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Chest mass biopsy - Medium 1-3 cm
Biopsy
Report in 288Hrs
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No Fasting Required
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Biopsy of chest wall/lung lesion.
₹370₹529
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Chest Mass Biopsy - Medium 1-3 cm
- Why is it done?
- To obtain tissue samples from a chest mass measuring 1-3 cm in diameter for histopathological examination and definitive diagnosis
- To differentiate between benign and malignant lesions when imaging alone is inconclusive
- To identify specific malignancy type, grade, and molecular characteristics for treatment planning
- To evaluate solitary pulmonary nodules or mediastinal masses with indeterminate imaging characteristics
- Performed when CT imaging raises suspicion for malignancy or when clinical presentation warrants tissue diagnosis
- Typically ordered when mass demonstrates growth on serial imaging or shows concerning imaging features
- Normal Range
- Normal Result: Benign tissue; no malignant cells identified on histopathological examination
- Benign diagnoses may include: hamartoma, inflammatory pseudotumor, granuloma, lipoma, or reactive/infectious processes
- Negative for Malignancy: Standard interpretation indicating absence of cancer cells
- Abnormal Result: Positive for malignancy; specific histological type and grade documented
- Indeterminate/Non-diagnostic: Insufficient tissue sample; repeat biopsy may be necessary
- Results presented with histological classification: benign, atypical/borderline, or malignant categories
- Interpretation
- Benign Findings: Indicates no malignancy; provides reassurance and may discontinue further workup or establish baseline for surveillance if warranted by imaging characteristics
- Malignant Findings: Confirms cancer diagnosis; histology type (adenocarcinoma, squamous cell, small cell, large cell, mesothelioma, sarcoma, lymphoma) guides treatment decisions and prognosis assessment
- Grade Assessment: Low-grade (G1) suggests slower progression; high-grade (G3-G4) indicates aggressive behavior and need for intensive treatment
- Molecular and Immunohistochemical Markers: EGFR mutations, ALK rearrangements, PD-L1 expression, and other markers influence targeted therapy eligibility and immunotherapy response predictions
- Atypical/Borderline Results: Require correlation with clinical context and imaging; may indicate pre-malignant changes, dysplasia, or lesions requiring repeat sampling and close follow-up
- Non-diagnostic Samples: Inadequate cellularity or material; repeat biopsy using alternative approach (core needle, bronchoscopy, surgical) recommended based on clinical probability and mass accessibility
- Factors Affecting Results: Sample adequacy, needle placement accuracy, tissue necrosis or hemorrhage, operator experience, and preservation methods influence diagnostic accuracy and interpretation reliability
- Associated Organs
- Primary Organ System: Lungs and respiratory system; also evaluates mediastinal structures, pleura, and chest wall involvement
- Lung Cancer Diagnosis: Non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), carcinoid tumors, and other primary lung malignancies
- Other Malignancies: Metastatic lesions from breast, colon, kidney, melanoma, and other primary cancers; mesothelioma; lymphoma
- Benign Conditions: Hamartoma, chondroma, inflammatory pseudotumor, tuberculosis, fungal infections (aspergilloma, coccidioidomycosis), sarcoidosis
- Potential Complications: Pneumothorax (1-5% occurrence), hemoptysis, pulmonary hemorrhage, infection, pleural effusion, air embolism (rare), and bleeding at biopsy site
- Risk Factors for Complications: Severe COPD, emphysema, bleeding disorders, anticoagulation therapy, difficult mass accessibility, and traversal of aerated lung parenchyma
- Follow-up Tests
- Staging Studies (if Malignancy Confirmed): PET-CT scan for metabolic activity and distant metastatic disease assessment; brain MRI for high-risk histologies
- Molecular Testing: Gene mutations (EGFR, KRAS, BRAF), ALK and ROS1 rearrangements, and tumor mutational burden assessment for targeted therapy selection
- Immunohistochemistry Studies: PD-L1 expression, cell of origin markers, and differentiation status to guide immunotherapy and prognostic assessment
- Repeat Biopsy: If initial sample is non-diagnostic using CT-guided core needle, fluoroscopy, or bronchoscopic approaches depending on mass location
- Chest Imaging Follow-up: Chest X-ray to evaluate post-biopsy complications (pneumothorax); CT scan if benign diagnosis and imaging surveillance needed
- Oncology Consultation: Referral for treatment planning, chemotherapy, targeted therapy, immunotherapy, or radiation therapy decision-making
- Pulmonology Follow-up: For benign findings requiring surveillance or post-biopsy complication management; typically 6-12 week imaging reassessment for indeterminate lesions
- Bronchoscopy or Surgical Biopsy: Alternative approaches if percutaneous biopsy is unsuccessful or higher diagnostic yield required for clinical management
- Fasting Required?
- Fasting: Yes, 6-8 hours fasting recommended if sedation or anesthesia will be used; patient should NPO after midnight if procedure scheduled for morning
- Medication Management: Hold anticoagulants (warfarin, DOACs) per institutional protocol typically 3-5 days before biopsy; continue aspirin unless directed otherwise; resume post-procedure per physician guidance
- Pre-procedure Laboratory Tests: Coagulation studies (PT/INR, PTT), platelet count, CBC; blood type and screen if high bleeding risk
- Baseline Imaging: Recent CT chest (within 4 weeks) for procedure planning; baseline chest X-ray recommended to document absence of pre-existing pneumothorax
- Pulmonary Function Assessment: Baseline oxygen saturation and respiratory status evaluation; consider ABG if severe COPD or hypoxemia present
- Patient Instructions: Arrange transportation (cannot drive same day with sedation); bring insurance cards and photo ID; wear loose comfortable clothing; notify provider of allergies, medications, and medical comorbidities
- Post-procedure Activity: Rest for 24 hours; avoid strenuous activity and heavy lifting for 2-3 days; notify physician if chest pain, persistent cough, shortness of breath, or hemoptysis develops
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