Colon biopsy - Medium 1-3 cm

Biopsy

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Medium colon tissue sample.

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Colon Biopsy - Medium 1-3 cm: Comprehensive Medical Test Guide

Why is it done?
- Test Description: A colon biopsy is a tissue sampling procedure where a small piece (1-3 cm) of tissue is removed from the colon during colonoscopy for microscopic examination and histopathological analysis.
- Primary Indications: Detection of colorectal cancer and precancerous lesions (polyps); Diagnosis of inflammatory bowel disease (Crohn's disease, ulcerative colitis); Investigation of chronic diarrhea or bleeding; Diagnosis of infectious colitis; Assessment of suspected familial polyposis; Evaluation of radiographic or endoscopic abnormalities; Surveillance in high-risk patients
- Timing and Circumstances: Performed during routine colonoscopy screening (age 45-50 and above); When polyps or suspicious lesions are identified; During evaluation of gastrointestinal symptoms; In monitoring of inflammatory bowel disease; As part of cancer surveillance protocols; When radiographic findings require tissue confirmation
Normal Range
- Normal Findings: Normal colonic mucosa with intact epithelium; Normal glandular architecture (crypts of Lieberkühn); Absence of dysplasia or malignancy; Minimal to absent inflammatory infiltrate; Normal subepithelial connective tissue; No evidence of pathogenic organisms or parasites
- Reference Values: Histology: Benign colonic mucosa; Dysplasia Grade: None (negative for dysplasia); Inflammation Grade: Normal or minimal; Specimen Size: 1-3 cm tissue fragment
- Interpretation Framework: Negative Result: Benign tissue, no malignancy, no significant pathology; Positive Result: Presence of dysplasia, malignancy, or significant pathologic findings; Borderline: Low-grade dysplasia or uncertain findings requiring correlation with clinical presentation
- Units of Measurement: Histological grade classification; Dysplasia grade (none, low-grade, high-grade); Tissue size in centimeters (1-3 cm); Inflammatory infiltrate quantification
Interpretation
- Benign Findings: Normal colonic mucosa; Hyperplastic polyps (common, usually not requiring intervention); Inflammatory changes consistent with irritable bowel syndrome; No dysplasia or malignancy
- Low-Grade Dysplasia (LGD): Early neoplastic changes with risk of progression to cancer; Indicates precancerous condition; Requires surveillance colonoscopy in 3-6 months; May warrant ablation or resection depending on location and size
- High-Grade Dysplasia (HGD): Advanced precancerous lesion with significant cancer risk; Often requires intervention (resection, ablation, or increased surveillance); May indicate need for colorectal surgery in extensive disease
- Colorectal Cancer: Presence of malignant cells; Requires staging (TNM classification); Determines treatment approach (surgery, chemotherapy, radiation); Prognosis dependent on grade, stage, and molecular characteristics
- Inflammatory Bowel Disease: Crohn's disease findings: Non-caseating granulomas, transmural inflammation, focal involvement; Ulcerative colitis findings: Continuous mucosal inflammation, crypt abscesses, ulcerations; Helps differentiate between IBD types and assess disease activity
- Infectious Causes: Identification of bacterial, viral, or parasitic organisms; Special stains (PAS, GMS, immunohistochemistry) may be required; Guides antimicrobial or antiparasitic therapy
- Factors Affecting Interpretation: Tissue specimen quality and orientation; Adequacy of sampling; Pathologist experience in gastrointestinal pathology; Clinical history and endoscopic appearance; Patient age and disease duration; Prior biopsies or treatments
Associated Organs
- Primary Organ System: Large intestine (colon); Rectum; Gastrointestinal tract; Epithelial tissue system
- Commonly Associated Diseases: Colorectal cancer (adenocarcinoma); Adenomatous polyps; Crohn's disease; Ulcerative colitis; Irritable bowel syndrome; Diverticular disease; Microscopic colitis; Ischemic colitis; Infectious colitis (bacterial, viral, parasitic); Familial adenomatous polyposis (FAP); Lynch syndrome; Sessile serrated polyps; Appendiceal neoplasms
- Diagnostic Applications: Definitive diagnosis of neoplastic lesions; Classification of polyps and determination of malignant potential; Staging of colorectal cancer (depth of invasion); Differentiation of inflammatory conditions; Identification of infectious organisms; Assessment of dysplasia in chronic IBD
- Potential Complications: Bleeding (minor or significant); Perforation of colon wall (rare); Infection; Incomplete resection of malignant lesions; Inadequate tissue sampling; Complications requiring hospitalization or surgical intervention
Follow-up Tests
- Based on Benign Findings: Routine colonoscopy surveillance in 5-10 years (average risk); Fecal immunochemical test (FIT) or high-sensitivity FOBT annually; Repeat colonoscopy sooner if symptoms develop
- Based on Low-Grade Dysplasia: Surveillance colonoscopy in 3-6 months; Repeat biopsy of same site; Endoscopic ablation or mucosal resection (EMR); Chromoendoscopy for better lesion detection; Consider resection if in sessile serrated polyp or adenoma
- Based on High-Grade Dysplasia: Immediate endoscopic resection or ablation; Repeat colonoscopy in 1 month to confirm complete removal; Surgical consultation if extensive or multifocal disease; Consider subtotal colectomy in ulcerative colitis with multifocal HGD
- Based on Malignancy Findings: CT abdomen/pelvis with contrast for staging; Chest imaging to exclude metastases; Carcinoembryonic antigen (CEA) level; Molecular testing (KRAS, BRAF, mismatch repair status); MRI pelvis if rectal cancer; Complete colonoscopy if not performed; Surgical consultation for resection; Oncology referral for treatment planning
- Based on Inflammatory Bowel Disease: Inflammatory markers (ESR, CRP, fecal calprotectin); Assessment of disease activity; Adjustment of medical therapy; Repeat colonoscopy based on disease stage and dysplasia status; Surveillance colonoscopy annually in quiescent disease; Imaging studies if complications suspected
- Based on Infectious Findings: Stool culture for bacterial pathogens; Polymerase chain reaction (PCR) testing for viral organisms; Specific stains and cultures based on organism identified; Repeat endoscopy after treatment completion to confirm resolution; Clinical symptom monitoring
- Complementary Tests: Immunohistochemistry for better characterization; Electron microscopy for viral identification; Genetic testing for hereditary syndromes; Immunophenotyping if lymphoma suspected; Complete blood count and metabolic panel
Fasting Required?
- Fasting Status: Yes - Fasting is required
- Fasting Duration: NPO (nothing by mouth) for 4-6 hours before procedure; Clear liquid diet 24 hours prior to procedure; Complete bowel cleansing regimen 12-24 hours before colonoscopy
- Special Instructions: Follow specific bowel preparation protocol (polyethylene glycol solution, sodium picosulfate, magnesium citrate, or other approved agents); Drink entire preparation solution as directed; Expect frequent bowel movements; Monitor for complete evacuation of stool
- Medications to Avoid or Adjust: Hold anticoagulants (warfarin, dabigatran) - consult provider about timing; Hold antiplatelet agents (aspirin, clopidogrel) if possible - discuss with physician; Hold iron supplements 3-5 days prior; Avoid non-steroidal anti-inflammatory drugs (NSAIDs) 7-10 days prior; Continue essential cardiac and blood pressure medications with minimal water; Hold diabetes medications morning of procedure
- Additional Patient Preparation: Arrange transportation as sedation will be administered; Wear comfortable, loose clothing; Remove jewelry and metal accessories; Provide complete medical and surgical history; Disclose all allergies (especially sedation agents); Inform provider of implanted devices (pacemaker, defibrillator); Discuss pregnancy status if applicable; Plan to have someone present for recovery; Avoid driving for 24 hours after procedure due to sedation effects

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