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Intestine biopsy - Large Biopsy 3-6 cm

Biopsy
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Report in 288Hrs

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No Fasting Required

Details

GI mucosal tissue histology.

₹666₹951

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Intestine Biopsy - Large Biopsy 3-6 cm

  • Why is it done?
    • To obtain tissue samples from the large intestine (colon) for histopathological examination and diagnosis of gastrointestinal disorders
    • Diagnose inflammatory bowel disease (IBD) including Crohn's disease and ulcerative colitis
    • Detect colonic malignancies and dysplasia, including colorectal cancer screening in high-risk patients
    • Identify infectious etiologies such as tuberculosis, fungal infections, or parasitic infections
    • Evaluate chronic diarrhea, persistent bleeding, or unexplained abdominal symptoms
    • Assess mucosal changes, polyps, strictures, or suspicious lesions detected during colonoscopy
    • Detect ischemic colitis, microscopic colitis, or other mucosal inflammatory conditions
    • Perform during colonoscopy when visual abnormalities or symptoms warrant tissue examination
  • Normal Range
    • Normal findings: Intact mucosal epithelium with regular crypt architecture, normal goblet cell population, absence of inflammation, and no dysplasia or malignancy
    • Normal mucosa characteristics: Single layer of columnar epithelium with well-organized glands, minimal lymphocytic infiltration (less than 5-7 lymphocytes per high-power field in lamina propria)
    • Negative for dysplasia: No evidence of low-grade dysplasia (LGD) or high-grade dysplasia (HGD)
    • Negative for malignancy: No invasive or metastatic cancer cells present
    • Negative for infection: No evidence of bacteria, fungi, parasites, or viral inclusions
    • Specimen size: Large biopsy typically ranges from 3-6 cm in greatest dimension, providing adequate tissue for comprehensive histopathological evaluation
  • Interpretation
    • Inflammatory Bowel Disease (IBD): Increased inflammation with crypt distortion, increased intraepithelial lymphocytes, crypt abscess formation, or transmural inflammation indicates IBD; specific pattern helps differentiate Crohn's disease from ulcerative colitis
    • Dysplasia (LGD/HGD): Low-grade dysplasia shows increased nuclear-to-cytoplasmic ratio and mild architectural distortion; high-grade dysplasia indicates significant nuclear atypia and increased risk of malignant transformation; requires close follow-up and possible intervention
    • Adenocarcinoma: Invasive malignant cells noted; grading (well, moderately, or poorly differentiated) and staging help determine prognosis and treatment options; mucinous or signet-ring cell types may be identified
    • Infectious Disease: Special stains (acid-fast bacilli for TB, PAS for fungi, silver stains for organisms) may identify specific pathogens; granulomas suggest tuberculosis or fungal infection; viral inclusions may indicate CMV or HSV colitis
    • Ischemic Colitis: Shows mucosal necrosis, preserved submucosa architecture, and absence of transmural involvement; helps distinguish from IBD
    • Microscopic Colitis: Normal or near-normal appearance grossly but shows increased intraepithelial lymphocytes and chronic inflammation on microscopy; includes lymphocytic colitis and collagenous colitis subtypes
    • Factors affecting interpretation: Specimen adequacy, tissue orientation, presence of sufficient mucosal tissue, fixation quality, patient's current medications (NSAIDs, biologics), recent antibiotic use, and clinical correlation essential for accurate diagnosis
  • Associated Organs
    • Primary organ: Large intestine (colon and rectum) - the lower portion of the gastrointestinal tract responsible for water absorption and stool formation
    • Related organ systems: Entire digestive tract, small intestine (can be involved in Crohn's disease), anal canal, mesenteric lymph nodes, and liver (through portal circulation)
    • Diseases commonly diagnosed: Ulcerative colitis, Crohn's disease, colorectal adenocarcinoma, colonic polyps with malignant potential, tuberculosis colitis, fungal infections (histoplasmosis, blastomycosis), parasitic infections (amebiasis, schistosomiasis), ischemic colitis, CMV colitis, and diverticular disease
    • Complications of abnormal results: Severe IBD may lead to toxic megacolon, perforation, or hemorrhage; colorectal cancer can metastasize to liver, lungs, and distant organs; chronic inflammation increases risk of systemic complications
    • Extraintestinal manifestations: IBD may cause joint inflammation (arthritis), skin manifestations (erythema nodosum, pyoderma gangrenosum), eye inflammation (uveitis, episcleritis), liver disease (primary sclerosing cholangitis), and systemic complications
  • Follow-up Tests
    • For inflammatory bowel disease: Repeat colonoscopy with biopsies every 1-2 years for surveillance; laboratory tests including complete blood count, comprehensive metabolic panel, C-reactive protein, and fecal calprotectin; imaging studies (CT enterography or MR enterography); small bowel evaluation if Crohn's disease confirmed
    • For dysplasia/malignancy: Urgent surgical consultation for high-grade dysplasia or cancer; staging studies (CT chest/abdomen/pelvis, MRI, or PET-CT) for carcinoma; colonoscopic surveillance may be discontinued after cancer diagnosis or if extensive disease noted; tumor marker studies (CEA, CA 19-9)
    • For infectious disease: Culture and sensitivity studies, molecular testing (PCR for CMV or other pathogens), blood cultures, serological testing, imaging studies to assess extent of disease, and follow-up biopsies after treatment initiation; chest X-ray if tuberculosis suspected
    • For ischemic changes: Vascular studies (CT angiography or doppler ultrasound) to assess arterial flow; repeat colonoscopy if severe ischemia to assess healing; renal function monitoring; evaluation for hypercoagulable states
    • For microscopic colitis: Symptom monitoring and therapeutic trial of mesalamine or budesonide; follow-up colonoscopy if symptoms persist; stool studies to exclude infection; dietary modifications trial
    • Complementary testing: Immunohistochemistry for specific markers (MSH2, MLH1, MSH6, PMS2 for Lynch syndrome screening if appropriate); flow cytometry if lymphoma suspected; electron microscopy for specific infections; p53 immunostain for dysplasia confirmation
  • Fasting Required?
    • Fasting: Yes, fasting is required because this biopsy is obtained during colonoscopy
    • Fasting duration: NPO (nothing by mouth) for 6-8 hours before the procedure; typically procedure scheduled in morning after overnight fast
    • Bowel preparation: Colonoscopy-specific colon cleansing preparation (polyethylene glycol solution, sodium phosphate, or movicol) required 12-24 hours before procedure to visualize colon mucosa clearly
    • Medications to avoid or adjust: Aspirin and NSAIDs should be discontinued 5-7 days before procedure due to bleeding risk; anticoagulants (warfarin, novel anticoagulants, heparin) managed in consultation with prescribing physician; antiplatelet agents (clopidogrel) may need temporary discontinuation; iron supplements should be stopped several days before
    • Other preparation requirements: Arrange transportation as sedation is typically used; discontinue certain medications per institutional protocol; clear liquids permitted up to 2 hours before procedure; notify endoscopist of bleeding disorders, allergies, or adverse reactions to anesthesia; arrive early for registration and consent; wear comfortable, loose-fitting clothing
    • Post-procedure considerations: Resume normal diet after recovery from anesthesia; results typically available within 5-7 business days; may experience mild abdominal discomfort or bleeding if large biopsy obtained; contact physician if severe pain, fever, or heavy bleeding occurs

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