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Fistula Tract - Large Biopsy 3-6 cm

Biopsy
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Report in 288Hrs

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No Fasting Required

Details

Histopathology of fistula tract.

₹666₹951

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Fistula Tract - Large Biopsy 3-6 cm

  • Why is it done?
    • To obtain tissue samples from an abnormal fistula tract measuring 3-6 cm in length for histopathological examination and diagnosis
    • To identify the underlying etiology of fistula formation, including malignancy, chronic inflammatory disease, infection, or trauma
    • To differentiate between benign and malignant fistula tracts
    • To detect infectious organisms including bacteria, fungi, and mycobacteria within the fistula tract
    • To guide treatment planning and determine prognosis based on histological findings
    • Performed when fistula has been present for more than 4 weeks or shows signs of complexity requiring larger sampling for diagnostic accuracy
  • Normal Range
    • Normal Result: Absence of malignant cells, granulomas, or causative organisms on histopathological examination
    • Normal Range: Non-specific chronic inflammation with fibrosis and granulation tissue characteristic of simple fistulization
    • No organism growth on culture or special stains (no acid-fast bacilli, fungi, or significant bacterial colonization)
    • Interpretation: A normal biopsy suggests benign, non-infectious etiology such as post-traumatic fistulization or uncomplicated drainage
    • Abnormal Range: Any finding of malignant cells, specific granulomatous disease, acid-fast bacilli (tuberculosis), fungal organisms, or atypical cellular changes
  • Interpretation
    • Malignancy Present: Squamous cell carcinoma, adenocarcinoma, or other malignant histology indicates malignant transformation of fistula tract; requires immediate oncologic consultation and staging
    • Granulomatous Disease: Caseating granulomas suggest tuberculosis; non-caseating granulomas may indicate sarcoidosis, Crohn's disease, or berylliosis
    • Infectious Agents: Presence of acid-fast bacilli, fungal elements (Actinomyces, Candida), or specific bacteria confirms infectious etiology requiring targeted antimicrobial therapy
    • Chronic Inflammation with Fibrosis: Indicates long-standing fistulization; suggests benign process if no other pathology identified
    • Epithelialized Tract: Epithelial lining indicates chronicity and suggests tract has become established; may be associated with increased malignant potential
    • Factors Affecting Results: Sample adequacy, proper fixation, presence of contamination, location of biopsy within tract, immunocompromised status, and use of immunosuppressive medications may influence interpretation
  • Associated Organs
    • Primary Organ Systems: Skin and soft tissues, gastrointestinal tract, genitourinary system, musculoskeletal system
    • Common Fistula Locations and Associated Conditions:
      • Anal/Perianal: Crohn's disease, pilonidal disease, trauma, abscess
      • Rectovaginal: Inflammatory bowel disease, radiation therapy, obstetric trauma
      • Cutaneous: Hidradenitis suppurativa, pilonidal disease, chronic infections, tuberculosis
      • Urinary: Trauma, calculi, chronic infection, malignancy
      • Bone/Joint: Osteomyelitis, tuberculosis, brucellosis
    • Diseases Identified Through Biopsy: Malignancy (squamous cell or adenocarcinoma), tuberculosis, atypical mycobacterial infections, fungal infections, Crohn's disease, hidradenitis suppurativa, brucellosis
    • Potential Complications of Abnormal Results: Malignant transformation with metastatic spread, systemic infection requiring prolonged antimicrobial therapy, sepsis, recurrent infections, chronic pain, functional impairment
    • Multi-Organ Involvement: Tuberculosis or systemic inflammatory conditions may have manifestations beyond fistula site affecting lungs, lymph nodes, and other organs
  • Follow-up Tests
    • If Malignancy Detected: CT scan for staging, MRI for local extent, PET-CT for metastases, immunohistochemistry for tumor markers, sentinel lymph node biopsy
    • If Tuberculosis Suspected: Chest X-ray, Mantoux test, IGRA (interferon-gamma release assay), gene Xpert MTB/RIF, sputum smear microscopy if pulmonary involvement
    • If Infection Confirmed: Repeat culture and sensitivity testing, additional histopathology with special stains, imaging (ultrasound, MRI) to assess tract extent, blood cultures if systemic infection suspected
    • If Inflammatory Bowel Disease Suspected: Colonoscopy with biopsy, small bowel imaging, fecal calprotectin, inflammatory markers (CRP, ESR)
    • Imaging Studies: Fistulography, ultrasound, MRI or CT to assess tract complexity, branching patterns, and associated cavities or organs involved
    • Laboratory Tests: Complete blood count, erythrocyte sedimentation rate, C-reactive protein, serology for specific infections (brucellosis, tuberculosis)
    • Monitoring Frequency: If malignancy: regular oncologic surveillance every 3-6 months; if infection: repeat imaging at 6-8 weeks after treatment initiation; if inflammatory: interval assessment per gastroenterology recommendations (3-6 months)
    • Repeat Biopsy: May be indicated if initial diagnosis inconclusive, recurrent symptoms after treatment, or change in fistula characteristics
  • Fasting Required?
    • Fasting Requirement: Generally NO fasting required for fistula tract biopsy; however, requirements depend on planned anesthesia type
    • If Local Anesthesia: No fasting necessary; patient may eat and drink normally before procedure
    • If General Anesthesia or IV Sedation: NPO (nothing by mouth) typically required for 6-8 hours before procedure; follow specific anesthesiologist instructions
    • Medications: Discontinue anticoagulants (warfarin, apixaban, rivaroxaban) 5-7 days before procedure; continue or hold antiplatelet agents (aspirin, clopidogrel) per clinician instructions; discuss all medications with healthcare provider
    • Pre-Procedure Preparation: Bathe or shower the area with antibacterial soap the night before; do not apply lotions or deodorants to biopsy site; wear comfortable, loose-fitting clothing; arrange transportation if anesthesia will be used
    • Special Instructions: Inform clinician of allergies (especially to lidocaine or other anesthetics), bleeding disorders, immunosuppression, or recent infections; arrive 30 minutes early; have signed informed consent
    • Post-Procedure Care: Can eat and drink immediately after if tolerated; pain management with acetaminophen or ibuprofen typically sufficient; keep biopsy site clean and dry; monitor for excessive bleeding or signs of infection

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