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Fibroid Biopsy - XL

Biopsy
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Report in 288Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Uterine fibroid histology.

₹888₹1,269

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Fibroid Biopsy - XL: Comprehensive Medical Test Information Guide

  • Section 1: Why is it done?
    • Test Overview: The Fibroid Biopsy - XL is a histopathological examination that obtains tissue samples from uterine fibroids (leiomyomas) to determine cellular composition, confirm benign vs malignant pathology, and assess for atypical features or degenerative changes.
    • Primary Indications: Differentiation of benign fibroids from leiomyosarcoma; evaluation of rapidly growing masses; assessment of post-menopausal fibroids; evaluation of unusual imaging characteristics; confirmation of diagnosis before surgical planning; assessment of fibroids with atypical clinical presentations.
    • Clinical Circumstances: Performed when imaging studies suggest malignancy; performed prior to myomectomy or hysterectomy if malignancy is suspected; performed during minimally invasive procedures for tissue acquisition; performed when fibroids show rapid growth or size changes; performed to evaluate fibroids with uncertain radiological features.
  • Section 2: Normal Range
    • Normal/Benign Findings: Benign leiomyoma with characteristic smooth muscle differentiation; well-organized muscle fibers arranged in fascicles; mitotic count <5 mitoses per 10 high power fields (hpf); absence of necrosis or significant atypia; regular nuclear membranes with normal chromatin pattern.
    • Interpretation Categories: Negative Result: Benign leiomyoma with no evidence of malignancy; Borderline/Atypical: Cellular leiomyoma or mitotically active leiomyoma requiring close clinical follow-up; Positive Result: Leiomyosarcoma or malignant transformation with increased mitotic activity, necrosis, and cellular atypia.
    • Units of Measurement: Mitotic figures per 10 hpf; tumor size in centimeters; presence/absence of necrosis; degree of cellular atypia on semi-quantitative scale; immunohistochemical marker expression percentages.
    • Normal vs Abnormal Interpretation: Normal indicates benign smooth muscle proliferation consistent with typical uterine fibroid; abnormal findings include increased mitotic activity (>5/10 hpf), tumor cell necrosis, severe cellular atypia, and features diagnostic of leiomyosarcoma.
  • Section 3: Interpretation
    • Benign Leiomyoma: Diagnosis of benign fibroid with standard morphology; consists of mature smooth muscle cells with minimal mitotic activity (<5/10 hpf); no evidence of necrosis or significant cellular atypia; patient typically requires symptom management rather than urgent intervention.
    • Cellular Leiomyoma: Benign variant with increased cellularity but preserved mitotic counts <5/10 hpf; may appear more aggressive clinically despite benign histology; requires close imaging surveillance and clinical follow-up to exclude malignant transformation.
    • Mitotically Active Leiomyoma: Benign fibroid with elevated mitotic activity (5-9/10 hpf) but lack of other malignant features; generally benign prognosis but requires enhanced surveillance; associated with lower recurrence-free survival compared to standard leiomyomas.
    • Leiomyosarcoma (LMS): Malignant smooth muscle tumor with ≥10 mitoses/10 hpf, or ≥5 mitoses/10 hpf with coagulation necrosis, or presence of severe cellular atypia; requires immediate treatment planning including oncologic consultation; prognosis depends on grade, size, and stage at diagnosis.
    • Factors Affecting Results: Specimen adequacy and size; tissue fixation quality; sampling location within the fibroid; hormonal status and menstrual cycle phase; prior treatments or interventions; immunohistochemical marker expression; Ki-67 proliferation index; p16 expression; presence of coagulation-type necrosis.
    • Clinical Significance: Benign findings allow conservative management; borderline findings necessitate close follow-up imaging every 3-6 months; malignant findings require urgent multidisciplinary management including oncology consultation; results influence surgical approach (myomectomy vs hysterectomy); results guide post-operative surveillance protocols.
  • Section 4: Associated Organs
    • Primary Organ System: Female reproductive system, specifically the uterus; involves the myometrium where smooth muscle tumors originate; may affect surrounding pelvic organs if large or invasive.
    • Medical Conditions Associated with Abnormal Results: Uterine leiomyosarcoma; endometrial cancer with myometrial involvement; adenomyosis with atypical features; smooth muscle neoplasms with malignant potential; metastatic disease to the uterus; related smooth muscle tumors in other organ systems.
    • Diseases This Test Helps Diagnose or Monitor: Benign uterine leiomyomas (fibroids); uterine leiomyosarcoma; malignant transformation of existing fibroids; atypical smooth muscle proliferations; degenerative fibroid changes; post-treatment fibroid recurrence; hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome.
    • Potential Complications or Risks with Abnormal Results: Leiomyosarcoma carries high risk of recurrence and metastasis; may spread to peritoneal cavity, lymph nodes, lungs, and liver; potential for vascular invasion and hematogenous spread; risk of peritoneal carcinomatosis; poor prognosis with 5-year survival rates of 30-50% for advanced disease; complications from necessary aggressive surgical treatment.
    • Related Organ Involvement: Fallopian tubes may be involved with large fibroids; ovaries affected by adhesions from large or degenerating fibroids; bladder compression causing urinary symptoms; rectosigmoid involvement with bowel symptoms; vascular involvement affecting blood supply.
  • Section 5: Follow-up Tests
    • If Benign Fibroid Confirmed: Baseline pelvic ultrasound for size documentation; pelvic MRI if multiple fibroids or pre-operative planning needed; CBC to assess for anemia from heavy menstrual bleeding; iron studies if anemia present; follow-up ultrasound every 1-2 years for size monitoring.
    • If Atypical or Borderline Findings: Pelvic ultrasound every 3 months for 12 months; pelvic MRI with contrast every 6 months for initial follow-up; immunohistochemical stains (Ki-67, p16) if not already performed; pathology review by gynecologic pathologist specialist; consideration of repeat biopsy if imaging changes noted.
    • If Leiomyosarcoma Diagnosed: Urgent oncology consultation; comprehensive staging including pelvic/abdominal/chest CT or MRI; complete blood work including CBC, metabolic panel; imaging of lungs (chest X-ray or CT chest); assessment for metastatic disease; potential for additional pathology review; consideration of molecular testing for prognostic markers.
    • Complementary Testing Recommendations: Pelvic ultrasound for sizing and baseline documentation; pelvic MRI for detailed assessment and surgical planning; CT or PET-CT for staging if malignancy suspected; immunohistochemistry panels (SMA, caldesmon, h-caldesmon); molecular studies if indicated; genetic testing if HLRCC syndrome suspected.
    • Monitoring Frequency: Benign fibroids: annual imaging for asymptomatic, every 3-6 months if symptoms; Atypical/borderline: every 3 months initially, then every 6 months; Leiomyosarcoma: intensive surveillance including imaging every 3 months for 2 years, then every 6 months for 3 years; post-treatment follow-up per oncology protocol.
  • Section 6: Fasting Required?
    • Fasting Requirement: No - Fasting is NOT required for fibroid biopsy procedures.
    • Pre-Procedure Preparation: Light meal or snacks acceptable morning of procedure; normal fluid intake permitted; morning routine medications may be continued unless specifically instructed otherwise; light breakfast 2-4 hours before procedure is acceptable.
    • Medication Considerations: Aspirin and NSAIDs: discontinue 5-7 days before procedure if possible to reduce bleeding risk; Anticoagulants (warfarin, apixaban, dabigatran): coordinate timing with prescribing physician; Blood thinners: notify provider at least 1 week in advance; Routine medications: continue as prescribed unless specifically instructed to stop; Pain medications: may be taken with small amount of water.
    • Special Instructions: Schedule procedure in follicular phase of menstrual cycle (days 8-12) when endometrial thickness is minimal; empty bladder 30 minutes before procedure if ultrasound-guided; avoid intercourse and douching for 24 hours before biopsy; wear comfortable, loose-fitting clothing; arrange transportation as sedation/anesthesia may be used; bring insurance card and identification; arrive 15-30 minutes early.
    • Post-Procedure Care: Resume normal diet immediately after procedure; normal fluid intake encouraged; rest for remainder of day recommended; mild cramping common and manageable with acetaminophen; avoid strenuous activity for 24-48 hours; avoid douching and tampons for 1 week; avoid intercourse for 1 week; expect possible light spotting or vaginal discharge for several days.
    • Contraindications and Additional Precautions: Active pelvic infection: postpone procedure until resolved; significant anticoagulation: coordinate with provider; severe bleeding disorders: notify provider in advance; pregnancy: confirm not pregnant before procedure; severe uterine cervicitis: may require pretreatment; allergy to local anesthetics: inform provider; baseline coagulation abnormalities: may require special testing.

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