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Colon biopsy - Large Biopsy 3-6 cm

Biopsy
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Report in 288Hrs

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No Fasting Required

Details

Large colon tissue sample.

₹666₹951

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Colon Biopsy - Large Biopsy 3-6 cm

  • Why is it done?
    • Obtains tissue samples from colorectal lesions or masses for histopathological examination and diagnosis
    • Detects and confirms malignancy in suspicious polyps, masses, or nodular lesions
    • Evaluates inflammatory bowel conditions including Crohn's disease, ulcerative colitis, and infectious colitis
    • Investigates unexplained chronic diarrhea, rectal bleeding, or bloody stools
    • Obtains larger tissue specimens for comprehensive analysis when standard biopsies are non-diagnostic
    • Assesses strictures, ulcers, or areas of abnormal mucosa that require detailed pathological evaluation
    • Typically performed during colonoscopy when endoscopic visualization reveals suspicious lesions or abnormal tissue
  • Normal Range
    • Normal/Negative Result: Tissue shows normal colonic mucosa with regular epithelial architecture, absence of dysplasia, malignancy, or significant inflammation
    • Benign Findings: Hyperplastic polyp, tubular adenoma, or other non-malignant lesions without dysplasia
    • Inflammatory Changes: Mild, non-specific inflammation consistent with normal variation or infectious processes
    • Abnormal/Positive Result: Presence of malignancy, dysplasia, significant inflammation (IBD), or specific infectious/neoplastic pathology
    • Interpretation Scale: Results are primarily qualitative (descriptive histopathology) rather than quantitative with numerical values
  • Interpretation
    • Adenocarcinoma: Indicates malignant transformation requiring staging studies, oncology consultation, and treatment planning
    • High-Grade Dysplasia (HGD): Pre-malignant lesion with significant risk of progression to cancer; may warrant polypectomy, endoscopic resection, or surveillance coloscopy
    • Low-Grade Dysplasia (LGD): Mild cellular abnormality with potential for progression; requires close endoscopic surveillance and repeat biopsies
    • Inflammatory Bowel Disease (IBD): Chronic inflammation with crypt distortion, increased lymphocytes, or crypt abscesses confirms Crohn's disease or ulcerative colitis diagnosis
    • Infectious Colitis: Identifies causative organisms or inflammatory patterns specific to bacterial, viral, or parasitic infections (e.g., Clostridium difficile, cytomegalovirus)
    • Polyp Classification: Detailed histology determines if polyp is hyperplastic, adenomatous, sessile serrated, traditional serrated, or other types affecting surveillance recommendations
    • Factors Affecting Results: Sample size and adequacy, tissue fixation, prior treatments (chemotherapy/radiation), immunosuppression status, and previous biopsy findings
    • Large Biopsy Advantage (3-6 cm): Larger specimen provides more comprehensive tissue evaluation, better assessment of lesion margins, and higher diagnostic accuracy compared to small forceps biopsies
  • Associated Organs
    • Primary Organ System: Colon (large intestine) and rectum - specifically the mucosa and submucosa layers
    • Colorectal Cancer: Most significant malignancy; adenocarcinoma is the most common type detected via biopsy
    • Inflammatory Bowel Disease (IBD): Ulcerative colitis and Crohn's disease - chronic inflammatory conditions requiring long-term monitoring
    • Infectious Colitis: Bacterial (Salmonella, Shigella, E. coli, C. difficile), viral (CMV, norovirus), parasitic (Entamoeba, Giardia), or fungal infections
    • Polyps and Adenomas: Precancerous lesions with varying malignant potential depending on type, size, and histology
    • Strictures and Ulcers: Can be associated with malignancy, IBD, ischemia, or radiation injury requiring tissue diagnosis
    • Other Conditions: Diverticulitis with complications, mucosal metaplasia, lymphoma, neuroendocrine tumors, or vascular malformations
    • Potential Risks/Complications: Larger biopsies carry slightly increased risk of bleeding, perforation, or infection compared to small forceps biopsies; more significant in patients on anticoagulation or with coagulopathies
  • Follow-up Tests
    • If Malignancy Confirmed: CT staging (chest/abdomen/pelvis), MRI pelvis, carcinoembryonic antigen (CEA) level, complete metabolic panel, genetic testing (microsatellite instability, mismatch repair deficiency) for Lynch syndrome screening
    • If Dysplasia Detected: Repeat colonoscopy in 3-6 months for surveillance, possible endoscopic resection or ablation, high-resolution chromo-endoscopy for targeted biopsies
    • If IBD Confirmed: Inflammation markers (ESR, CRP, fecal calprotectin), routine surveillance colonoscopy every 1-3 years depending on extent and severity, immunosuppressive therapy initiation
    • If Infection Identified: Stool culture and sensitivity, C. difficile toxin studies, antibiotic susceptibility testing, targeted antimicrobial therapy based on organism identification
    • For Large Adenomas: Follow-up colonoscopy at 6 weeks to verify complete resection, repeat colonoscopy surveillance intervals based on adenoma characteristics (size, number, histology)
    • Non-Diagnostic or Equivocal Results: Repeat colonoscopy with additional biopsies, endoscopic ultrasound (EUS), or other imaging for further characterization
    • Routine Surveillance: Screening colonoscopy intervals vary from 5-10 years for normal results depending on age and risk factors; annual surveillance for IBD patients
    • Immunohistochemistry (IHC) Studies: May be performed on tissue sections for specific marker identification (p53, Ki-67, mismatch repair proteins) to assist in diagnosis and prognosis
  • Fasting Required?
    • Fasting Required: YES - NPO (nothing by mouth) for at least 6-8 hours prior to colonoscopy
    • Duration: Typically 6-8 hours of fasting; most commonly performed in morning after overnight fast from previous evening
    • Bowel Preparation: Complete colon cleansing with polyethylene glycol (PEG) solution, sodium phosphate, or picosulfate preparation taken 12-24 hours before procedure - this is CRITICAL for adequate visualization and biopsy
    • Medications to Avoid or Adjust: Anticoagulants (warfarin, apixaban, rivaroxaban, dabigatran) - discontinue 3-5 days before procedure; aspirin - continue (unless high risk); NSAIDs - stop 7 days before; antiplatelet agents require individualized assessment
    • Iron Supplements: Discontinue 3-5 days prior (darkens stool and obscures visualization)
    • Diabetes Medications: Adjust insulin and oral hypoglycemics on day of procedure due to fasting and bowel prep; metformin may be held per protocol
    • Liquid Diet Restrictions: Day before procedure: clear liquids only (broth, water, clear juice, black coffee/tea); avoid red/purple liquids that can simulate blood
    • Sedation Arrangements: Conscious sedation (propofol, midazolam) is typically used; arrange for responsible adult driver after procedure and avoid operating machinery for 24 hours
    • Pre-Procedure Checklist: Informed consent signed; baseline vital signs recorded; IV line established; physician review of medications and allergies; NPO status confirmed

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