lesions.
  • Fasting Required?
    • Fasting Status: No - Fasting is NOT required for cervix biopsy.
    • Pre-procedure Preparation: Schedule appointment when NOT menstruating if possible. Avoid douching, tampons, and sexual intercourse for 24 hours before procedure. Empty bladder before procedure. Patient should wear easily removable clothing.
    • Medications to Avoid: Aspirin and NSAIDs should be withheld 3-5 days before procedure if tolerated, to reduce bleeding risk. Anticoagulant/antiplatelet medications should be discussed with provider; discontinuation may be recommended depending on indication. Acetaminophen is acceptable for pain relief.
    • Anesthesia Considerations: Local anesthesia (lidocaine spray or solution) is typically applied to the cervix prior to biopsy. Systemic anesthesia is not required. NPO status not necessary unless additional procedures planned.
    • Additional Instructions: Bring current medications list. Inform provider of bleeding disorders, anticoagulation therapy, or contraindications to local anesthesia. Arrange transportation if sedation provided. Patient education regarding expected sensations (pressure, mild discomfort, possible vaginal spotting) should be completed.
    • Post-procedure Care: Avoid intercourse, douching, and tampons for 1 week. Some spotting or mild discharge normal for 3-5 days. Rest recommended for 24 hours. Report heavy bleeding, severe pain, fever, or foul-smelling discharge. Results typically available in 7-14 business days.

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