Fibroid Medium biopsy 1-3 cm

Biopsy

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Uterine fibroid histology.

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Fibroid Medium Biopsy 1-3 cm - Comprehensive Medical Test Guide

Why is it done?
- Test Purpose: A tissue biopsy procedure to obtain samples from uterine fibroids (leiomyomas) measuring 1-3 cm in diameter for histopathological examination and diagnosis
- Primary Indications: Confirm benign nature of fibroid lesions; Rule out malignant transformation; Differentiate between fibroids and other uterine masses; Evaluate atypical or suspicious fibroid characteristics on imaging
- Clinical Circumstances: When imaging findings are inconclusive; Prior to treatment planning; When rapid growth is observed; In presence of atypical imaging features; During evaluation of abnormal uterine bleeding with fibroid findings; When malignancy cannot be excluded clinically
Normal Range
- Benign Fibroid Finding (Normal): Histological confirmation of leiomyoma (benign smooth muscle tumor); Composed of mature smooth muscle cells arranged in interlacing fascicles; Well-circumscribed, unencapsulated lesion; Absence of significant atypia or mitotic activity
- Result Interpretation - Negative Result: No malignancy detected; Consistent with benign fibroid pathology; No evidence of sarcomatous transformation
- Result Interpretation - Positive Result: Malignant tissue identified (leiomyosarcoma, endometrial stromal sarcoma, or other malignancy); Evidence of cellular atypia or increased mitotic activity; Requires immediate clinical intervention
- Units of Measurement: Specimen size 1-3 cm (largest dimension); Histopathological examination reported qualitatively; Microscopic grading based on nuclear morphology and mitotic index
Interpretation
- Benign Leiomyoma (Standard Finding): Confirms diagnosis of fibroid; Shows typical smooth muscle differentiation; Exhibits low mitotic activity (<5 mitoses per 10 high-power fields); Indicates conservative management may be appropriate; Favorable prognosis
- Atypical Leiomyoma: Increased nuclear atypia with normal mitotic activity; Nuclear enlargement and hyperchromasia present; Requires closer clinical follow-up; Borderline lesion with low malignant potential; May warrant repeat imaging surveillance
- Mitotically Active Leiomyoma: 5-9 mitoses per 10 high-power fields; Otherwise benign appearance; Intermediate risk lesion; Requires clinical correlation and possible imaging follow-up; Treatment consideration may be warranted
- Leiomyosarcoma: >10 mitoses per 10 high-power fields; Marked nuclear atypia; Significant hyperchromasia; Requires urgent surgical intervention; Necessitates staging studies and oncology consultation; Poor prognosis without treatment
- Endometrial Stromal Sarcoma: Low-grade malignancy with characteristic features; Requires specialized immunohistochemical analysis; May show JAZF1-JJAZ1 translocation; Requires aggressive treatment; Variable prognosis
- Factors Affecting Interpretation: Specimen adequacy and size; Fixation quality and timing; Sampling location within lesion; Patient age and menopausal status; Prior medical treatments affecting tissue; Radiological imaging correlation; Patient symptoms and clinical presentation
Associated Organs
- Primary Organ Systems: Uterus (principal site of fibroid development); Reproductive system; Female endocrine system; Vascular system (blood supply to tumors)
- Associated Medical Conditions - Benign Findings: Uterine fibroid (leiomyoma); Abnormal uterine bleeding; Menorrhagia or metrorrhagia; Pelvic pain or pressure symptoms; Infertility or recurrent pregnancy loss; Mass effect on adjacent structures
- Associated Malignant Conditions: Uterine leiomyosarcoma; Low-grade endometrial stromal sarcoma; Undifferentiated uterine sarcoma; Carcinosarcoma (malignant mixed Müllerian tumor); Metastatic malignancy to uterus
- Conditions Diagnosed or Monitored: Benign uterine leiomyoma (confirmed diagnosis); Atypical smooth muscle tumors; Uterine malignancies; Pathological determination of fibroid type and grade; Assessment of malignant transformation
- Potential Complications/Risks with Abnormal Results: If malignancy found: Need for extensive surgical staging; Potential chemotherapy or radiation therapy; Reduced fertility if aggressive treatment required; Hemorrhage or hematometra from sarcomatous tumors; Tumor rupture or dissemination; Need for hysterectomy; Significant psychological impact; Metastatic disease potential
Follow-up Tests
- If Benign Leiomyoma Confirmed: Pelvic ultrasound or MRI at 6-12 months to assess growth; Follow-up imaging annually if asymptomatic; Complete blood count (CBC) to evaluate for anemia from bleeding; Iron studies if menorrhagia present; Clinical reassessment every 6-12 months
- If Atypical Leiomyoma Found: Pelvic MRI every 3-6 months to monitor for growth; Gynecology oncology consultation; Advanced imaging (PET-CT) if rapid growth noted; Repeat biopsy if significant changes on imaging; Close clinical surveillance and symptom monitoring
- If Mitotically Active Leiomyoma: Pelvic ultrasound or MRI at 1-3 months; Oncology consultation recommended; Consider immunohistochemical studies (ER, PR, p53); Frequent imaging surveillance; Discussion of treatment options
- If Leiomyosarcoma Diagnosed: Urgent gynecology oncology consultation; CT chest/abdomen/pelvis for staging; MRI pelvis for local extent assessment; Complete blood work including LFTs; Urgent surgical intervention typically required; Possible adjuvant chemotherapy planning; Imaging surveillance post-treatment every 3 months initially
- If Endometrial Stromal Sarcoma Found: Molecular testing (JAZF1-JJAZ1 translocation); Staging CT imaging; Oncology consultation for treatment planning; Possible extended hysterectomy with bilateral salpingo-oophorectomy; Hormonal therapy consideration; Long-term imaging follow-up every 6-12 months
- Complementary/Related Tests: Immunohistochemistry (Ki-67, p53, ER, PR, desmin); Flow cytometry if sarcoma suspected; Cytogenetics or FISH analysis; Pelvic ultrasound; Pelvic MRI; Transabdominal or transvaginal ultrasound; Hysterosalpingography if fertility preservation important
Fasting Required?
- Fasting Requirement: No fasting required - This is a tissue biopsy procedure, not a blood test
- Anesthesia Considerations: If procedure requires general or spinal anesthesia: NPO (nothing by mouth) 6-8 hours prior; If local anesthesia only: No fasting typically required
- Medications to Avoid: Anticoagulants (warfarin, apixaban, rivaroxaban): Discontinue 3-5 days prior; Antiplatelet agents (aspirin, clopidogrel): Typically stop 7-10 days before; NSAIDs: Discontinue 48 hours prior; Herbal supplements with bleeding risk (ginkgo, garlic, ginger): Stop 1-2 weeks before; Consult physician before stopping any medications
- Pre-procedure Preparation: Schedule biopsy during follicular phase (early cycle) for better visualization; Arrange transportation if sedation planned; Avoid tampons or douches for 48 hours prior; Empty bladder before procedure; Wear loose, comfortable clothing; Remove all jewelry, piercings, and metal objects if imaging involved; Have valid photo ID and insurance card; Review informed consent and procedure risks
- Laboratory Preparation: Baseline laboratory studies (PT/INR, PTT, CBC) if patient on anticoagulation; Pregnancy test if applicable (biopsy contraindicated in pregnancy); Renal function and liver function tests may be required; Bleeding time and platelet count assessment
- Post-procedure Instructions: Light diet initially; Gradual return to normal diet once tolerated; Avoid strenuous activity for 48 hours; No intercourse or tampon use for 1-2 weeks; Mild cramping and spotting are normal; Contact provider if heavy bleeding, severe pain, or fever develops; Pain management as needed (acetaminophen preferred)

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